Two other syndromes have been described which appear closely related to PSSD. One is post-finasteride syndrome (PFS). First described in 2011, this occurs in young men taking finasteride to stall hair loss (Irwig and Kolukula, Reference Irwig and Kolukula2011). It also occurs with other 5-α reductase inhibitors – dutasteride and saw palmetto. Genital anaesthesia, loss of libido and sexual dysfunction are features of this syndrome. Initial finasteride treatment can produce some sexual dysfunction, but this is less common when compared with SSRIs. It is unclear if the sexual dysfunction that appears on treatment is continuous with PFS or distinct from it. ·······
These enduring post-treatment syndromes may interface with tardive dyskinesia linked to antipsychotic drugs in the 1960s. Antipsychotics can cause dyskinesias on treatment, which ordinarily resolve when treatment is stopped. Dyskinesias can also emerge on withdrawal but clear up in time. Tardive dyskinesia is a syndrome that involves dyskinetic movements centred on the jaw and lower facial area, which can emerge on treatment but become more marked when treatment stops. The syndrome can endure for years or decades afterwards.
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This article refers to a similarity between our problem (PFS, Post-SSRI, etc) and tardive dyskinesia.
As for tardive dyskinesia, two-hit hypothesis about its mechanism is proposed in the following article.
Such hypothesis can hold good for PFS and Post-SSRI in parts. (But in the latter, not only one particular gene but also 186 gene in brain and thousands of gene in body are up- or down- regulated. )
This hypothesis may help us to imagine what happened.