The following is an incomplete list of completed studies on the topic of PSSD.
Animal Literature
Neonatal Antidepressant Exposure has Lasting Effects on Behavior and Serotonin Circuitry
(Maciag et al., 2013)
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3118509/
“Here, we show that chronic neonatal (postnatal days 8–21) exposure to citalopram (5 mg/kg, twice daily, s.c.), a potent and highly selective SSRI, results in profound reductions in both the rate-limiting serotonin synthetic enzyme (tryptophan hydroxylase) in dorsal raphe and in serotonin transporter expression in cortex that persist into adulthood. Furthermore, neonatal exposure to citalopram produces selective changes in behavior in adult rats including increased locomotor activity and decreased sexual behavior similar to that previously reported for antidepressants that are nonselective monoamine transport inhibitors.”
Maternal exposure to the antidepressant fluoxetine impairs sexual motivation in adult male mice
(Gouvêa et al., 2004)
https://www.ncbi.nlm.nih.gov/pubmed/18457868
“Global inspection of other cortical areas, such as the hippocampus, also revealed prominent reductions in the SERT-immunoreactive fiber network (data not shown). Moreover, the effects of citalopram on SERT fiber labeling were found to persist into adulthood—PN130 (Figure 7). Similar analysis of clomipramine-treated subjects revealed a nonsignificant effect of drug exposure on cortical SERT innervation; although it should be noted that a trend for decreased immunoreactivity was detected in some individual cases.”
These studies show that treatment with SSRIs cause persistant changes in the expression of SERT in the rodent brain, and that treatment of young rats with SSRIs leads to persistant decreases in sexual activity that carry into adulthood.
But what about in humans?
Clinical Literature
Here are a few (of many) peer-reviewed papers on the topic:
1) Persistent Sexual Side Effects after SSRI Discontinuation, Antonei B. Csoka, Stuart Shipko, 2006
2) Genital anaesthesia persisting six years after sertraline discontinuation, Bolton JM, Sareen J, Reiss JP, 2006
3) Post SSRI Sexual Dysfunction, Audrey Bahrick, 2006
4) Prolonged Post-Treatment Genital Anesthesia and Sexual Dysfunction Following Discontinuation of Citalopram and the Atypical Antidepressant Nefazodone, Robert P. Kauffman, Amanda Murdock, 2007
5) Persistent Sexual Dysfunction after Discontinuation of Selective Serotonin Reuptake Inhibitors, Antonei Csoka, Audrey Bahrick, Olli-Pekka Mehtonen, 2008
6) Persistence of Sexual Dysfunction Side Effects after Discontinuation of Antidepressant Medications: Emerging Evidence, Audrey S. Bahrick, 2008
7) Persistent Genital Arousal Disorder in Women: Case Reports of Association with Anti-Depressant Usage and Withdrawal, Sandra R. Leibluma & David Goldmeierb, 2008
8) Persistent sexual dysfunction in genitourinary medicine clinic attendees induced by selective serotonin reuptake inhibitors, Farnsworth KD, Dinsmore WW, 2009
9) The impact of persistent sexual side effects of selective serotonin reuptake inhibitors after discontinuing treatment: a qualitative study, Rebecca Diane Stinson, 2013
10) Does sexual dysfunction persist upon discontinuation of selective serotonin reuptake inhibitors?, G.C. Ekhart, E.P. van Puijenbroek, 2014
11) One hundred and twenty cases of enduring sexual dysfunction following treatment, Hogan C, Le Noury J, Healy D, Mangin D, 2014
12) Penile anesthesia in post SSRI sexual dysfunction (PSSD) responds to low-power laser irradiation: A case study and hypothesis about the role of transient receptor potential (TRP) ion channels, Waldinger MD, van Coevorden RS, Schweitzer DH, Georgiadis J, 2014
13) Post-SSRI Sexual Dysfunction: Clinical Characterization and Preliminary Assessment of Contributory Factors and Dose-Response Relationship. Ben-Sheetrit J, Aizenberg D, Csoka AB, Weizman A, Hermesh H., 2015
