Diagnostic criteria for enduring sexual dysfunction after treatment with antidepressants, finasteride and isotretinoin

BACKGROUND: 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. OBJECTIVE: 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). METHODS: 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. RESULTS: 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. CONCLUSIONS: These criteria will help in both clinical and research settings. As with all criteria, they will likely need modification in the light of developments.

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Evaluation of sexual dysfunction in gynecologic cancer survivors using DSM-5 diagnostic criteria

BMC Women s Health ◽

10.1186/s12905-021-01559-z ◽

2022 ◽

Vol 22 (1) ◽

Author(s):

Hao Lin ◽

Hung-Chun Fu ◽

Chen-Hsuan Wu ◽

Yi-Jen Tsai ◽

Yin-Jou Chou ◽

...

Keyword(s):

Logistic Regression ◽

Endometrial Cancer ◽

Sexual Dysfunction ◽

Cancer Survivors ◽

Diagnostic Criteria ◽

Sexual Interest ◽

Gynecologic Cancer ◽

Multiple Logistic Regression ◽

Dsm 5 ◽

Arousal Disorder

Abstract Background In gynecologic cancer survivors, female sexual dysfunction (FSD) remains under-investigated. We attempted to estimate the prevalence of FSD associated with distress in gynecologic cancer survivors using diagnostic and statistical manual of mental disorders fifth edition (DSM-5) diagnostic criteria and to identify women at risk for FSD. Methods We conducted a cross-sectional analysis of premenopausal women aged 20–50 with various gynecologic cancers at least one year after treatment between January 2017 and December 2019. Data of sociodemographics and physical conditions were collected via face-to-face interview during outpatient clinic visits. The domains we used to define FSD were based on DSM-5 diagnostic criteria. Statistical analysis was carried out using Student's t test, Chi-square test and multiple logistic regression. Results A total of 126 gynecologic cancer survivors with a mean age of 42.4 years were included for analysis and 55 of them (43.7%) were diagnosed as having FSD associated with distress based on DSM-5 criteria. More than half of women (65.1%) reported decreased sexual satisfaction after cancer treatment. According to DSM-5 definition, the most common female sexual disorders were sexual interest/arousal disorder (70.9%), followed by genitopelvic pain/penetration disorder (60.0%), and orgasmic disorder (20.0%). In multiple logistic regression model, endometrial cancer diagnosis was the only independent factor predicting less influence of cancer treatment on FSD (OR 0.370; 95% CI 0.160, 0.856). Conclusion The first study to use DSM-5 criteria for estimation of FSD prevalence. This enables clinicians to identify which women are actually needed to seek medical help. A prevalence of 43.7% of FSD associated with distress was found in a group of gynecologic cancer survivors with the most common being sexual interest/arousal disorder. Endometrial cancer survivors were at low risk for developing FSD after treatment.

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Criteria positive and criteria negative anaphylaxis, with a focus on undifferentiated somatoform idiopathic anaphylaxis: A review and case series

Allergy and Asthma Proceedings ◽

10.2500/aap.2020.41.200076 ◽

2020 ◽

Vol 41 (6) ◽

pp. 436-441 ◽

Cited By ~ 1

Author(s):

Daniel A. Rosloff ◽

Kunal Patel ◽

Paul J. Feustel ◽

Jocelyn Celestin

Keyword(s):

