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Diagnostic criteria for enduring sexual dysfunction after treatment with antidepressants, finasteride and isotretinoin (2021)


Int J Risk Saf Med. 2021 Oct 26. doi: 10.3233/JRS-210023.

Diagnostic criteria for enduring sexual dysfunction after treatment with antidepressants, finasteride and isotretinoin

David Healy 1, Audrey Bahrick 2, Maarten Bak 3 4, Angelo Barbato 5, Rocco Salvatore Calabrò 6, Barbara M Chubak 7, Fiammetta Cosci 3 8 9, Antonei B Csoka 10, Barbara D'Avanzo 5, Silvia Diviccaro 11, Silvia Giatti 11, Irwin Goldstein 12 13, Heiko Graf 14, Wayne J G Hellstrom 15, Michael S Irwig 16 17, Emmanuele A Jannini 18, Paddy K C Janssen 19 20, Mohit Khera 21, Manoj Therayil Kumar 22, Joanna Le Noury 23, Michał Lew-Starowicz 24, David E J Linden 25, Celine Lüning 26, Dee Mangin 1, Roberto Cosimo Melcangi 11, Omar Walid Muquebil Ali Al Shaban Rodríguez 27, Jalesh N Panicker 28 29, Arianna Patacchini 8, Amy M Pearlman 30, Caroline F Pukall 31, Sanjana Raj 32, Yacov Reisman 33, Rachel S Rubin 34, Rudy Schreiber 35, Stuart Shipko 36, Barbora Vašečková 37, Ahad Waraich 13

Affiliations

  • 1Department of Family Medicine, McMaster University, Hamilton, ON, Canada.
  • 2University Counseling Service, University of Iowa, Iowa City, IA, USA.
  • 3Department of Psychiatry and Neuropsychology, Maastricht University, Maastricht, The Netherlands.
  • 4FACT, Mondriaan Mental Health, Maastricht/Heerlen, The Netherlands.
  • 5Unit for Quality of Care and Rights Promotion in Mental Health, IRCCS Istituto di Ricerche Farmacologiche Mario Negri, Milan, Italy.
  • 6IRCCS Centro Neurolesi Bonino-Pulejo, Messina, Italy.
  • 7Department of Urology, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
  • 8Department of Health Sciences, University of Florence, Florence, Italy.
  • 9Clinical Pharmacopsychology Laboratory, University of Florence, Florence, Italy.
  • 10Department of Anatomy, Howard University College of Medicine, Washington, DC, USA.
  • 11Department of Pharmacological and Biomolecular Sciences, University of Milan, Milan, Italy.
  • 12Alvarado Hospital, San Diego, CA, USA.
  • 13San Diego Sexual Medicine, San Diego, CA, USA.
  • 14Department of Psychiatry and Psychotherapy, Ulm University, Ulm, Germany.
  • 15Department of Urology, Tulane University School of Medicine, New Orleans, LA, USA.
  • 16Beth Israel Deaconess Medical Center, Boston, MA, USA.
  • 17Harvard Medical School, Boston, MA, USA.
  • 18Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy.
  • 19Department of Clinical Pharmacy and Toxicology, Maastricht University Medical Centre, Maastricht, The Netherlands.
  • 20Department of Hospital Pharmacy, VieCuri Medical Center, Venlo, The Netherlands.
  • 21Department of Urology, Baylor School of Medicine, Houston, TX, USA.
  • 22Institute for Mind and Brain, Kerala, India.
  • 23North Wales Department of Psychological Medicine, Bangor, Wales, UK.
  • 24Department of Psychiatry, Centre of Postgraduate Medical Education, Warsaw, Poland.
  • 25School for Mental Health and Neuroscience, Department of Psychiatry and Neuropsychology, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands.
  • 26Department of Psychology and Psychotherapy, Witten/Herdecke University, Germany.
  • 27Psychiatry Service, Hospital Universitario San Agustín, Avilés, Asturias, Spain.
  • 28Department of Uro-Neurology, The National Hospital for Neurology and Neurosurgery, Queen Square, London, UK.
  • 29Department of Brain Repair and Rehabilitation, UCL Queen Square Institute of Neurology, Faculty of Brain Sciences, University College London, London, UK.
  • 30Carver College of Medicine, University of Iowa Health Care, Iowa City, IA, USA.
  • 31Department of Psychology, Queen's University, Kingston, ON, Canada.
  • 32Faculty of Social and Behavioural Sciences, Utrecht University, Utrecht, The Netherlands.
  • 33Flare-Health, Amstelveen, The Netherlands.
  • 34Department of Urology, Georgetown University School of Medicine, Washington, DC, USA.
  • 35Department of Neuropsychology and Psychopharmacology, Faculty of Psychology and Neuroscience, Maastricht University, Maastricht, The Netherlands.
  • 36Private Practice, Pasadena, CA, USA.
  • 37Psychiatric Clinic, Slovak Medical University and University Hospital, Bratislava, Slovakia.

