October 21, 2018

The Effect of Citalopram on Genome-Wide DNA Methylation of Human Cells (2018)



. 2018; 2018: 8929057.
Published online 2018 Jul 25. doi:  10.1155/2018/8929057

The Effect of Citalopram on Genome-Wide DNA Methylation of Human Cells

Antonei B. Csoka: ude.drawoh@akosc.ienotna
Academic Editor: Igor Koturbash

Abstract


Commonly used pharmaceutical drugs might alter the epigenetic state of cells, leading to varying degrees of long-term repercussions to human health. To test this hypothesis, we cultured HEK-293 cells in the presence of 50 μM citalopram, a common antidepressant, for 30 days and performed whole-genome DNA methylation analysis using the NimbleGen Human DNA Methylation 3x720K Promoter Plus CpG Island Array. A total of 626 gene promoters, out of a total of 25,437 queried genes on the array (2.46%), showed significant differential methylation (p < 0.01); among these, 272 were hypomethylated and 354 were hypermethylated in treated versus control. Using Ingenuity Pathway Analysis, we found that the chief gene networks and signaling pathways that are differentially regulated include those involved in nervous system development and function and cellular growth and proliferation. Genes implicated in depression, as well as genetic networks involving nucleic acid metabolism, small molecule biochemistry, and cell cycle regulation were significantly modified. Involvement of upstream regulators such as BDNF, FSH, and NFκB was predicted based on differential methylation of their downstream targets. The study validates our hypothesis that pharmaceutical drugs can have off-target epigenetic effects and reveals affected networks and pathways. We view this study as a first step towards understanding the long-term epigenetic consequences of prescription drugs on human health.
PMID:
 
30148158
 
PMCID:
 
PMC6083487
 
DOI:
 
10.1155/2018/8929057

June 13, 2018

Citizen petition: Sexual side effects of SSRIs and SNRIs (2018)



 2018;29(3-4):135-147. doi: 10.3233/JRS-180745.

Citizen petition: Sexual side effects of SSRIs and SNRIs.

1
Data Based Medicine Americas Ltd., 95 Sandringham Drive, Toronto, Ontario, Canada, M3H 1E1. Email: david.healy@rxisk.org.
PMID:
 
29733031
 
DOI:
 
10.3233/JRS-180745

LINK: https://www.ncbi.nlm.nih.gov/pubmed/29733031

FULL TEXT: https://rxisk.org/wp-content/uploads/2018/06/JRS745-1.pdf

June 12, 2018

Enduring sexual dysfunction after treatment with antidepressants, 5α-reductase inhibitors and isotretinoin: 300 cases (2018)



 2018;29(3-4):125-134. doi: 10.3233/JRS-180744.

Enduring sexual dysfunction after treatment with antidepressants, 5α-reductase inhibitors and isotretinoin: 300 cases.

Healy D1Le Noury J1Mangin D2.


1
North Wales Department of Psychological Medicine, Bangor, Wales, UK.
2
David Braley and Nancy Gordon Chair of Family Medicine, Department of Family Medicine, McMaster University, ON, Canada.

Abstract

OBJECTIVE:

To investigate clinical reports of post-SSRI sexual dysfunction (PSSD), post-finasteride syndrome (PFS) and enduring sexual dysfunction following isotretinoin.

METHODS:

Data from RxISK.org, a global adverse event reporting website, have been used to establish the clinical features, demographic details and clinical trajectories of syndromes of persistent sexual difficulties following three superficially different treatment modalities.

RESULTS: We report on 300 cases of enduring sexual dysfunction from 37 countries following 14 different drugs comprised of serotonin reuptake inhibiting antidepressants, 5α-reductase inhibitors and isotretinoin. While reports of certain issues were unique to the antidepressants, such as the onset of premature ejaculation and persistent genital arousal disorder (PGAD), there was also a significant overlap in symptom profile between the drug groups, with common features including genital anaesthesia, pleasureless or weak orgasm, loss of libido and impotence. Secondary consequences included relationship breakdown and impaired quality of life.

CONCLUSIONS: These data point to a legacy syndrome or syndromes comprising a range of disturbances to sexual function. More detailed studies will require developments in coding systems that recognise the condition(s). Further exploration of these tardive sexual syndromes may yield greater understanding of tardive syndromes in general.

