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

David Healy; Audrey Bahrick; Maarten Bak; Angelo Barbato; Rocco Salvatore Calabrò; Barbara M Chubak; Fiammetta Cosci; Antonei B Csoka; Barbara D'Avanzo; Silvia Diviccaro; Silvia Giatti; Irwin Goldstein; Heiko Graf; Wayne J G Hellstrom; Michael S Irwig; Emmanuele A Jannini; Paddy K C Janssen; Mohit Khera; Manoj Therayil Kumar; Joanna Le Noury; Michał Lew-Starowicz; David E J Linden; Celine Lüning; Dee Mangin; Roberto Cosimo Melcangi; Omar Walid Muquebil Ali Al Shaban Rodríguez; Jalesh N Panicker; Arianna Patacchini; Amy M Pearlman; Caroline F Pukall; Sanjana Raj; Yacov Reisman; Rachel S Rubin; Rudy Schreiber; Stuart Shipko; Barbora Vašečková; Ahad Waraich

doi:10.3233/JRS-210023

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

David Healy^*, Audrey Bahrick, Maarten Bak, Angelo Barbato, Rocco Salvatore Calabrò, Barbara M Chubak, Fiammetta Cosci, Antonei B Csoka, Barbara D'Avanzo, Silvia Diviccaro, Silvia Giatti, Irwin Goldstein, Heiko Graf, Wayne J G Hellstrom, Michael S Irwig, Emmanuele A Jannini, Paddy K C Janssen, Mohit Khera, Manoj Therayil Kumar, Joanna Le NouryMichał Lew-Starowicz, David E J Linden, Celine Lüning, Dee Mangin, Roberto Cosimo Melcangi, Omar Walid Muquebil Ali Al Shaban Rodríguez, Jalesh N Panicker, Arianna Patacchini, Amy M Pearlman, Caroline F Pukall, Sanjana Raj, Yacov Reisman, Rachel S Rubin, Rudy Schreiber, Stuart Shipko, Barbora Vašečková, Ahad Waraich

^*Corresponding author for this work

Research output: Contribution to journal › Article › Academic › peer-review

8 Citations (Web of Science)

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.

Original language	English
Pages (from-to)	65-76
Number of pages	12
Journal	International Journal of Risk and Safety in Medicine
Volume	33
Issue number	1
Early online date	26 Oct 2021
DOIs	https://doi.org/10.3233/JRS-210023
Publication status	Published - 22 Feb 2022

Keywords

Post-SSRI sexual dysfunction
antidepressants
selective serotonin reuptake inhibitors
finasteride
isotretinoin
GENITAL AROUSAL DISORDER
PREMATURE EJACULATION
DOUBLE-BLIND
PERSISTENT
CITALOPRAM
EFFICACY
SAFETY

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10.3233/JRS-210023Licence: CC BY-NC

Cite this

Healy, D., Bahrick, A., Bak, M., Barbato, A., Calabrò, R. S., Chubak, B. M., Cosci, F., Csoka, A. B., D'Avanzo, B., Diviccaro, S., Giatti, S., Goldstein, I., Graf, H., Hellstrom, W. J. G., Irwig, M. S., Jannini, E. A., Janssen, P. K. C., Khera, M., Kumar, M. T., ... Waraich, A. (2022). Diagnostic criteria for enduring sexual dysfunction after treatment with antidepressants, finasteride and isotretinoin. International Journal of Risk and Safety in Medicine, 33(1), 65-76. https://doi.org/10.3233/JRS-210023

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

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, selective serotonin reuptake inhibitors, finasteride, isotretinoin, GENITAL AROUSAL DISORDER, PREMATURE EJACULATION, DOUBLE-BLIND, PERSISTENT, CITALOPRAM, EFFICACY, SAFETY",

