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
