PSSD
Post-SSRI sexual dysfunction[edit]
Science and Treatment Summaries[edit]
Wikipedia[edit]
- An old Wikipedia page on PSSD has an excellent summary of the science. Wikipedia is currently an ideological battlezone where some editors wish to downplay the existence of PSSD. The PSSD page currently redirects to a subsection on the SSRI page, where the PSSD content is significantly shorter in length.
Discord[edit]
- Boost's Discord server has plenty of resources related to PSSD and PFS.
- See this list of support groups for links to other Discord servers such as the SFN-focused Discord.
To use Discord, install the smartphone app or view Discord using a desktop browser (or the Discord desktop app).
PSSD Lab / Ghost[edit]
- An excellent primer on PSSD - evidence that it exists, links to resources, etc.
- Video explaining the 5-HT1A Autoreceptor Desensitization theory.
- Suggested treatment plan with a quick summary of PSSD characteristics.
Recovery stories[edit]
u/JacobCook715[edit]
While this Reddit user's account is suspended, the research is available online.
- Reddit post: https://www.reddit.com/r/PSSD/comments/12g5u0n/pssd_recovery_database_100_full_partial_recoveries/
- Excel document: https://1drv.ms/x/s!AsSCWpHHo6fMg4U7iP7gb61d2praow
The PSSD Lab (Wordpress blog) is one source of data used in this compilation.
TalkingAnt[edit]
Jrod[edit]
https://docs.google.com/spreadsheets/d/1bP3CDR8RKTe-rr74-2Eh-TFIsMrleCFr3luyEGq7ayw/edit
r/PSSDHealing[edit]
https://www.reddit.com/r/pssdhealing/
Best treatments for sexual function and PSSD[edit]
Research[edit]
PSSD Network list of published studies[edit]
https://www.pssdnetwork.org/literature
Published papers on SSRI-induced sexual dysfunction (not to be confused with POST SSRI sexual dysfunction)[edit]
- Genome-wide association study of SSRI/SNRI-induced sexual dysfunction [...] - https://doi.org/10.1016/j.psychres.2012.01.023 Sci-Hub - This study found that 11 SNPs mapped to the intronic region of the MDGA2 gene were associated with SSRI sexual dysfunction.
u/Bubzoluck (PharmD)[edit]
The Reddit user Bubzoluck has posted results of his/her PSSD survey. Findings include:
- Two thirds were male. 80 responses received.
- Young demographic. (It is unclear if this is a reflection of the Reddit demographic?)
- Most people were on their PSSD med for less than a year
- Most people reported having PSSD for >1 year since stopping their med
- SSRIs were the most common cause of PSSD (82.5%). 3 medications were the most common- Zoloft/sertraline (30%), Lexapro/escitalopram (20%), and Prozac/fluoxetine (12%).
Core symptoms were:
- Sexual Symptoms
- Difficulty generating or sustaining an erection
- Reduced genital sensation
- Pleasureless or weak orgasms
- Reduced response to sex stimuli
- Vaginal dryness
- Cognitive Symptoms
- Difficulty concentrating
- Short an/or long term memory impairment
- Loss of creativity and visualization inside mind
- Speaking, reading, writing, solving slower
- Difficulty understanding information
- Mood Symptoms
- Depression and low moods
- Feelings of emptiness or helplessness
- Loss of energy and insomnia
- Suicidal ideation
- Lower self-esteem and lack of pleasure
Sheetrit et al.[edit]
Post-SSRI Sexual Dysfunction; Clinical Characterization and Preliminary Assessment of Contributory Factors and Dose-Realted Relationship by Joseph Ben-Sheetrit et. al Journal of Clin Pharm, 06/2015. DOI:10.1097/JCP.0000000000000300
The paper is available here.
This 2015 paper makes an argument that PSSD is a real condition.
Despite the aforementioned limitations, the current investigation adds to the emerging evidence that SSRI/SNRI-induced sexual dysfunction persists in some patients beyond drug discontinuation and suggests that this phenomenon may not be fully explained by alternative non-pharmacological factors, including depression and anxiety.