Abstract

Background: A set of enduring conditions have been reported in the literature involving persistent sexual dysfunction after discontinuation of serotonin reuptake inhibiting antidepressants, 5 alpha-reductase inhibitors and isotretinoin.

Objective: To develop diagnostic criteria for post-SSRI sexual dysfunction (PSSD), persistent genital arousal disorder (PGAD) following serotonin reuptake inhibitors, post-finasteride syndrome (PFS) and post-retinoid sexual dysfunction (PRSD).

Methods: The original draft was designed using data from two published case series (Hogan et al., 2014 and Healy et al., 2018), which represent the largest public collections of data on these enduring conditions. It was further developed with the involvement of a multidisciplinary panel of experts.

Results: A set of criteria were agreed upon for each of the above conditions. Features of PSSD, PFS and PRSD commonly include decreased genital and orgasmic sensation, decreased sexual desire and erectile dysfunction. Ancillary non-sexual symptoms vary depending on the specific condition but can include emotional blunting and cognitive impairment. PGAD presents with an almost mirror image of unwanted sensations of genital arousal or irritability in the absence of sexual desire. A new term, post-SSRI asexuality, is introduced to describe a dampening of sexual interest and pleasure resulting from a pre-natal or pre-teen exposure to a serotonin reuptake inhibitor.

Conclusions: These criteria will help in both clinical and research settings. As with all criteria, they will likely need modification in the light of developments.

Keywords: Post-SSRI sexual dysfunction; antidepressants; finasteride; isotretinoin; selective serotonin reuptake inhibitors.


Fonte: https://content.iospress.com/articles/international-journal-of-risk-and-safety-in-medicine/jrs210023


Criteri diagnostici per la disfunzione sessuale duratura dopo il trattamento con antidepressivi, finasteride e isotretinoina

BACKGROUND: Una serie di condizioni durature sono state riportate in letteratura che comprendono la disfunzione sessuale persistente dopo la sospensione di antidepressivi inibitori della ricaptazione della serotonina, inibitori della 5 alfa-reduttasi e isotretinoina. 

OBIETTIVO: Sviluppare criteri diagnostici per la disfunzione sessuale post-SSRI (PSSD), il disturbo persistente dell'eccitazione genitale (PGAD) dopo gli inibitori della ricaptazione della serotonina, la sindrome post-finasteride (PFS) e la disfunzione sessuale post-retinoide (PRSD). 

METODI: Il progetto originale è stato progettato utilizzando i dati di due serie di casi pubblicati (Hogan et al., 2014 e Healy et al., 2018), che rappresentano le più grandi raccolte pubbliche di dati su queste condizioni durature. È stato ulteriormente sviluppato con il coinvolgimento di un gruppo multidisciplinare di esperti. 

RISULTATI: Una serie di criteri sono stati concordati per ciascuna delle condizioni di cui sopra. Le caratteristiche di PSSD, PFS e PRSD includono comunemente la diminuzione della sensazione genitale e orgasmica, la diminuzione del desiderio sessuale e la disfunzione erettile. I sintomi non sessuali accessori variano a seconda della condizione specifica, ma possono includere l'attenuazione emotiva e il deterioramento cognitivo. Il PGAD si presenta con un'immagine quasi speculare di sensazioni indesiderate di eccitazione genitale o irritabilità in assenza di desiderio sessuale. Un nuovo termine, l'asessualità post-SSRI, viene introdotto per descrivere un'attenuazione dell'interesse e del piacere sessuale risultante da un'esposizione pre-natale o pre-adolescenziale a un inibitore della ricaptazione della serotonina. 

CONCLUSIONI: Questi criteri saranno utili sia in ambito clinico che di ricerca. Come tutti i criteri, avranno probabilmente bisogno di modifiche alla luce degli sviluppi.


Testo completo in Italiano