Być może antagoniści dopaminy
(leki zmniejszające przekaźnictwo dopaminy), po odstawieniu spowodują większa aktywność układu dopaminy ze względu na sensytyzację receptorów dopaminy. W tym artykule znajdziemy informacje że sensytyzacja i desensytyzacja receptorów może nastapić po zażyciu nawet 1 dawki leku. Co może tłumaczyć przypadki PSSD po zazyciu kilku dawek leku SSRI:http://www.utexas.edu/research/asrec/dopamine.html
-- 02 cze 2013, 22:48 --Poniżej zamieszczam trochę artykułów naukowych dokumentujących PSSD:
Bahrick, Audrey S., and Mark M. Harris, "Sexual Side Effects of Antidepressant Medications: An Informed Consent Accountability Gap."
Journal Of Contemporary Psychotherapy, Vol 39(2), June 2009, pp 135-143. No PubMed abstract. http://www.mediafire.com/download/418mevgy4gzo9eo/09_06_sexual_side_effects_bahrick.pdf
Abstract from the paper:
Sexual side effects of antidepressant medications are far more common than initially reported, and their scope, quality, and duration remain poorly captured in the literature. Antidepressant treatment emergent sexual dysfunctions may decrease clients’ quality of life, complicate psychotherapy, and damage the treatment alliance. Potential damage to the treatment alliance is greatest when clients have not been adequately informed of risks related to sexual side effects. It had previously been assumed that sexual side effects always resolve shortly after medications are discontinued. Emerging evidence, however, suggests that in some individuals, sexual dysfunction side effects may persist indefinitely. The authors argue that all psychologists should be well-informed about sexual side effects risks of antidepressant medications, should routinely conduct a pre-medication baseline assessment of sexual functioning, and take an active role in the informed consent process.
Farnsworth K, Dinsmore W. Persistent sexual dysfunction in genitourinary medicine clinic attendees induced by selective serotonin reuptake inhibitors.
International Journal of STD & AIDS [serial online]. 2009;20(1):68-69. No PubMed abstract. http://www.mediafire.com/download/2ing236fwwzkx36/09_01_persistent+sexual+dysfunction_farnsworth.pdf
From this letter to the journal editor:
Sir: It is widely known that selective serotonin reuptake inhibitors (SSRIs) can cause various types of sexual dysfunction (SD) and recent studies have shown that prevalence may be as high as 60%1 among SSRI users. Emerging evidence shows that in some patients SD may persist and even worsen, long after treatment cessation. It is this group of long-term post-SSRI treatment sufferers that we are concerned with here....
Csoka AB, Bahrick A, Mehtonen O. Persistent sexual dysfunction after discontinuation of selective serotonin reuptake inhibitors. Journal of Sexual Medicine
[serial online]. January 2008;5(1):227-233.
Abstract at http://www.ncbi.nlm.nih.gov/pubmed/18173768
Sexual dysfunctions such as low libido, anorgasmia, genital anesthesia, and erectile dysfunction are very common in patients taking selective serotonin reuptake inhibitors (SSRIs). It has been assumed that these side effects always resolve after discontinuing treatment, but recently, four cases were presented in which sexual function did not return to baseline. Here, we describe three more cases. Case #1: A 29-year-old with apparently permanent erectile dysfunction after taking fluoxetine 20 mg once daily for a 4-month period in 1996. Case #2: A 44-year-old male with persistent loss of libido, genital anesthesia, ejaculatory anhedonia, and erectile dysfunction after taking 20-mg once daily citalopram for 18 months. Case #3: A 28-year-old male with persistent loss of libido, genital anesthesia, and ejaculatory anhedonia since taking several different SSRIs over a 2-year period from 2003-2005.
No psychological issues related to sexuality were found in any of the three cases, and all common causes of sexual dysfunction such as decreased testosterone, increased prolactin or diabetes were ruled out. Erectile capacity is temporarily restored for Case #1 with injectable alprostadil, and for Case #2 with oral sildenafil, but their other symptoms remain. Case #3 has had some reversal of symptoms with extended-release methylphenidate, although it is not yet known if these prosexual effects will persist when the drug is discontinued.
SSRIs can cause long-term effects on all aspects of the sexual response cycle that may persist after they are discontinued. Mechanistic hypotheses including persistent endocrine and epigenetic gene expression alterations were briefly discussed.