Diagnostic Criteria ◽

Statistical Significance ◽

Case Series ◽

Poor Response ◽

Response To Treatment ◽

Fisher Exact Test ◽

Subjective Symptoms ◽

Significant Difference ◽

Physical Findings ◽

Idiopathic Anaphylaxis

Background: Undifferentiated somatoform (US) idiopathic anaphylaxis (IA) is considered a psychogenic disorder characterized by a lack of observable physical findings and poor response to treatment. Although failure to diagnose true anaphylaxis can have disastrous consequences, identification of US-IA is crucial to limit unnecessary expenses and use of health care resources. Objective: To better define the presentation and understand the potential relationship between US-IA and underlying psychiatric comorbidities. Methods: We retrospectively reviewed 110 visits by 107 patients to our institution for evaluation and management of anaphylaxis over a 1-year period. The patients were classified as having either criteria positive (CP) or criteria negative (CN) anaphylaxis based on whether they met Second National Institute of Allergy and Infectious Disease/Food Allergy and Anaphylaxis Network Symposium criteria for the clinical diagnosis of anaphylaxis. Patient characteristics, including objective and subjective signs and symptoms, and the presence of psychiatric diagnoses were collected and analyzed. Statistical significance was assessed by using the Fisher exact test. A literature review of US-IA and other psychogenic forms of anaphylaxis was performed. Results: Patients with CP anaphylaxis were more likely to present with hypotension, wheezing, urticaria, and vomiting than were patients with CN anaphylaxis. The patients with CN anaphylaxis were more likely to present with subjective symptoms of sensory throat tightness or swelling compared with patients with CP anaphylaxis. No significant difference was detected in the prevalence of psychiatric conditions between the two groups. Conclusion: Patients who met previously established diagnostic criteria for anaphylaxis were more likely to present with objective physical findings than those who did not meet criteria for true anaphylaxis. CN patients who presented for treatment of anaphylaxis were more likely to present with subjective symptoms. Formal diagnostic criteria should be used by clinicians when evaluating patients with suspected anaphylaxis.

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Sexual Dysfunctions Related to Drugs Used in the Management of Lower Urinary Tract Symptoms Due to Benign Prostatic Hyperplasia: A Narrative Review on α-Blockers and 5-Alpha Reductase Inhibitors

Uro ◽

10.3390/uro1030012 ◽

2021 ◽

Vol 1 (3) ◽

pp. 82-98

Author(s):

Antonio La Torre ◽

Caterina Palleria ◽

Irene Tamanini ◽

Andrea Scardigli ◽

Tommaso Cai ◽

...

Keyword(s):

Urinary Tract ◽

Benign Prostatic Hyperplasia ◽

Sexual Dysfunction ◽

Lower Urinary Tract ◽

Prostatic Hyperplasia ◽

Sexual Dysfunctions ◽

Reductase Inhibitors ◽

Urinary Tract Symptoms ◽

5 Alpha Reductase Inhibitors ◽

Lower Urinary

This is a critical review of the current literature data about sexual dysfunction as a potential side effect related to drugs commonly used for the treatment of Benign Prostatic Hyperplasia and Lower Urinary Tract Symptoms. In this narrative review, we analyzed data from the literature related to the development of sexual dysfunctions during the treatment of BPH or LUTS. Both α-blockers and 5-alpha reductase inhibitors (5-ARIs) can induce erectile dysfunction, ejaculatory disorders and a reduction in sexual desire. The sexual side effect profile of these drugs is different. Among the α-blockers, silodosin appears to have the highest incidence of ejaculatory disorders. Persistent sexual side effects after the discontinuation of finasteride have been recently reported; however, further studies are needed to clarify the true incidence and the significance of this finding. However, most of the published studies are affected by a weak methodology and other important limitations, with only a few RCTs available. Therefore, it is desirable that future studies will include validated tools to assess and diagnose the sexual dysfunction induced by these medications, especially for ejaculation and sexual desire disorders.

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The Risk of Acute Pancreatitis and Selective Serotonin Reuptake Inhibitors Use: A Meta-Analysis of Case–Control Studies

Dose-Response ◽

10.1177/1559325820902352 ◽

2020 ◽

Vol 18 (1) ◽

pp. 155932582090235

Author(s):

Shih-Wei Lai ◽

Cheng-Chan Yu ◽

Cheng-Li Lin ◽

Kuan-Fu Liao

Keyword(s):

Acute Pancreatitis ◽

Serotonin Reuptake ◽

Selective Serotonin Reuptake Inhibitors ◽

Meta Analysis ◽

Statistical Significance ◽

Case Series ◽

Serotonin Reuptake Inhibitors ◽

Selective Serotonin ◽

Statistical Association ◽

Case Control Studies

Background/Objective: Some case series and case report have shown the association between the risk of acute pancreatitis and use of selective serotonin reuptake inhibitors. The results of systematic studies were not consistent. Methods: A meta-analysis was performed to investigate the risk of acute pancreatitis associated with use of selective serotonin reuptake inhibitors. Results: There was no statistical association between the risk of acute pancreatitis and selective serotonin reuptake inhibitors use (odds ratio: 1.19, 95% confidence interval: 0.93-1.51). Conclusions: Despite reaching no statistical significance, the possibility of the association between the risk of acute pancreatitis and selective serotonin reuptake inhibitors use cannot be totally excluded.

