Post-SSRI Sexual Dysfunction (PSSD): Biological Plausibility, Symptoms, Diagnosis, and Presumed Risk Factors.
Level 5 - mechanism / opinion, no new human data
Narrative literature review synthesizing clinical features and theoretical neurobiological mechanisms without systematic methodology or primary empirical data.
PubMed 34627736 · doi:10.1016/j.sxmr.2021.07.001
What was done
An extensive narrative literature review of PubMed was conducted to evaluate symptom patterns, potential risk factors, proposed pathophysiological mechanisms, diagnostic considerations, and management approaches for post-SSRI sexual dysfunction (PSSD).
What was found
The abstract reports no quantitative data or statistical estimates. It outlines key clinical features occurring after cessation of SSRIs, SNRIs, or tricyclic antidepressants, including genital anesthesia, erectile dysfunction, orgasmic or ejaculatory anhedonia, and non-sexual symptoms such as apathy and blunted affect. Proposed pathophysiological mechanisms include epigenetic changes, dopamine-serotonin interactions, serotonin neurotoxicity, and endocrine alterations. Diagnosis is currently made by excluding other causes of sexual dysfunction, and no therapeutic intervention has demonstrated definitive efficacy.
Why it matters
This review highlights PSSD as a recognized clinical entity to aid clinicians in distinguishing it from depression-related sexual dysfunction and avoiding potentially harmful drug re-exposure.
Limits
The paper is a non-systematic narrative review relying primarily on case reports, theoretical biological plausibility, and expert synthesis. No primary clinical data, formal risk-of-bias assessments, prevalence figures, or validated diagnostic criteria are provided.
Cited by
- supports Some individuals experience persistent sexual and mood-related side effects that do not resolve even after discontinuing SSRI antidepressants.