Post-SSRI sexual dysfunction syndrome is a problem that may occur even after the patient stops taking antidepressants. Various types of abnormalities may appear in its course, e.g. decreased libido, erectile dysfunction or vaginal dryness. Sexual dysfunction as a consequence of taking antidepressants may lead to a deterioration of the quality of life - are there any treatments for sexual dysfunction syndrome after SSRI?

Contents:

  1. Post-SSRI Sexual Dysfunction Syndrome - Causes
  2. Post-SSRI Sexual Dysfunction Syndrome - Symptoms
  3. Post-SSRI Sexual Dysfunction Syndrome - Recognizing
  4. Post-SSRI Sexual Dysfunction Syndrome - treatment
  5. Post-SSRI Sexual Dysfunction Syndrome - should its risk deter SSRIs?

Post-SSRI sexual dysfunction syndrome(PSSD) is one of the possible side effects of antidepressant therapy.

In psychiatry, antidepressants are one of the most widely used pharmaceuticals. Contrary to their name, they are used not only in the treatment of depression - they are also used in the case of, among others, anxiety disorders or eating disorders.

Like any medication, antidepressants can have different side effects. Usually in this case, headaches, nausea, dizziness or abdominal pain are mentioned. For many patients, however, the worst side effect of taking antidepressants is the sexual dysfunction that follows them.

Both serotonin reuptake inhibitors (SSRIs), tricyclic antidepressants (TLPDs), as well as serotonin and norepinephrine reuptake inhibitors (SNRIs) and other antidepressants can lead to sexual dysfunction - according to some authors, such problems may be of varying severity They can appear in up to almost 100% of people using antidepressants.

Post-SSRI Sexual Dysfunction Syndrome - Causes

The fact that sexual dysfunctions can occur while taking antidepressants is usually not surprising - but they usually disappear when the patientstop taking such medications.

Post-SSRI Sexual Dysfunction Syndrome is a special entity, because in this case, sexual dysfunctions may appear during the use of these drugs, but - which is the most characteristic feature of this problem - they may persist, and sometimes even intensify after stopping antidepressants.

So far, it has not been established why this is possible - the only thing that is known is that the problem arises with the use of serotonin reuptake inhibitors, such as fluoxetine, escitalopram or paroxetine.

It is suspected that the occurrence of the syndrome may be affected by hormonal and epigenetic changes as a result of taking SSRI antidepressants.

However, due to the fact that the sexual dysfunction syndrome after SSRI seems to be more and more common, scientists dealing with it suggest the need for research, thanks to which not only its exact pathogenesis has been known, but also it would be possible to determine its exact pathogenesis. frequency.

Post-SSRI Sexual Dysfunction Syndrome - Symptoms

PSSD can develop in both women and men. The following abnormalities are considered possible symptoms of the sexual dysfunction syndrome after SSRI:

  • libido decrease
  • inability to reach orgasm (anorgasmia)
  • sensory disturbance in the reproductive organs (patients may complain of the feeling that their genitals have been somehow treated with anesthetics)
  • reducing the intensity of sensations during climax
  • vaginal dryness
  • premature ejaculation
  • erectile dysfunction (it happens that men with PSSD do not get an erection at all, and it is possible that despite the fact that the shaft of their penis becomes erect, the glans of their penis will remain firm)
  • reduction of nipple sensitivity to touch

Symptoms of sexual dysfunction syndrome may appear even after just a few days of taking antidepressants.

As already mentioned, they may persist for some time after discontinuation of these drugs - in some patients they remain present for several days to several weeks, while in others the symptoms of PSSD may appear for up to several years after stopping the inhibitors serotonin reuptake.

Post-SSRI Sexual Dysfunction Syndrome - Recognizing

It seems reasonable to mention the PSSD, because not many specialists are really aware of the problem,therefore, patients who come to them may have recommended treatment, which will not necessarily allow them to deal with unpleasant symptoms.

It happens that the source of sexual dysfunction is considered to be psychological problems, in addition, it is sometimes considered that sexual disorders result from the fact that the drugs used by the patient did not fully produce the expected effects.

In such cases, the patient may be advised, for example, to increase the dosage of his antidepressant, which may not necessarily lead to the resolution of symptoms of the sexual dysfunction syndrome after an SSRI.

The most important in the diagnosis of PSSD is the link between the occurrence of sexual disorders and the patient's use of drugs from the group of serotonin reuptake inhibitors.

It should be emphasized, however, that you should always keep in mind other possible causes of sexual dysfunction - even in men, erectile dysfunction may actually result from PSSD, but it can also be caused by untreated diabetes or advanced atherosclerosis.

Vaginal dryness in women may, in turn, be associated with the menopause and the resulting decline in estrogen levels in the body. In general, it can be said that the diagnosis of sexual dysfunction syndrome after SSRI should be made with great caution.

Post-SSRI Sexual Dysfunction Syndrome - treatment

So far, no treatment regimens for the treatment of sexual dysfunction syndrome after SSRI have been developed - this is due to the fact that this unit has only recently been mentioned.

The happy news is that for most patients - after a shorter or longer period of time - the problem resolves on its own.

On the other hand, there are references in the literature that patients who used SSRIs report, inter alia, the fact that their orgasms are not as intense and enjoyable as before taking antidepressants.

While there are indeed no guidelines for treating PSSD, various efforts are being made to help patients cope with the symptoms of this disorder.

One of the basic principles is modification of the treatment - both changes in the dosage of antidepressants are possible, as well as changing the drug used by the patient to another one, one that has a lower potential to generate sexual dysfunction.

In those people whose sexual dysfunctions persist despite the discontinuation of antidepressants, the use of other drugs is helpful - for example, mianserin is sometimes helpful in the case of decreased libido or erectile dysfunction.

Post-SSRI Sexual Dysfunction Syndrome - should its risk deter SSRIs?

PSSD can actually significantly worsen the quality of life of patients - should SSRIs be avoided to patients?

Not necessarily - in general, due to their tolerance and effectiveness, they are finally drugs of the first line in the treatment of many different mental disorders.

It is worth emphasizing here that, yes - sexual dysfunctions are not pleasant - on the other hand, however, a much greater risk appears when, for example, depressive disorders are not treated at all.

About the authorBow. Tomasz NęckiA graduate of the medical faculty at the Medical University of Poznań. An admirer of the Polish sea (most willingly strolling along its shores with headphones in his ears), cats and books. In working with patients, he focuses on always listening to them and spending as much time as they need.

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Category:

Psychiatry