KEYWORDS:

Post-SSRI sexual dysfunction (PSSD); antidepressants; erectile dysfunction; finasteride; isotretinoin; selective serotonin reuptake inhibitors (SSRIs)
PMID:
 
29733030
 
DOI:
 
10.3233/JRS-180744


LINK: https://www.ncbi.nlm.nih.gov/pubmed/29733030
FULL TEXThttps://rxisk.org/wp-content/uploads/2018/06/JRS744-2.pdf

Post-finasteride syndrome and post-SSRI sexual dysfunction: two sides of the same coin? (2018)



 2018 Apr 19. doi: 10.1007/s12020-018-1593-5. [Epub ahead of print]

Post-finasteride syndrome and post-SSRI sexual dysfunction: two sides of the same coin?

1
Dipartimento di Scienze Farmacologiche e Biomolecolari, Università degli Studi di Milano, Milan, Italy.
2
Dipartimento di Neuroscienze "Rita Levi Montalcini", Università degli studi di Torino, Neuroscience Institute Cavallieri Ottolenghi (NICO), Orbassano, Italy.
3
Dipartimento di Scienze Farmacologiche e Biomolecolari, Università degli Studi di Milano, Milan, Italy. roberto.melcangi@unimi.it.

Abstract

Sexual dysfunction is a clinical condition due to different causes including the iatrogenic origin. For instance, it is well known that sexual dysfunction may occur in patients treated with antidepressants like selective serotonin reuptake inhibitors (SSRI). A similar side effect has been also reported during treatment with finasteride, an inhibitor of the enzyme 5alpha-reductase, for androgenetic alopecia. Interestingly, sexual dysfunction persists in both cases after drug discontinuation. These conditions have been named post-SSRI sexual dysfunction (PSSD) and post-finasteride syndrome (PFS). In particular, feeling of a lack of connection between the brain and penis, loss of libido and sex drive, difficulty in achieving an erection and genital paresthesia have been reported by patients of both conditions. It is interesting to note that the incidence of these diseases is probably so far underestimated and their etiopathogenesis is not sufficiently explored. To this aim, the present review will report the state of art of these two different pathologies and discuss, on the basis of the role exerted by three different neuromodulators such as dopamine, serotonin and neuroactive steroids, whether the persistent sexual dysfunction observed could be determined by common mechanisms.

KEYWORDS:

Dopamine; Neuroactive steroids; Serotonin; Sexual behavior

Post-SSRI Sexual Dysfunction: Preclinical to Clinical. Is It Fact or Fiction? (2018)



 2018 Apr;6(2):217-223. doi: 10.1016/j.sxmr.2017.11.004. Epub 2018 Feb 17.

Post-SSRI Sexual Dysfunction: Preclinical to Clinical. Is It Fact or Fiction?

1
Department of Urology, Acibadem Mehmet Ali Aydinlar University School of Medicine, Istanbul, Turkey. Electronic address: enisraufcoskuner@hotmail.com.
2
Department of Urology, Health Sciences University, Okmeydani Training and Research Hospital, Istanbul, Turkey.
3
Department of Urology, Acibadem Mehmet Ali Aydinlar University School of Medicine, Istanbul, Turkey.
4
Department of Psychology, Acibadem Bakirkoy Hospital, Istanbul, Turkey.

Abstract

INTRODUCTION:

Selective serotonin reuptake inhibitors (SSRIs) are a widely used class of drug for various psychiatric disorders during the lifespan, including pregnancy, lactation, childhood, and adolescence. Deterioration in sexual functioning is a major and serious adverse effect of SSRIs. There is emerging evidence that SSRIs can have long-lasting effects on sexuality.

AIM:

To summarize the long-lasting effects of SSRIs on sexuality, starting with animal models and continuing with the clinical experience of different investigators.

METHOD:

A literature review of relevant publications in PubMed.

MAIN OUTCOME MEASURES:

To assess the long-lasting effects of SSRIs on sexuality.

RESULTS:

Although the persistent effects of SSRIs on sexuality have been little studied in humans, animal studies suggest that SSRIs might cause permanent sexual dysfunction after ending SSRI exposure at a young age but not in adulthood in rats. There are no prospective randomized controlled trials in humans and the present evidence is derived from case reports, incidental research findings, and experiences of some internet communities.

CONCLUSION:

There is some preclinical evidence from animal studies for enduring SSRI-induced sexual dysfunction, but the available clinical information could prevent a clear decision about the existence of post-SSRI sexual dysfunction, its pathophysiology, and its management. We need more research to fill in the gaps in our knowledge. Coskuner ER, Culha MG, Ozkan B, Kaleagasi EO. Post-SSRI Sexual Dysfunction: Preclinical to Clinical. Is It Fact or Fiction? Sex Med Rev 2018;6:217-223.