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Effects of emotional state on sexual desire and sexual dysfunction

Motivation and Emotion ◽

10.1007/bf00992203 ◽

1985 ◽

Vol 9 (4) ◽

pp. 315-330 ◽

Cited By ~ 8

Author(s):

Albert Mehrabian ◽

Linda Stanton-Mohr

Keyword(s):

Sexual Dysfunction ◽

Sexual Desire ◽

Emotional State

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Selective serotonin reuptake inhibitor-induced sexual dysfunction: efficacy of a drug holiday

American Journal of Psychiatry ◽

10.1176/ajp.152.10.1514 ◽

1995 ◽

Vol 152 (10) ◽

pp. 1514-1516 ◽

Cited By ~ 83

Keyword(s):

Sexual Dysfunction ◽

Selective Serotonin Reuptake Inhibitor ◽

Reuptake Inhibitor ◽

Serotonin Reuptake ◽

Drug Holiday ◽

Selective Serotonin ◽

Serotonin Reuptake Inhibitor

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Regulatory perspective on clinical trials and end points for female sexual dysfunction, in particular, hypoactive sexual desire disorder: formulating recommendations in an environment of evolving clinical science

International Journal of Impotence Research ◽

10.1038/sj.ijir.3901481 ◽

2006 ◽

Vol 19 (1) ◽

pp. 30-36 ◽

Cited By ~ 12

Author(s):

D Shames ◽

S E Monroe ◽

D Davis ◽

L Soule

Keyword(s):

Clinical Trials ◽

Sexual Dysfunction ◽

Sexual Desire ◽

Female Sexual Dysfunction ◽

Clinical Science ◽

Hypoactive Sexual Desire Disorder ◽

End Points ◽

Regulatory Perspective ◽

Desire Disorder

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Case Series: Adderall® Augmentation of Serotonin Reuptake Inhibitors in Childhood-Onset Obsessive Compulsive Disorder

Journal of Child and Adolescent Psychopharmacology ◽

10.1089/104454602760219207 ◽

2002 ◽

Vol 12 (2) ◽

pp. 165-171 ◽

Cited By ~ 10

Author(s):

Thomas Owley ◽

Soyna Owley ◽

Bennett Leventhal ◽

Edwin H. Cook

Keyword(s):

Obsessive Compulsive Disorder ◽

Serotonin Reuptake ◽

Case Series ◽

Serotonin Reuptake Inhibitors ◽

Childhood Onset ◽

Obsessive Compulsive ◽

Compulsive Disorder

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Openness to Sexuality as a Predictor of Gender Non-Specificity of Visual Sexual Interest in Heterosexual Women

Inquiry@Queen's Undergraduate Research Conference Proceedings ◽

10.24908/iqurcp.9807 ◽

2018 ◽

Author(s):

Nicole Persall

Keyword(s):

Gender Difference ◽

Sexual Desire ◽

Sexual Attitudes ◽

Sexual Interest ◽

Past Research ◽

Heterosexual Men ◽

Tracking Data ◽

Male And Female ◽

Heterosexual Women ◽

Sexual Arousability

Past research has indicated that there is a gender difference in regards to sexual arousal; such that heterosexual men typically show a pattern of gender-specificity, whereas women show a pattern of gender non-specificity. Although this is a robust finding, there is little research examining the predictors of this finding. The current study uses eye-tracking data (i.e., gaze time to male and female images) to examine the effect of openness to sexuality on visual sexual interest. Openness to sexuality is assessed using three factors: sexual attitudes, sexual desire, and sexual arousability. I predict that greater openness to sexuality (i.e., more positive sexual attitudes, greater sexual desire, and greater sexual arousability) is correlated with greater gender non-specificity of visual sexual interest.

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