Enduring sexual dysfunction after treatment with antidepressants, 5α-reductase inhibitors and isotretinoin: 300 cases
Healy et al., 2018
“clinically the priorities are to raise awareness of these issues among patients and professionals, and to find treatments for a debilitating set of conditions that can have a profound impact on quality of life.”
Healy et al. analysed 300 patient responses to structured questions provided by and submitted to rxisk.org, an independent drug safety website. The cohort was comprised of patients suffering persistent sexual dysfunction following use of 5alpha reductase inhibitors, Isotretinoin and Serotonin Reuptake Inhibitors, with treatment duration ranging from a single dose to over 16 years.
Overlap was seen in symptoms including erectile dysfunction, Libido loss, genital anaesthesia, difficulty achieving orgasm, pleasureless orgasm, premature ejaculation, emotional blunting, loss of nocturnal erections, penile or testicular pain, reduction of penis size, decreased testosterone, watery ejaculate, testicular atrophy, and other skin numbness.
Across drug groups, the sexual dysfunction became markedly worse or even began after cessation of treatment in many instances. For all three drug groups there were reports of profound dysfunction appearing within days of stopping.
They note the need for a revision of causality algorithms with regards to adverse events to accommodate lasting and progressing effects of treatment beyond withdrawal.
They conclude the need for comparative investigation in these cohorts and a systematic approach with structured symptom sets to possibly establish the existence of a single syndrome.
