Cutting the First Turf to Heal Post-SSRI Sexual Dysfunction: A Male Retrospective Cohort Study. 2022

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anacleta
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Cutting the First Turf to Heal Post-SSRI Sexual Dysfunction: A Male Retrospective Cohort Study. 2022

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Cutting the First Turf to Heal Post-SSRI Sexual Dysfunction: A Male Retrospective Cohort Study

by Rosaria De Luca 1,Mirjam Bonanno 1,Alfredo Manuli 2 andRocco Salvatore Calabrò 1,*

1 Neurorehabilitation Unit, IRCCS Centro Neurolesi “Bonino Pulejo”, 98166 Messina, Italy
2 UOC Physical Medicine and Rehabilitation, AOU Policlinico G Martino, 98166 Messina, Italy
*Author to whom correspondence should be addressed.
Academic Editor: Hiroshi Sakagami
Medicines 2022, 9(9), 45; https://doi.org/10.3390/medicines9090045 (registering DOI)

Received: 6 June 2022 / Revised: 6 August 2022 / Accepted: 31 August 2022 / Published: 1 September 2022
(This article belongs to the Section Neurology and Neurologic Diseases)


Abstract

Post-SSRI sexual dysfunction (PSSD) is a set of heterogeneous sexual problems, which may arise during the administration of selective serotonin reuptake inhibitors (SSRIs) and persist after their discontinuation. PSSD is a rare clinical entity, and it is commonly associated with non-sexual concerns, including emotional and cognitive problems and poor quality of life. To date, however, no effective treatment is available. The aim of this study was to retrospectively evaluate the potential efficacy of the different treatments used in clinical practice in improving male PSSD. Of the 30 patients referred to our neurobehavioral outpatient clinic from January 2020 to December 2021, 13 Caucasian male patients (mean age 29.53 ± 4.57 years), previously treated with SSRIs, were included in the study. Patients with major depressive disorder and/or psychotic symptoms were excluded a priori to avoid overlapping symptomatology, and potentially reduce the misdiagnosis rate. To treat PSSD, we decided to use drugs positively affecting the brain dopamine/serotonin ratio, such as bupropion and vortioxetine, as well as other compounds. This latter drug is known not to cause or reverse iatrogenic SD. Most patients, after treatment with vortioxetine and/or nutraceuticals, reported a significant improvement in all International Index of Erectile Function-(IIEF-5) domains (p < 0.05) from baseline (T0) to 12-month follow-up (T1). Moreover, the only patient treated with pelvic muscle vibration reached very positive results. Although our data come from a retrospective open-label study with a small sample size, drugs positively modulating the central nervous system serotonin/dopamine ratio, such as vortioxetine, could be used to potentially improve PSSD. Large-sample prospective cohort studies and randomized clinical trials are needed to investigate the real prevalence of this clinical entity and confirm such a promising approach to a potentially debilitating illness.


Download PDF https://www.mdpi.com/2305-6320/9/9/45
Thomas
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Re: Cutting the First Turf to Heal Post-SSRI Sexual Dysfunction: A Male Retrospective Cohort Study. 2022

Unread post by Thomas »

I am quite surprised that this study wasn’t discussed more here, whereas obscure theories from users lead to hundreds of comments. This is the first and only study I have seen about curing PSSD. And it's what my psychiatrist has just prescribed. I am going to try it.
Escitalopram, 10mg/day, Jan-May 2019. Fluoxetine, May-Sept 2019. Mirtazapine 7,5mg/day, November 2019-January 2020. Escitalopram, 5mg/day, Feb-May 2020.
Symptoms: sexual & emotional numbness
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Determined-Mind
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Re: Cutting the First Turf to Heal Post-SSRI Sexual Dysfunction: A Male Retrospective Cohort Study. 2022

Unread post by Determined-Mind »

This is one of the studies that motivated me to try vortioxetine last month.
Here's my report

It's one of the few drugs known to improve anhedonia in both depressive (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7910099/ + https://pubmed.ncbi.nlm.nih.gov/35221687/ + https://pubmed.ncbi.nlm.nih.gov/30766492) and schizophrenic patients for both social and physical anhedonia https://journals.sagepub.com/doi/10.117 ... 4231199925

Vortioxetine may indirectly increase glutamate levels in the prefrontal brain, improving symptoms of anhedonia. Its action mechanics are very interesting and are detailed here https://psychscenehub.com/psychinsights ... -action-2/

Bupropion was also the first drug I tried to improve my sexual anhedonia. I liked it.
Here is my report.

I think the effects of bupropion depend very much on the biological context of our brain. I benefited from it for months when I was severe but not complete sexual anhedonia (2/10). Today, my baseline is lower than it was (0/10) and when I tried bupropion again, it did nothing.
:arrow: You're looking for a cure or want to help the community? I've created an interactive table listing possible treatments for PSSD.

Feel free to contribute anonymously and share your experiences with different substances (+150 options)!
Thomas
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Re: Cutting the First Turf to Heal Post-SSRI Sexual Dysfunction: A Male Retrospective Cohort Study. 2022

Unread post by Thomas »

Determined-Mind wrote: Sun Jan 28, 2024 7:01 am This is one of the studies that motivated me to try vortioxetine last month.
Here's my report
I can’t see your report but I don’t see either how a report about a shorter-than-one-month trial could be relevant regarding a drug known to need at least a one-month period to lead to results. Am I missing something?
Escitalopram, 10mg/day, Jan-May 2019. Fluoxetine, May-Sept 2019. Mirtazapine 7,5mg/day, November 2019-January 2020. Escitalopram, 5mg/day, Feb-May 2020.
Symptoms: sexual & emotional numbness
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Determined-Mind
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Re: Cutting the First Turf to Heal Post-SSRI Sexual Dysfunction: A Male Retrospective Cohort Study. 2022

Unread post by Determined-Mind »

Ah sorry, I just saw that to read the comments you have to be logged in - registered.

Report :

* 5 mg: nothing to report
* 10 mg: for the first few days I felt more bodily sensations (but not sexual - my case is severe, I'm at 0/10)
* 15 mg: I once again experienced more bodily sensations of pleasure
* I had to stop the treatment because of itching.
* Still, it gave me hope!
:arrow: You're looking for a cure or want to help the community? I've created an interactive table listing possible treatments for PSSD.

Feel free to contribute anonymously and share your experiences with different substances (+150 options)!
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