GoldenHour515 Survey[edit]
Dropbox: https://www.dropbox.com/sh/18wiqi15udhz2e0/AABD1gHfv3Dy0sfJ6TKZlowDa?dl=0
Deleted Reddit thread: https://www.reddit.com/r/PSSD/comments/15982kr/survey_results/ (It is not available through archive.org unfortunately.)
- 5/135 participants stated that PSSD symptoms began after reinstatement. This suggests that (for those 5 participants) the main cause of PSSD was not an immutable characteristic such as genetics.
- Symptom comparison between PSSD, COVID vaccine injury, and Long COVID (based on GoldenHour515's data): https://forum.sickandabandoned.com/t/some-overlap-between-pssd-long-covid-and-post-vax/254
Studies currently recruiting[edit]
See currently recruiting PSSD studies.
Post Finasteride Syndrome[edit]
Patients can experience debilitating symptoms following the discontinuation of finasteride and potentially other anti-androgen drugs: dutasteride, isotretinoin (Accutane) and serotonergic antidepressants (e.g. SSRIs).
Science summary[edit]
Post-Finasteride Syndrome (PFS) is a rare and devastating disease encompassing persistent physiological, sexual, and neurological health problems following exposure to a 5alpha reductase inhibitor. The condition comprises a broad and variable clinical spectrum and is responsible for relationship breakdown, disability preventing work, isolation and suicide. Herein, the administrators of the patient support website propeciahelp.com summarise the current published research into PFS, add to the understanding of the condition, and present a mechanistic hypothesis to support further scientific investigation.
Research[edit]
Baylor College[edit]
Analysis by Axolotl on the PropeciaHelp forum: https://forum.propeciahelp.com/t/differential-gene-expression-in-post-finasteride-syndrome-patients-dr-khera-baylor/49564/93
Plain English summary: https://www.pfsnetwork.org/science/differential-gene-expression-in-post-finasteride-syndrome-patients
This study is the first to consider and demonstrate gene expression differences in patients with PFS as a potential etiology of sexual dysfunction.
Howell and colleagues are saying that the differences in gene expression (1,446 genes significantly over-expressed and 2,318 genes significantly under-expressed) are a potential cause (etiology) of sexual dysfunction.
Article (paywalled): https://doi.org/10.1016/j.jsxm.2021.05.009 | You can request a copy of the article via ResearchGate: https://www.researchgate.net/publication/353127752_Differential_Gene_Expression_in_Post-Finasteride_Syndrome_Patients
PFS Network survey[edit]
- The number of official health diagnoses received by PFS patients increased by 89% after the onset of Post-Finasteride Syndrome
- 64% of patients experienced at least one symptom in every symptomatic domain: Physical, neurological and sexual
- 51% of patients surveyed took the drug for less than 200 days, demonstrating no correlation between duration of use and severity of symptoms
- 72% were extremely dissatisfied with healthcare received after the onset of PFS
https://www.pfsnetwork.org/blog/2023-updates-from-pfs-network
The mid-year update states that their team will be publishing a series of articles using data collected from their survey of PFS patients. (The survey also collected data from PSSD patients.)
PropeciaHelp/PFS Network GWAS mini-study[edit]
This study was unfortunately hindered by a very low sample size.
Unfortunately, and quite expectedly, no single SNP was observed beyond this significance threshold. The team analyzed the data with a stringent significance threshold of p<5x10^-8 so it is unlikely that there will be results that meet the stringent hurdle.
There didn’t appear to be any greater correlation between either case group or control group and over-represented SNPs in any trait/disease featured on ImputeMe.
Nothing in the top results of the gene or pathway analyses this round sticks out as indicative of epigenetic mechanisms, known diseases, common symptoms in PFS/PAS/PSSD, steroid metabolism, AR signalling, known diseases, immunity, autoimmunity, gluten intolerance, etc…
https://forum.propeciahelp.com/t/23andme-patient-data-analysis/38786/64
The only “hotspot” (near significance threshold) was the chr4 ~10179769-10194628 region. The only nearby genes were characterized as a couple pseudogenes, along with WDR1 3 and a non-coding micro-RNA, MIR3138, which appears to be located in an intron of WDR1.
https://forum.propeciahelp.com/t/23andme-patient-data-analysis/38786/66