Post-finasteride syndrome and post-SSRI sexual dysfunction: two sides of the same coin?

  title={Post-finasteride syndrome and post-SSRI sexual dysfunction: two sides of the same coin?},
  author={Silvia Giatti and Silvia Diviccaro and Giancarlo Panzica and Roberto Cosimo Melcangi},
Sexual dysfunction is a clinical condition due to different causes including the iatrogenic origin. For instance, it is well known that sexual dysfunction may occur in patients treated with antidepressants like selective serotonin reuptake inhibitors (SSRI). A similar side effect has been also reported during treatment with finasteride, an inhibitor of the enzyme 5alpha-reductase, for androgenetic alopecia. Interestingly, sexual dysfunction persists in both cases after drug discontinuation… 

Diagnostic criteria for enduring sexual dysfunction after treatment with antidepressants, finasteride and isotretinoin

Diagnostic criteria for post-SSRI sexual dysfunction, persistent genital arousal disorder (PGAD) following serotonin reuptake inhibitors, post-finasteride syndrome (PFS) and post-retinoid sexual dysfunction (PRSD) are developed.

Post-finasteride syndrome: An emerging clinical problem

Post-Selective Serotonin Reuptake Inhibitor Sexual Dysfunctions (PSSD): Clinical Experience with a Multimodal Approach

This study described for the first time a feasible and handy treatment procedure for PSSD, framework to improve patients complains, sexual function and satisfaction, and quality of life.

Post-Finasteride Syndrome - When will we Get the Courage to Fight the Dictating Pharma Industry - Despite Awareness of "Sexual, Neurological and Metabolic Side Effects in Young Men for Over a Decade"

This comprehensive review has been done with an effort for the medical community who took hippocratic oath to serve the humanity why they cannot get up and protest against the side effects that in a subgroup of men might get irreversible side effects rather than label the poor men as psychotic or delusional.

Sexual Dysfunctions Related to Drugs Used in the Management of Lower Urinary Tract Symptoms Due to Benign Prostatic Hyperplasia: A Narrative Review on α-Blockers and 5-Alpha Reductase Inhibitors

A critical review of the current literature data about sexual dysfunction as a potential side effect related to drugs commonly used for the treatment of Benign Prostatic Hyperplasia and Lower Urinary Tract Symptoms finds that silodosin appears to have the highest incidence of ejaculatory disorders.

Antidepressant‐induced sexual dysfunction

  • Jody Rothmore
  • Psychology, Medicine
    The Medical journal of Australia
  • 2020
The risk of sexual dysfunction is greatest with SSRIs and serotonin and noradrenaline reuptake inhibitors (SNRIs), less with tricyclic antidepressants, and least with moclobemide, agomelatine, reboxetine and bupropion.

Post-finasteride syndrome: our current knowledge

The results of studies on sexual, physical, and psychological disorders have shown mixed results and some experts attribute post-finasteride syndrome to a group of «mysterious diseases» based on psychosocial factors.

Post-finasteride syndrome: a surmountable challenge for clinicians.

  • A. Traish
  • Medicine, Psychology
    Fertility and sterility
  • 2020

Post-finasteride syndrome – does it really exist?

The prolonged use of 5α-steroid reductase inhibitors in patients with alopecia can cause persistent side effects called a post-finasteride syndrome (PFS), that is not just a simple coexistence of events, but rather a definite syndrome with an iatrogenic background.

Are There Any Sex/Gender Differences in Post-Selective Serotonin Reuptake Inhibitors (SSRI) Sexual Dysfunction (PSDD)?

  • Y. Reisman
  • Psychology, Medicine
    Current Sexual Health Reports
  • 2019
The available data on sex/gender differences in PSSD is summarized to evaluate if different approaches in diagnosis or treatment of different genders are needed and to assess sexual function prior, during, and also after treatment with antidepressants.



Sexual Consequences of Post-SSRI Syndrome.

  • Y. Reisman
  • Psychology, Medicine
    Sexual medicine reviews
  • 2017

Sexual Dysfunction Related to Drugs: a Critical Review. Part V: α-Blocker and 5-ARI Drugs.

A critical review of the current literature to identify possible intervention strategies for sexual dysfunction related to α-blocker and 5-ARI drugs and the use of phosphodiesterase type 5 (PDE5) inhibitors in combination with these drugs.

Post-SSRI Sexual Dysfunction: A Literature Review.

Effects of SSRIs on sexual function: a critical review.

The effects of SSRIs on sexual functioning seem strongly dose-related and may vary among the group according to serotonin and dopamine reuptake mechanisms, induction of prolactin release, anticholinergic effects, inhibition of nitric oxide synthetase, and propensity for accumulation over time.

Adverse side effects of 5α-reductase inhibitors therapy: persistent diminished libido and erectile dysfunction and depression in a subset of patients.

INTRODUCTION 5α-reductase inhibitors (5α-RIs), finasteride and dutasteride, have been approved for treatment of lower urinary tract symptoms, due to benign prostatic hyperplasia, with marked clinical

Persistent sexual side effects of finasteride: could they be permanent?

  • M. Irwig
  • Psychology, Medicine
    The journal of sexual medicine
  • 2012
In most men who developed persistent sexual side effects despite the discontinuation of finasteride, the sexual dysfunction continued for many months or years, which should be made aware of the potential adverse medication effects.

Finasteride adverse effects in subjects with androgenic alopecia: A possible therapeutic approach according to the lateralization process of the brain

It is suggested that subjects having preference for a certain sexual orientation and/or predisposition for a given dominant hand could be advised before finasteride administration, that present an increased risk/sensitivity to develop adverse effects.

Post-SSRI Sexual Dysfunction: Clinical Characterization and Preliminary Assessment of Contributory Factors and Dose-Response Relationship

The findings add to previous reports and support the existence of PSSD, which may not be fully explained by alternative nonpharmacological factors related to sexual dysfunction, including depression and anxiety.

Genetic and Clinical Predictors of Sexual Dysfunction in Citalopram-Treated Depressed Patients

Genetic polymorphisms, including those of the serotonin and glutamate systems, are examined for association with erectile dysfunction, anorgasmia, and decreased libido during citalopram treatment to suggest the potential for glutamatergic treatment targets for sexual dysfunction during major depressive episodes.

Inhibitors of 5α-reductase-related side effects in patients seeking medical care for sexual dysfunction

The data indicates that use of 5ARI in men with sexual dysfunction does not significantly exacerbate pre-existing ejaculatory or erectile difficulties, but can further impair their sexual life by reducing sexual drive and spontaneous erection.