KEYWORDS:

Post-SSRI Syndrome; Selective Serotonin Reuptake Inhibitors; Serotonin; Sexual Dysfunction

Post-SSRI Sexual Dysfunction: A Literature Review (2017)



 2018 Jan;6(1):29-34. doi: 10.1016/j.sxmr.2017.07.002. Epub 2017 Aug 1.

Post-SSRI Sexual Dysfunction: A Literature Review.

1
Department of Urology, Tulane University School of Medicine, New Orleans, LA, USA.
2
Department of Urology, Tulane University School of Medicine, New Orleans, LA, USA. Electronic address: whellst@tulane.edu.

Abstract

INTRODUCTION:

Selective serotonin reuptake inhibitors (SSRIs) are a widely used class of drug. Post-SSRI sexual dysfunction (PSSD) is a condition in which patients continue to have sexual side effects after discontinuation of SSRI use. The prevalence of persistent sexual side effects after discontinuing SSRIs is unknown. The recognition and study of PSSD will increase our knowledge base of this underreported and distressing condition.

AIM:

To provide coverage of the current literature on PSSD, update information on the pathophysiology of PSSD, and discuss potential management options.

METHODS:

Comprehensive review of literature pertaining to PSSD.

MAIN OUTCOME MEASURES:

The symptoms, classification, pathophysiology, diagnostic considerations, and management of PSSD were reviewed.

RESULTS:

Common PSSD symptoms include genital anesthesia, pleasure-less or weak orgasm, decreased sex drive, erectile dysfunction, and premature ejaculation. Different theories have been proposed to explain the pathophysiology of PSSD: epigenetic gene expression theory, cytochrome actions, dopamine-serotonin interactions, proopiomelanocortin and melanocortin effects, serotonin neurotoxicity, downregulation of 5-hydroxytryptamine receptor 1A, and hormonal changes in the central and peripheral nervous systems. The diagnosis of PSSD is achieved by excluding all other etiologies of sexual dysfunction. Treating PSSD is challenging, and many strategies have been suggested and tried, including serotonergic antagonists and dopaminergic agonists. There is still no definitive treatment for PSSD. Low-power laser irradiation and phototherapy have shown some promising results.

CONCLUSION:

PSSD is a debilitating condition that adversely affects quality of life. Further studies are warranted to investigate the prevalence, pathophysiology, and treatment of PSSD. Bala A, Nguyen HMT, Hellstrom WJG. Post-SSRI Sexual Dysfunction: A Literature Review. Sex Med Rev 2018;6:29-34.

KEYWORDS:

Post-SSRI Sexual Dysfunction; Selective Serotonin Reuptake Inhibitors
PMID:
 
28778697
 
DOI:
 
10.1016/j.sxmr.2017.07.002

LINK: https://www.ncbi.nlm.nih.gov/pubmed/28778697

July 06, 2017

Post-serotonine selective reuptake inhibitors persistent sexual dysfunction after serotonine selective reuptake inhibitors treatment: A case report after stopping paroxetine (2017)

Disfunción sexual persistente tras el tratamiento con inhibidores selectivos de la recaptación de serotonina: a propósito de un caso tras la retirada de paroxetina 

 


Post-serotonine selective reuptake inhibitors persistent sexual dysfunction after serotonine selective reuptake inhibitors treatment: A case report after stopping paroxetine


Omar Walid Muquebil Ali Al Shaban Rodríguez a,
Enrique Álvarez de Morales Gómez-Moreno b
Jennifer Fernández Fernández a
Carmen Fresno García c
María del Mar Fernández Fernández a

a Centro de Salud Mental de Luarca, Luarca, Asturias, España
b Centro de Salud Mental IV, Gijón, Asturias, España
c Unidad Docente Multiprofesional de Salud Mental de Asturias, Oviedo, Asturias, España
Recibido 09 mayo 2017, Aceptado 17 mayo 2017


Abstract

Recent evidence suggests that the sexual dysfunction that often appears during treatment with selective serotonin reuptake inhibitors (SSRIs) or selective serotonin and noradrenaline reuptake inhibitors (SNRIs) persists in some patients after stopping the treatment. A clinical case is presented that suggests a high probability having a causal relationship to the withdrawal of paroxetine according to the criteria suggested by Ben-Sheetrit et al. In the article ‘Post-SSRI sexual dysfunction’: a young male with no concurrent physical illness, with no drug treatments or use of toxic substances (except for very moderate and occasional consumption of alcohol), and free of affective symptoms at the present moment that could better explain the presence of sexual dysfunction. Twelve weeks after withdrawal of paroxetine, there was a persistent decrease in libido and moderate difficulties in maintaining erection. The increasing interest in the evaluation of sexual dysfunction secondary to antidepressants, and the commitment on the sexual sphere of our patients, facilitates the identification of cases.


