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

Int J Risk Saf Med. 2018;29(3-4):125-134. doi: 10.3233/JRS-180744.

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.RESULTSWe 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.CONCLUSIONSThese 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).

MeSH terms

  • 5-alpha Reductase Inhibitors / adverse effects*
  • Adolescent
  • Adult
  • Aged
  • Antidepressive Agents / adverse effects*
  • Dermatologic Agents / adverse effects*
  • Female
  • Humans
  • Isotretinoin / adverse effects*
  • Libido / drug effects
  • Male
  • Middle Aged
  • Product Surveillance, Postmarketing
  • Quality of Life
  • Sexual Dysfunction, Physiological / chemically induced*
  • Young Adult

Substances

  • 5-alpha Reductase Inhibitors
  • Antidepressive Agents
  • Dermatologic Agents
  • Isotretinoin