Diagnostic criteria for enduring sexual dysfunction after treatment with antidepressants, finasteride and isotretinoin.
Diagnostic criteria for enduring sexual dysfunction after treatment with antidepressants, finasteride and isotretinoin.
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DOI：
10.3233/jrs-210023
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发表时间：
2022
期刊：
影响因子：
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通讯作者：
Waraich A
中科院分区：
文献类型：
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作者：
Healy D;Bahrick A;Bak M;Barbato A;Calabrò RS;Chubak BM;Cosci F;Csoka AB;D'Avanzo B;Diviccaro S;Giatti S;Goldstein I;Graf H;Hellstrom WJG;Irwig MS;Jannini EA;Janssen PKC;Khera M;Kumar MT;Le Noury J;Lew-Starowicz M;Linden DEJ;Lüning C;Mangin D;Melcangi RC;Rodríguez OWMAAS;Panicker JN;Patacchini A;Pearlman AM;Pukall CF;Raj S;Reisman Y;Rubin RS;Schreiber R;Shipko S;Vašečková B;Waraich A
文献中已经报道了一组持续性功能障碍，涉及停用5-羟色胺再摄取抑制抗抑郁药、5-α-还原酶抑制剂和异维甲酸后的持续性功能障碍。制定SSRI后性功能障碍(PSSD)、5-羟色胺再摄取抑制剂后持续性生殖器觉醒障碍(PGAD)、非那雄胺后综合征(PFS)和维甲酸后性功能障碍(PRSD)的诊断标准。最初的草案是使用两个已发表的病例系列(Hogan等人，2014和Healy等人，2018)的数据设计的，这是关于这些持久疾病的最大公开数据收集。在一个多学科专家小组的参与下，它得到了进一步发展。对上述每一种情况都商定了一套标准。PSSD、PFS和PRSD的特征通常包括生殖器和性高潮感觉下降，性欲下降和勃起功能障碍。伴随的非性症状因具体情况而异，但可能包括情绪迟钝和认知障碍。PGAD呈现了一个几乎是镜像的形象，即在没有性欲的情况下，不想要的生殖器唤醒或易怒的感觉。一个新的术语，SSRI后无性，被引入来描述由于产前或青春期暴露于5-羟色胺再摄取抑制剂而导致的性兴趣和快感的抑制。这些标准将有助于临床和研究环境。与所有标准一样，它们可能需要根据事态发展进行修改。
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. 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). 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. 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. These criteria will help in both clinical and research settings. As with all criteria, they will likely need modification in the light of developments.