LINK:  https://www.researchgate.net/publication/317963753_Disfuncion_sexual_persistente_tras_el_tratamiento_con_inhibidores_selectivos_de_la_recaptacion_de_serotonina_a_proposito_de_un_caso_tras_la_retirada_de_paroxetina

http://www.elsevier.es/es-revista-psiquiatria-biologica-46-pdf-S1134593417300258-S200

Sexual Consequences of Post-SSRI Syndrome. (2017)



Sex Med Rev. 2017 Jun 19. pii: S2050-0521(17)30046-X. doi: 10.1016/j.sxmr.2017.05.002. [Epub ahead of print]

Sexual Consequences of Post-SSRI Syndrome.

1  Amstelland Hospital, Amstelveen, The Netherlands. Electronic address: uro.amsterdam@gmail.com.

Abstract

 

INTRODUCTION:

Sexual dysfunctions are well-known side effects of selective serotonin reuptake inhibitor (SSRI) use. Altered libido, erectile dysfunction, vaginal dryness, ejaculatory disorders, and orgasmic problems are frequently reported by patients treated with SSRIs. Moreover, these antidepressant-emergent sexual dysfunctions do not always resolve after discontinuation of the medication and can persist indefinitely. These complaints are termed post-SSRI sexual dysfunctions (PSSD).

AIM:

To examine the existence of this clinical entity, possible theoretical mechanisms, possible risk factors, and possible treatment modalities.

METHODS:

Through literature research and clinical experience, the available information about PSSD is reviewed.

MAIN OUTCOME MEASURES:

Summary of the current literature with insights into possible causes and management options.

RESULTS:

There are some indications that antidepressant-emergent sexual dysfunctions do not always resolve after discontinuation of the medication and can persist indefinitely in some individuals. Although some or all sexual side effects that start with the use of SSRIs might continue after stopping the medication, other sexual complaints can develop. Decreased capacity to experience sexual pleasure is the most frequent characteristic of this syndrome.

CONCLUSION:

The research and understanding of PSSD remain limited and not well understood; however, the data support the existence of PSSD, which can have a substantial effect on the quality of life of these patients. More research is warranted to show the cause and possible mechanisms of PSSD that could lead to the correct diagnosis and treatment.

Reisman Y. Sexual Consequences of Post-SSRI Syndrome. Sex Med Rev 2017;X:XXX-XXX.

KEYWORDS:

Depression; Post-SSRI Sexual Dysfunction; Selective Serotonin Reuptake Inhibitors; Sexual Dysfunctions

Persistent sexual dysfunction after early exposure to SSRIs: Systematic review of animal studies. (2016)


 2016 Mar 16;28(1):1-12. doi: 10.3233/JRS-160668.

Persistent sexual dysfunction after early exposure to SSRIs: Systematic review of animal studies.

Abstract

BACKGROUND:

Sexual dysfunction is a common adverse effect of selective serotonin reuptake inhibitors (SSRIs) and there is a concern that the sexual harms might persist after discontinuation of therapy.

OBJECTIVE:

To assess whether the use of SSRIs in animals can lead to persistent sexual dysfunction.

METHODS:

Systematic review of animal studies measuring sexual behaviour after end of treatment with SSRIs or serotonin norepinephrine reuptake inhibitors.

DATA SOURCES:

We searched PubMed and EMBASE.

RESULTS:

We included 14 studies. The general quality of the studies was poor. Only four studies reported use of randomisation and none mentioned allocation concealment. All studies used placebo and were therefore blinded. For rats exposed to SSRIs compared with those exposed to placebo, we found a higher risk of no mounting behaviour (RR = 0.73; 95% CI = 0.62-0.86), no intromission behaviour (RR = 0.74; 95% CI = 0.60-0.92) and no ejaculation behaviour (RR = 0.49, 95% CI = 0.24-1.00).

CONCLUSION:

Our results showed substantial and lasting effects on sexual behaviour in rats after exposure to an SSRI early in life on important sexual outcomes.

