Persistent sexual dysfunction after SSRI withdrawal: a scoping review and presentation of 86 cases from the Netherlands

Expert Opin Drug Saf. 2021 Nov 18. doi: 10.1080/14740338.2022.2007883. Online ahead of print.


Background: : Sexual dysfunction is highly prevalent worldwide. A specific form is persistent sexual dysfunction after SSRI withdrawal. We conducted a systematic literature review in order to characterize factors related to post SSRI sexual dysfunction (PSSD) and analyzed spontaneous reports of persistent sexual dysfunction reported to the Netherlands Pharmacovigilance Centre Lareb.

Research design and methods: A systematic literature review was conducted following the PRISMA-ScR guidelines. In addition, reports of PSSD submitted to the Netherlands Pharmacovigilance Centre Lareb between 1992 and 2021 were analyzed.

Results: : A total of 237 articles were retrieved through the search and 33 articles were selected for inclusion in this review, in accordance with the inclusion criteria. Information regarding the characteristics of the condition, it's clinical management, patient characteristics and impact of PSSD is presented. A total of 86 reports of persistent sexual dysfunction, were analyzed. The longest case being a patient with PSSD for 23 years. The main symptoms were: loss or decreased libido (n= 53), erectile dysfunction (n= 23) and anorgasmia (n= 5).

Conclusions: PSSD impact includes sexual, psychological and social consequences. Little is known about the mechanisms underlying PSSD and no effective treatment exists. It is necessary to increase recognition of PSSD among prescribers and improve its management at the clinical level.

Keywords: PSSD; SSRIs withdrawal; persistent sexual dysfunction; post SSRI sexual dysfunction.