Results of a new study on genital/peripheral nerve treatment of patients with PSSD, PFS and PAS

[anacleta]

Dr Kenneth M Peters, urologist at Beaumont Hospital, Royal Oak, Michigan, on 23 February 2024 anticipates the results of a forthcoming study on Twitter
https://twitter.com/KennethMPeters1/sta ... 1376681245

NM094 | POST-RETINOID, POST-FINASTERIDE AND POST-SSRI SYNDROMES: PATIENT EVALUATION AND INITIAL TREATMENT

Kenneth M. Peters (1,2), Jackson A. Stachelek (1), Bernadette M.M. Zwaans (1,2)

1- Corewell Health William Beaumont University Hospital, Royal Oak, MI;
2- Oakland University William Beaumont School of Medicine, Rochester, MI

Introduction

Retinoids for acne, finasteride for hair loss and SSRIs for depression have been implicated in severe, persistent sexual dysfunction after cessation of these drugs. The incidence of the syndrome is unknown. Clinical presentation is similar between patients, suggesting a common cause. No effective treatments are known.

Methods

3 male patients ages 22 (Accutane), 23 (SSRI) and 33 (finasteride) presented with severe sexual dysfunction, anhedonia (loss of ability to feel pleasure), lack of genital sensation, erectile dysfunction, “brain- fog”, and loss of sexual desire for >2 yrs. All had acute onset of these symptoms after stopping their medication. Evaluation included questionnaires, sensory testing, monitoring of nocturnal erections and corneal confocal microscopy (CCM) to assess for neuropathy. To activate the peripheral nerves, patients apply a high frequency peripheral nerve stimulator (Biowave®) to the penis and perineum for at least 1 hour/day and underwent 8 low intensity extracorporeal shock wave therapy (Li-ESWT) (SoftWave®) 2500 shocks/session at 12mJ to the penis and perineum.

Results

The International Index of Erectile Function demonstrated dysfunction in erectile, orgasmic, desire and satisfaction. Von Frey filament testing showed reduced penile sensation, FirmTech® device measured on average 2-3 weak nocturnal erections, and CCM testing indicated variable neuro-inflammation. All patients who used the Biowave® reported improved penile sensation and tumescence. Erection quality improved after shockwave therapy. All patients continue with anhedonia and feeling of disconnect between the penis and the brain.

Conclusions

Post-accutane, finasteride and SSRI syndromes are devastating. It is unknown if this is a central effect due to alterations in hormone receptors and cell conductivity or a peripheral neuropathy. Our focus on activating the peripheral nerves is ongoing, but despite improvements in penile sensation and tumescence, the connectivity between the brain and genitalia continues to impact sexual desire and enjoyment. There is an urgent need for research into male and female sexuality with a focus on the impact of these drugs on sexual dysfunction. Better drug counseling is needed.

Funding: The study was unfunded

[6-Eggs!]

Not sure with the first two, but SSRI and psych drug related syndromes with includes PSSD are central with certainty except for outlier cases.

I have been able to without a doubt rule out peripheral involvement, probably even the spinal cord in my case even though it's part of the CNS, all of my symptoms are stemming from the brain itself.

[The_Eye]

Seriously, you managed to rule out your Peripheral NS ? Well I don't know your symptoms, but in my case, for instance, I'm numb under the belt. So that makes me wonder how and why the numbness is 'selective' of this particular area.