KEYWORDS:

Selective serotonin reuptake inhibitors (SSRIs); animal studies; long lasting harm; permanent sexual dysfunction; systematic review
PMID:
 
27176752
 
DOI:
 
10.3233/JRS-160668
[Indexed for MEDLINE]


LINK: https://www.ncbi.nlm.nih.gov/pubmed/27176752

Post-SSRI Sexual Dysfunction: Clinical Characterization and Preliminary Assessment of Contributory Factors and Dose-Response Relationship. (2015)



J Clin Psychopharmacol. 2015 Jun;35(3):273-8. doi: 10.1097/JCP.0000000000000300.

Post-SSRI Sexual Dysfunction: Clinical Characterization and Preliminary Assessment of Contributory Factors and Dose-Response Relationship.

1
From the *Geha Mental Health Center, Petah Tikva; †Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel; and ‡Department of Anatomy, School of Medicine, Howard University, Washington D.C.

Abstract

 

Emerging evidence suggests that sexual dysfunction emerging during treatment with selective serotonin reuptake inhibitors (SSRIs) and/or serotonin-norepinephrine reuptake inhibitors (SNRIs) persists in some patients beyond drug discontinuation (post-SSRI sexual dysfunction [PSSD]). We sought to identify and characterize a series of such cases and explore possible explanatory factors and exposure-response relationship. Subjects who responded to an invitation in a forum dedicated to PSSD filled out a survey via online software. Case probability was defined according to the following 3 categories of increasing presumed likelihood of PSSD. Noncases did not meet the criteria for possible cases. Possible cases were subjects with normal pretreatment sexual function who first experienced sexual disturbances while using a single SSRI/SNRI, which did not resolve upon drug discontinuation for 1 month or longer as indicated by Arizona Sexual Experience Scale scores. High-probability cases were also younger than 50-year-olds; did not have confounding medical conditions, medications, or drug use; and had normal scores on the Hospital Anxiety and Depression Scale. Five hundred thirty-two (532) subjects completed the survey, among which 183 possible cases were identified, including 23 high-probability cases. Female sex, genital anesthesia, and depression predicted current sexual dysfunction severity, but dose/defined daily dose ratio and anxiety did not. Genital anesthesia did not correlate with depression or anxiety, but pleasureless orgasm was an independent predictor of both depression and case probability. Limitations of the study include retrospective design and selection and report biases that do not allow generalization or estimation of incidence. However, our findings add to previous reports and support the existence of PSSD, which may not be fully explained by alternative nonpharmacological factors related to sexual dysfunction, including depression and anxiety.
PMID:
25815755
DOI:
10.1097/JCP.0000000000000300
[Indexed for MEDLINE]


LINK: http://www.ncbi.nlm.nih.gov/pubmed/25815755 

http://www.researchgate.net/publication/272943368_Post-SSRI_Sexual_Dysfunction_%28PSSD%29_Clinical_Characterization_and_Preliminary_Assessment_of_Contributory_Factors_and_Dose-Response_Relationship

Penile anesthesia in post SSRI sexual dysfunction (PSSD) responds to low-power laser irradiation: A case study and hypothesis about the role of transient receptor potential (TRP) ion channels. (2014)



Eur J Pharmacol. 2015 Apr 15;753:263-8. doi: 10.1016/j.ejphar.2014.11.031. Epub 2014 Dec 4.

Penile anesthesia in Post SSRI Sexual Dysfunction (PSSD) responds to low-power laser irradiation: a case study and hypothesis about the role of transient receptor potential (TRP) ion channels.


1  Division of Pharmacology, Utrecht Institute for Pharmaceutical Sciences, Faculty of BetaSciences, Utrecht University, Universiteitslaan 99, 3584 CG Utrecht, The Netherlands; Private Practice Psychiatry and Neurosexology, Amstelveen, The Netherlands. Electronic address: md@waldinger.demon.nl.
2  Medisch Centrum Buitenveldert, Amsterdam, The Netherlands.
3  Department of Internal Medicine and Endocrinology, Reinier de Graaf Groep of Hospitals, Delft-Voorburg, The Netherlands.
4  Department of Neuroscience, Section Anatomy, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.

