isotretinoin and Sexual-Dysfunction--Physiological

A set of enduring conditions have been reported in the literature involving persistent sexual dysfunction after discontinuation of serotonin reuptake inhibiting antidepressants, 5 alpha-reductase inhibitors and isotretinoin.. To develop diagnostic criteria for post-SSRI sexual dysfunction (PSSD), persistent genital arousal disorder (PGAD) following serotonin reuptake inhibitors, post-finasteride syndrome (PFS) and post-retinoid sexual dysfunction (PRSD).. The original draft was designed using data from two published case series (Hogan et al., 2014 and Healy et al., 2018), which represent the largest public collections of data on these enduring conditions. It was further developed with the involvement of a multidisciplinary panel of experts.. A set of criteria were agreed upon for each of the above conditions. Features of PSSD, PFS and PRSD commonly include decreased genital and orgasmic sensation, decreased sexual desire and erectile dysfunction. Ancillary non-sexual symptoms vary depending on the specific condition but can include emotional blunting and cognitive impairment. PGAD presents with an almost mirror image of unwanted sensations of genital arousal or irritability in the absence of sexual desire. A new term, post-SSRI asexuality, is introduced to describe a dampening of sexual interest and pleasure resulting from a pre-natal or pre-teen exposure to a serotonin reuptake inhibitor.. These criteria will help in both clinical and research settings. As with all criteria, they will likely need modification in the light of developments.

Topics: Adolescent; Antidepressive Agents; Child; Finasteride; Humans; Isotretinoin; Male; Selective Serotonin Reuptake Inhibitors; Sexual Dysfunction, Physiological

To investigate clinical reports of post-SSRI sexual dysfunction (PSSD), post-finasteride syndrome (PFS) and enduring sexual dysfunction following isotretinoin.. 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.

Topics: 5-alpha Reductase Inhibitors; Adolescent; Adult; Aged; Antidepressive Agents; Dermatologic Agents; Female; Humans; Isotretinoin; Libido; Male; Middle Aged; Product Surveillance, Postmarketing; Quality of Life; Sexual Dysfunction, Physiological; Young Adult

There have been reports for over a decade linking serotonin reuptake inhibitors, finasteride and isotretinoin with enduring sexual dysfunction after treatment stops.. To explore the clinical pictures linked to all 3 drugs.. We have selected 120 reports to RxISK.org reporting the problem and mined these for data on age, gender, drug of use, and impact of the problem.. The data make it clear that the three drugs show extensive overlap in symptom profile, regardless of sex or country of origin.. The availability of 120 reports from over 20 countries add to the case for the validity of the syndrome. This is severe and enduring condition can result in death. An understanding of its physiology and an approach to treatment are needed.

Topics: 5-alpha Reductase Inhibitors; Adolescent; Adult; Aged; Female; Finasteride; Humans; Isotretinoin; Keratolytic Agents; Male; Middle Aged; Selective Serotonin Reuptake Inhibitors; Sexual Dysfunction, Physiological; Young Adult

Topics: Adult; Ejaculation; Humans; Isotretinoin; Male; Sexual Dysfunction, Physiological