author = "David Healy and Audrey Bahrick and Maarten Bak and Angelo Barbato and Calabr{\`o}, {Rocco Salvatore} and Chubak, {Barbara M} and Fiammetta Cosci and Csoka, {Antonei B} and Barbara D'Avanzo and Silvia Diviccaro and Silvia Giatti and Irwin Goldstein and Heiko Graf and Hellstrom, {Wayne J G} and Irwig, {Michael S} and Jannini, {Emmanuele A} and Janssen, {Paddy K C} and Mohit Khera and Kumar, {Manoj Therayil} and {Le Noury}, Joanna and Micha{\l} Lew-Starowicz and Linden, {David E J} and Celine L{\"u}ning and Dee Mangin and Melcangi, {Roberto Cosimo} and Rodr{\'i}guez, {Omar Walid Muquebil Ali Al Shaban} and Panicker, {Jalesh N} and Arianna Patacchini and Pearlman, {Amy M} and Pukall, {Caroline F} and Sanjana Raj and Yacov Reisman and Rubin, {Rachel S} and Rudy Schreiber and Stuart Shipko and Barbora Va{\v s}e{\v c}kov{\'a} and Ahad Waraich",

year = "2022",

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doi = "10.3233/JRS-210023",

language = "English",

volume = "33",

pages = "65--76",

journal = "International Journal of Risk and Safety in Medicine",

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Healy, D, Bahrick, A, Bak, M, Barbato, A, Calabrò, RS, Chubak, BM, Cosci, F, Csoka, AB, D'Avanzo, B, Diviccaro, S, Giatti, S, Goldstein, I, Graf, H, Hellstrom, WJG, Irwig, MS, Jannini, EA, Janssen, PKC, Khera, M, Kumar, MT, Le Noury, J, Lew-Starowicz, M, Linden, DEJ, Lüning, C, Mangin, D, Melcangi, RC, Rodríguez, OWMAAS, Panicker, JN, Patacchini, A, Pearlman, AM, Pukall, CF, Raj, S, Reisman, Y, Rubin, RS, Schreiber, R, Shipko, S, Vašečková, B & Waraich, A 2022, 'Diagnostic criteria for enduring sexual dysfunction after treatment with antidepressants, finasteride and isotretinoin', International Journal of Risk and Safety in Medicine, vol. 33, no. 1, pp. 65-76. https://doi.org/10.3233/JRS-210023

TY - JOUR

T1 - Diagnostic criteria for enduring sexual dysfunction after treatment with antidepressants, finasteride and isotretinoin

AU - Healy, David

AU - Bahrick, Audrey

AU - Bak, Maarten

AU - Barbato, Angelo

AU - Calabrò, Rocco Salvatore

AU - Chubak, Barbara M

AU - Cosci, Fiammetta

AU - Csoka, Antonei B

AU - D'Avanzo, Barbara

AU - Diviccaro, Silvia

AU - Giatti, Silvia

AU - Goldstein, Irwin

AU - Graf, Heiko

AU - Hellstrom, Wayne J G

AU - Irwig, Michael S

AU - Jannini, Emmanuele A

AU - Janssen, Paddy K C

AU - Khera, Mohit

AU - Kumar, Manoj Therayil

AU - Le Noury, Joanna

AU - Lew-Starowicz, Michał

AU - Linden, David E J

AU - Lüning, Celine

AU - Mangin, Dee

AU - Melcangi, Roberto Cosimo

AU - Rodríguez, Omar Walid Muquebil Ali Al Shaban

AU - Panicker, Jalesh N

AU - Patacchini, Arianna

AU - Pearlman, Amy M

AU - Pukall, Caroline F

AU - Raj, Sanjana

AU - Reisman, Yacov

AU - Rubin, Rachel S

AU - Schreiber, Rudy

AU - Shipko, Stuart

AU - Vašečková, Barbora

AU - Waraich, Ahad

PY - 2022/2/22

Y1 - 2022/2/22

N2 - 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.

AB - 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.

KW - Post-SSRI sexual dysfunction

KW - antidepressants

KW - selective serotonin reuptake inhibitors

KW - finasteride

KW - isotretinoin

KW - GENITAL AROUSAL DISORDER

KW - PREMATURE EJACULATION

KW - DOUBLE-BLIND

KW - PERSISTENT

KW - CITALOPRAM

KW - EFFICACY

KW - SAFETY

U2 - 10.3233/JRS-210023

DO - 10.3233/JRS-210023

M3 - Article

C2 - 34719438

SN - 0924-6479

VL - 33

SP - 65

EP - 76

JO - International Journal of Risk and Safety in Medicine

JF - International Journal of Risk and Safety in Medicine

IS - 1

ER -