Abstract

 

Treatment of paroxetine-induced penile anesthesia in Post SSRI Sexual Dysfunction (PSSD) by Low-power Laser Irradiation (LPLI) is unknown in medical literature. The aim of the current article is to report partial efficacy of LPLI for paroxetine-induced persistent penile anesthesia. We report on a male patient who presented with a history of reversible loss of smell, taste and skin sensitivity occurring within a week after start of 20mg/day paroxetine-hemihydrate for a depressive period. Concurrently, patient suffered from penile anesthesia, scrotum hypesthesia, anejaculation and erectile difficulties with normal sexual desire. During 2.5 years of paroxetine treatment and throughout 2 years after paroxetine discontinuation, genital and sexual complaints persisted. Penile anesthesia was treated by LPLI with single and multi diode pulsed laser probes. After 20 LPLI-treatment sessions of 15min each, patient reported partial return of penile touch and temperature sensation. Clinical improvement of glans penis sensitivity was reported to 20% and 40%, compared to pre-paroxetine treatment penile sensitivity during erect and flaccid states, respectively. However, anejaculation and erectile difficulties remained unchanged. Briefly, in the current patient with early onset of PSSD, LPLI treatment reduced paroxetine-induced penile anesthesia. It is hypothesized that SSRI treatment induces disturbances of transient receptor potential (TRP) ion channels of mechano-, thermo- and chemosensitive nerve endings and receptors resulting in the penile anesthesia in PSSD. It is further hypothesized that there are two types of PSSD, one of which occurs soon after the start of SSRI treatment.

Low-power laser irradiation; Paroxetine; Penile anesthesia; Post SSRI sexual dysfunction; TRPV1; Transient receptor potential
PMID:
25483212
DOI:
10.1016/j.ejphar.2014.11.031

One hundred and twenty cases of enduring sexual dysfunction following treatment. (2014)


Int J Risk Saf Med. 2014;26(2):109-16. doi: 10.3233/JRS-140617.

One hundred and twenty cases of enduring sexual dysfunction following treatment.

1  North Wales Department of Psychological Medicine, Bangor, Wales, UK.
2  David Braley & Nancy Gordon Chair of Family Medicine, Department of Famil

 

Abstract

 

BACKGROUND:

There have been reports for over a decade linking serotonin reuptake inhibitors, finasteride and isotretinoin with enduring sexual dysfunction after treatment stops.

OBJECTIVE:

To explore the clinical pictures linked to all 3 drugs.

METHODS:

We have selected 120 reports to RxISK.org reporting the problem and mined these for data on age, gender, drug of use, and impact of the problem.

RESULTS:

The data make it clear that the three drugs show extensive overlap in symptom profile, regardless of sex or country of origin.

CONCLUSIONS:

The availability of 120 reports from over 20 countries add to the case for the validity of the syndrome. This is severe and enduring condition can result in death. An understanding of its physiology and an approach to treatment are needed.

KEYWORDS:

SSRIs; erectile dysfunction; finasteride; genital anesthesia; isotretinoin; loss of libido
PMID:
24902508
DOI:
10.3233/JRS-140617

Does sexual dysfunction persist upon discontinuation of selective serotonin reuptake inhibitors? (2014)



Tijdschr Psychiatr. 2014;56(5):336-40.

[Does sexual dysfunction persist upon discontinuation of selective serotonin reuptake inhibitors?]

[Article in Dutch]

Abstract

 

BACKGROUND:

Cases reported in the literature suggest that in some individuals sexual dysfunction associated with selective serotonin reuptake inhibitors (SSRIS) may persist following the discontinuation of ssris.

AIM:

To find out how many reports of persistent sexual dysfunction associated with the use of ssris were received by the Netherlands Pharmacovigilance Centre, Lareb.

METHOD:

The database of the Netherlands Pharmacovigilance Centre Lareb was searched for reports of sexual dysfunction in patients who had been using SSRIS and whose sexual functioning had not returned to normal at the time of notification.

RESULTS:

The database of the Netherlands Pharmacovigilance Centre Lareb contained 19 reports of persistent sexual dysfunction in patients who had stopped using ssris for two months up to three years and who had not regained normal sexual functioning. The sexual disorders that were reported most frequently were reduced libido, erectile dysfunction and delayed orgasm. It seems likely that these disorders were caused not only by pharmacological effects of ssris but also by psychological factors.

CONCLUSION:

Although it has previously been assumed that patients always regain normal sexual functioning shortly after discontinuation of ssris, emerging evidence suggests that this may not be the case.
PMID:
24838589
[Indexed for MEDLINE]


LINK: http://www.ncbi.nlm.nih.gov/pubmed/24838589
FULL TEXT (Dutch): http://www.tijdschriftvoorpsychiatrie.nl/assets/articles/56-2014-5-artikel-Ekhart.pdf

Persistent sexual dysfunction in genitourinary medicine clinic attendees induced by selective serotonin reuptake inhibitors. (2009)



Int J STD AIDS. 2009 Jan;20(1):68-9. doi: 10.1258/ijsa.2008.008402.

