The pathophysiology of Post SSRI Sexual Dysfunction – Lessons from a case study (2023)

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anacleta
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The pathophysiology of Post SSRI Sexual Dysfunction – Lessons from a case study (2023)

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The pathophysiology of Post SSRI Sexual Dysfunction – Lessons from a case study

Biomedicine & Pharmacotherapy - Volume 161, May 2023, 114166 Review

Authors - Samantha Klaas (a), Jessica Barbut Siva (a), Maarten Bak (b, c), Mark Govers (d), Rudy Schreiber (a)

(a) Faculty of Psychology and Neuroscience Section Neuropsychology & Psychopharmacology Maastricht University, Maastricht, the Netherlands
(b) Faculty of Health, Life Sciences and Medicine Department of Psychiatry & Neuropsychology (Division 2) Maastricht University, Maastricht, the Netherlands
(c) FACT-3 Mondriaan GGZ Maastricht, the Netherlands
(d) Faculty of Health, Life Sciences and Medicine Health Services Research, School CAPHRI Care & Public Health Research Institute

Received 22 June 2022, Revised 19 December 2022, Accepted 28 December 2022, Available online 8 March 2023, Version of Record 8 March 2023.

https://doi.org/10.1016/j.biopha.2022.114166

Highlights

• A post-SSRI-sexual dysfunction case study taking a design-thinking approach.
• A narrative literature review of the pathophysiology guided by the case study.
• Serotonergic, noradrenergic, neurosteroid and oxytocin systems are involved.
• Potential use of pharma- and nutraceutical agents, however none are FDA approved.
• Complexity of case and pathophysiology emphasizes need for personalized medicine.

Abstract

Background
Although Post-SSRI Sexual Dysfunction (PSSD) has finally been recognized by the European Medicines Agency as a medical condition that can outlast discontinuation of SSRI and SNRI antidepressants, this condition is still largely unknown by patients, doctors, and researchers, and hence, poorly understood, underdiagnosed, and undertreated.

Objective
Becoming familiar with the symptomatology of PSSD and understanding the underlying mechanisms and treatment options.

Method
We applied a design thinking approach to innovation to 1) provide insights into the medical condition as well as the personal needs and pains of a targeted patient; and 2) generate ideas for new solutions from the perspective of this particular patient. These insights and ideas informed a literature search on the potential pathophysiological mechanisms that could underlie the patient’s symptoms.

Results
The 55-year-old male patient developed symptoms of low libido, delayed ejaculation, erectile dysfunction, ‘brain zaps*’*, overactive bladder and urinary inconsistency after discontinuation of the SNRI venlafaxine. In many of these symptoms a dysregulation in serotonergic activity has been implicated, with an important role of 5-HT1A receptor downregulation and possible downstream effects on neurosteroid and oxytocin systems.

Conclusions
The clinical presentation and development of symptoms are suggestive of PSSD but need further clinical elaboration. Further knowledge of post-treatment changes in serotonergic – and possibly noradrenergic – mechanisms is required to improve our understanding of the clinical complaints and to inform appropriate treatment regimes.


Full text (Open access): https://www.sciencedirect.com/science/a ... 2222015554
temp2021
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Re: The pathophysiology of Post SSRI Sexual Dysfunction – Lessons from a case study (2023)

Unread post by temp2021 »

This forum is highlighted and cited in this study in reference to yohimbine effects/side effect.
6-Eggs!
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Re: The pathophysiology of Post SSRI Sexual Dysfunction – Lessons from a case study (2023)

Unread post by 6-Eggs! »

This is great to see it's being recognized and taken more seriously now and how each person needs to be looked at uniquely, it's not a one size fits all situation by any stretch.
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