The pathophysiology of Post SSRI Sexual Dysfunction - Lessons from a case study.
Biomed Pharmacother
; 161: 114166, 2023 May.
Article
in En
| MEDLINE
| ID: mdl-36898260
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.Key words
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Sexual Dysfunction, Physiological
/
Serotonin and Noradrenaline Reuptake Inhibitors
/
Erectile Dysfunction
Limits:
Humans
/
Male
/
Middle aged
Language:
En
Journal:
Biomed Pharmacother
Year:
2023
Document type:
Article