Persistent sexual dysfunction in genitourinary medicine clinic attendees induced by selective serotonin reuptake inhibitors.

PMID:
19103903
DOI:
10.1258/ijsa.2008.008402


[Indexed for MEDLINE] 


LINK: http://www.ncbi.nlm.nih.gov/pubmed/19103903
FULL TEXT:
http://www.mediafire.com/view/2ing236fwwzkx36/09_01_persistent+sexual+dysfunction_farnsworth.pdf

Persistent genital arousal disorder in women: case reports of association with anti-depressant usage and withdrawal (2008)


J Sex Marital Ther. 2008;34(2):150-9. doi: 10.1080/00926230701636205.

Persistent genital arousal disorder in women: case reports of association with anti-depressant usage and withdrawal.

1
Robert Wood Johnson Medical School, Department of Psychiatry, University of Medicine and Dentistry of New Jersey, Piscataway, New Jersey 08854, USA. leiblum@umdnj.edu

 

Abstract


Little is known with certitude about the triggers of persistent genital arousal disorder (PGAD) in women, although there appears to be certain common features of the disorder. Women complain of unbidden feelings of genital arousal that are qualitatively different from sexual arousal that is preceded by sexual desire/and or subjective arousal. The majority of women find PGAD distressing and report only brief relief with orgasm. In this article, we describe five women who believe they developed PGAD either after withdrawing from selective serotonin reuptake inhibitor (SSRI) anti-depressants or while using them. We discuss these sexual symptoms in relation to what is already known about prolonged SSRI withdrawal syndromes and the possible etiologies of these conditions. While not a common cause of PGAD, it is possible that use of, and withdrawal from, pharmacological agents contributes to the development of PGAD.

PMID:
18224549
DOI:
10.1080/00926230701636205
[Indexed for MEDLINE] 


LINK:

Persistence of Sexual Dysfunction Side Effects after Discontinuation of Antidepressant Medications: Emerging Evidence (2008)


Persistence of Sexual Dysfunction Side Effects after Discontinuation of Antidepressant Medications: Emerging Evidence

DOI: 10.2174/1874350100801010042

· University of Iowa

Abstract

Post-market prevalence studies have found that Selective Serotonin Reuptake Inhibitor (SSRI) and Serotonin-Norepinephrine Reuptake Inhibitor (SNRI) sexual side effects occur at dramatically higher rates than initially reported in pre-market trials. Prescribing and practice conventions rest on the untested assumption that individuals who develop sex-ual dysfunction secondary to SSRI and SNRI antidepressant medications return fully to their pre-medication sexual func-tioning baseline shortly after discontinuing treatment. Most individuals probably do return to their previous level of sexual functioning, however recent case reports, consumer-provided Internet-based information, incidental research findings, and empirical evidence of persistent post SSRI sexual benefits in the premature ejaculation literature suggest that for some in-dividuals, SSRI and SNRI-emergent sexual side effects persist indefinitely after discontinuing the medications. The litera-ture poorly captures the full spectrum of SSRI/SNRI sexual side effects, and a lack of systematic follow-up in the sexual side effects research precludes detection of post SSRI/SNRI sexual dysfunction, leaving the formal knowledge base in-adequate and even inaccurate, raising informed consent issues, and leaving clinicians vulnerable to practicing in ways that may be hurtful to patients in spite of their best efforts to inform themselves.

LINK: https://www.researchgate.net/publication/228667893_Persistence_of_Sexual_Dysfunction_Side_Effects_after_Discontinuation_of_Antidepressant_Medications_Emerging_Evidence

http://psychrights.org/research/Digest/SSRIs/PersistentSSRISexSideEffects.pdf

Persistent Sexual Dysfunction after Discontinuation of Selective Serotonin Reuptake Inhibitors (2008)


J Sex Med. 2008 Jan;5(1):227-33. doi: 10.1111/j.1743-6109.2007.00630.x.

Persistent sexual dysfunction after discontinuation of selective serotonin reuptake inhibitors.

