Cutting the First Turf to Heal Post-SSRI Sexual Dysfunction: A Male Retrospective Cohort Study (2022)

Cutting the First Turf to Heal Post-SSRI Sexual Dysfunction: A Male Retrospective Cohort Study

by Rosaria De Luca 1, Mirjam Bonanno 1, Alfredo Manuli 2 and Rocco Salvatore Calabrò 1

1 Neurorehabilitation Unit, IRCCS Centro Neurolesi “Bonino Pulejo”, 98166 Messina, Italy
2 UOC Physical Medicine and Rehabilitation, AOU Policlinico G Martino, 98166 Messina, Italy

Academic Editor: Hiroshi Sakagami
Medicines 2022, 9(9), 45;

Received: 6 June 2022 / Revised: 6 August 2022 / Accepted: 31 August 2022 / Published: 1 September 2022

Post-SSRI sexual dysfunction (PSSD) is a set of heterogeneous sexual problems, which may arise during the administration of selective serotonin reuptake inhibitors (SSRIs) and persist after their discontinuation. PSSD is a rare clinical entity, and it is commonly associated with non-sexual concerns, including emotional and cognitive problems and poor quality of life. To date, however, no effective treatment is available. The aim of this study was to retrospectively evaluate the potential efficacy of the different treatments used in clinical practice in improving male PSSD. Of the 30 patients referred to our neurobehavioral outpatient clinic from January 2020 to December 2021, 13 Caucasian male patients (mean age 29.53 ± 4.57 years), previously treated with SSRIs, were included in the study. Patients with major depressive disorder and/or psychotic symptoms were excluded a priori to avoid overlapping symptomatology, and potentially reduce the misdiagnosis rate. To treat PSSD, we decided to use drugs positively affecting the brain dopamine/serotonin ratio, such as bupropion and vortioxetine, as well as other compounds. This latter drug is known not to cause or reverse iatrogenic SD. Most patients, after treatment with vortioxetine and/or nutraceuticals, reported a significant improvement in all International Index of Erectile Function-(IIEF-5) domains (p < 0.05) from baseline (T0) to 12-month follow-up (T1). Moreover, the only patient treated with pelvic muscle vibration reached very positive results. Although our data come from a retrospective open-label study with a small sample size, drugs positively modulating the central nervous system serotonin/dopamine ratio, such as vortioxetine, could be used to potentially improve PSSD. Large-sample prospective cohort studies and randomized clinical trials are needed to investigate the real prevalence of this clinical entity and confirm such a promising approach to a potentially debilitating illness.

Full text:


Glad to see you’ve started to look and study these issues. I have a doctor friend here in Brazil who told me that at the last endocrinology medical congress they talked about post-finasteride syndrome


I experienced a crash from taking Vortioxetine for a few days, but then felt much better in the months following it.

better in what sense?

Mentally and sexually. Slept better, better mood, higher libido, just generally had a higher baseline than before it.

did you use finasteride and then use vortio? I have physical symptoms :frowning:
It’s been two months since I had the crash, I feel so tired, everything makes me tired. do you have physical symptoms?

Did you have any sexual symptoms aside from the libido issues? My sleep, mood, and libido have significantly improved without any drugs recently. But there’re no positive changes in my physical sides.

Yes. Also, I had fatigue and definitely felt awful physically in many different ways. I wouldn’t recommend doing what I did, I was not aware that I was taking any risk by taking Vortioxetine, but it helped me tremendously.

1 Like

I did but by that point they were not as bad as some people describe here.

1 Like

what were your symptoms? Can you measure how much they have improved?

can you be more clear about feeling awful?