Study puts risk of developing PSSD at 0.46%

A “low” (but significant) chance 0.46% chance of destroying your life… who can say no!
The authors briefly discuss PFS too and acknowledge that 0.46% is probably an underestimation.

As the PFS Network has put it… a hidden public health crisis!

Sexual dysfunction is a common side effect of Serotonergic antidepressants (SA) treatment, and persists in some patients despite drug discontinuation, a condition termed post-SSRI sexual dysfunction (PSSD). The risk for PSSD is unknown but is thought to be rare and difficult to assess. This study aims to estimate the risk of erectile dysfunction (ED) and PSSD in males treated with SAs.
A 19-year retrospective cohort analysis was conducted using a computerized database of the largest HMO in Israel. ED was defined by phosphodiesterase-5 inhibitors prescriptions. 12,302 males aged 21–49 met the following criteria: non-smokers, no medical or psychiatric comorbidities or medications associated with ED, no alcohol or substance use. Logistic regression was used for estimation of ED risk in SA-treated subjects compared to non-SA-treated controls, assessed with and without the effects of age, body mass index (BMI), socioeconomic status (SES), depression and anxiety, yielding crude and adjusted odds ratios (cOR and aOR, respectively).
SAs were associated with an increased risk for ED (cOR = 3.6, p < 0.000001, 95% CI 2.8–4.8), which remained significant after adjusting for age, SES, BMI, depression and anxiety (aOR = 3.2, p < 0.000001, 95% CI 2.3–4.4). The risk for PSSD was 1 in 216 patients (0.46%) treated with SAs. The prevalence of PSSD was 4.3 per 100,000.
This work offers a first assessment of the small but significant risk of irreversible ED associated with the most commonly prescribed class of antidepressants which should enhance the process of receiving adequate informed consent for therapy.

The focus on ED was necessary in order to be able to detect sexual dysfunction beyond self-report, but we acknowledge that it may underestimate the true prevalence of PSSD. Further, our estimation may reflect the risk in otherwise healthy individuals and may again represent an underestimation of the prevalence of PSSD in the general population.


What’s crazy about this is the fact that over 13% of those age 18 and above are on this crap in the U.S. alone. If this estimation is accurate, and I see no reason why it wouldn’t be, it would follow that there are several million people globally with some form of PSSD.

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The methodology of this study is similar to an earlier one that sought to detect persistent ED following finasteride use by analysis of PDE5i prescriptions in medical records. That study estimated the rate of persistent ED after finasteride use at about 0.8%.

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