1
University of Pittsburgh--Medicine, Pittsburgh, PA, USA. csokaA@dom.pitt.edu

Abstract

 

INTRODUCTION:

Sexual dysfunctions such as low libido, anorgasmia, genital anesthesia, and erectile dysfunction are very common in patients taking selective serotonin reuptake inhibitors (SSRIs). It has been assumed that these side effects always resolve after discontinuing treatment, but recently, four cases were presented in which sexual function did not return to baseline. Here, we describe three more cases. Case #1: A 29-year-old with apparently permanent erectile dysfunction after taking fluoxetine 20 mg once daily for a 4-month period in 1996. Case #2: A 44-year-old male with persistent loss of libido, genital anesthesia, ejaculatory anhedonia, and erectile dysfunction after taking 20-mg once daily citalopram for 18 months. Case #3: A 28-year-old male with persistent loss of libido, genital anesthesia, and ejaculatory anhedonia since taking several different SSRIs over a 2-year period from 2003-2005.

RESULTS:

No psychological issues related to sexuality were found in any of the three cases, and all common causes of sexual dysfunction such as decreased testosterone, increased prolactin or diabetes were ruled out. Erectile capacity is temporarily restored for Case #1 with injectable alprostadil, and for Case #2 with oral sildenafil, but their other symptoms remain. Case #3 has had some reversal of symptoms with extended-release methylphenidate, although it is not yet known if these prosexual effects will persist when the drug is discontinued.

CONCLUSION:

SSRIs can cause long-term effects on all aspects of the sexual response cycle that may persist after they are discontinued. Mechanistic hypotheses including persistent endocrine and epigenetic gene expression alterations were briefly discussed.
PMID:
18173768
DOI:
10.1111/j.1743-6109.2007.00630.x
[Indexed for MEDLINE]


LINK: http://www.ncbi.nlm.nih.gov/pubmed/18173768

Prolonged Post-Treatment Genital Anesthesia and Sexual Dysfunction Following Discontinuation of Citalopram and the Atypical Antidepressant Nefazodone (2007)

Prolonged Post-Treatment Genital Anesthesia and Sexual Dysfunction Following Discontinuation of Citalopram and the Atypical Antidepressant Nefazodone


Article · The Open Women’ Health Journal, December 2007
SSRI therapy is commonly associated with sexual side effects, but it is assumed that these distressing symp-toms resolve with termination of therapy. The atypical antidepressant nefazodone is infrequently associated with sexual dysfunction and may be substituted for SSRI's when sexual symptoms are intolerable. Recently, scattered case reports of persistent sexual dysfunction and genital anesthesia persisting well after termination of SSRI antidepressant therapy have surfaced. In each case, the underlying depressive disorder was in remission. Case: A 32-year old women with major depression was treated with citalopram but switched to nefazodone after 4 weeks of therapy due to genital anesthesia and orgasmic dysfunction. These symptoms continued following institution of nefa-zodone therapy and have persisted for over a year since termination of antidepressant treatment. Her depression remains in full remission. Discussion: It is likely that persistent post-treatment genital anesthesia and other sexual side effects are underreported, and physicians should be aware of this bothersome phenomenon. Formal post-treatment surveillance for this condition is war-ranted. Pharmacogenomic research may ultimately allow physicians to predict who is at risk for antidepressant induced sexual side effects.
FULL TEXT:

https://www.researchgate.net/publication/228663300_Prolonged_Post-Treatment_Genital_Anesthesia_and_Sexual_Dysfunction_Following_Discontinuation_of_Citalopram_and_the_Atypical_Antidepressant_Nefazodone

Genital anaesthesia persisting six years after sertraline discontinuation. (2006)


J Sex Marital Ther. 2006 Jul-Sep;32(4):327-30.

Genital anaesthesia persisting six years after sertraline discontinuation.

1
Department of Psychiatry, University of Manitoba, Winnipeg, Manitoba, Canada.

Abstract

Sexual side-effects, in general, are common with selective serotonin-reuptake inhibitors (SSRIs). Genital anaesthesia is a rare side-effect previously described with sertraline and fluoxetine use. With SSRI discontinuation, the sexual side-effects are expected to resolve. We report a case of a 26-year-old male who experienced genital anaesthesia during sertraline treatment and continued to be symptomatic despite medication discontinuation 6 years previously. To date, there have been no published reports of SSRI-induced sexual side-effects persisting beyond SSRI discontinuation. This case highlights the complex interplay of psychopharmacologic and psychodynamic factors that can occur in patients with sexual dysfunction.
PMID:
16709553
DOI:
10.1080/00926230600666410
[Indexed for MEDLINE] 


LINK: http://www.ncbi.nlm.nih.gov/pubmed/16709553

Post SSRI Sexual Dysfunction (2006)


Post SSRI Sexual Dysfunction 


Audrey Bahrick - ASAP Tablet 09/2006

FULL TEXThttp://www.researchgate.net/publication/236587031_Post_SSRI_Sexual_Dysfunction