Kauffman, R., Murdock A. "Prolonged Post-Treatment Genital Anesthesia and Sexual Dysfunction Following Discontinuation of Citalopram and the Atypical Antidepressant Nefazodone."
The Open Women Health Journal, 2007 (1), 1-3. No Pubmed abstract. http://www.mediafire.com/download/ecbr82l82aqlz7l/07_prolonged+post-treatment+genital+anesthesia+_kauffman.pdf
Abstract from the paper: SSRI therapy is commonly associated with sexual side effects, but it is assumed that these distressing symptoms resolve with termination of therapy. The atypical antidepressant nefazodone is infrequently associated with sexual dysfunction and may be substituted for SSRI’s when sexual symptoms are intolerable. Recently, scattered case reports of persistent sexual dysfunction and genital anesthesia persisting well after termination of SSRI antidepressant therapy have surfaced. In each case, the underlying depressive disorder was in remission.
Case: A 32-year old women with major depression was treated with citalopram but switched to nefazodone after 4 weeks of therapy due to genital anesthesia and orgasmic dysfunction. These symptoms continued following institution of nefazodone therapy and have persisted for over a year since termination of antidepressant treatment. Her depression remains in full remission.
Discussion: It is likely that persistent post-treatment genital anesthesia and other sexual side effects are underreported, and physicians should be aware of this bothersome phenomenon. Formal post-treatment surveillance for this condition is war- ranted. Pharmacogenomic research may ultimately allow physicians to predict who is at risk for antidepressant induced sexual side effects.
Bahrick, Audrey S, "Post-SSRI Sexual Dysfunction."
ASAP Tablet, Vol 7(3), Sept 2006, pg 2.
No PubMed abstract. http://www.mediafire.com/download/llbqps2wuamfdmq/06_09_pssd_bahrick.pdf
From the article:
Post-market research has now firmly established that the SSRIs and SNRIs can significantly affect most every aspect of sexual functioning at rates significantly higher than the 5-15% reported in pre-market trials. Depending on definitions of sexual dysfunction and methodology, post-market prevalence studies have found rates between 36% and 98%. The 5 to 15% rates of SSRI and SNRI-induced sexual side-effects listed in the current drug-insert literature are based on information obtained in the initial trials via spontaneous reports of individuals who had been on the medications for a short time. The differences in reported rates between the pre-market trials and post-market prevalence studies are an artifact of methodology; we now know that when individuals are directly asked about their experience of sexual side effects via either a structured clinical interview or a self-report inventory, we obtain vastly different rate information than if we rely on individuals to spontaneously volunteer personally sensitive information about changes in sexual functioning....
Csoka AB, Shipko S. "Persistent sexual side effects after SSRI discontinuation."
Psychother Psychosom. 2006;75(3):187-8. No PubMed abstract. http://www.mediafire.com/download/hn31cmg4n28bq3x/06_pssd_Csoka.pdf
Bolton J, Sareen J, Reiss J. Genital anaesthesia persisting six years after sertraline discontinuation. Journal of Sex & Marital Therapy [serial online].
July 2006;32(4):327-330. http://www.mediafire.com/download/ja7uun3cr7mmgu7/06_Genital+Anaesthesia_bolton.pdf
Also see references here http://www.nationmaster.com/encyclopedia/Post-SSRI-Sexual-Dysfunction
^ Bahrick A. Post SSRI Sexual Dysfunction. American Society for the Advancement of Pharmacotherapy Tablet 2006; 7:2-10.
^ Kauffman, RP. Persistent Sexual Side Effects after Discontinuation of Psychotropic Medications Primary Psychiatry. 2008;15:24.
^ Zajecka J, Mitchell S, Fawcett J. Treatment-emergent changes in sexual function with selective serotonin reuptake inhibitors as measured with the rush sexual inventory Psychopharmacol. Bull. 1997;33:755-60. PMID 9493488.
^ Balon, R. SSRI-associated sexual dysfunction Am J Psychiatry. 2006;163:1504-1509. PMID 16946173.
^ Montejo AL, Llorca G, Izquierdo JA, Carrasco JL, Daniel E, Perez-Sola V, Vicens E, Bousono M, Sanchez-Iglesias S, Franco M, Cabezudo A, Rubio V, Ortega MA, Puigdellivol M, Domenech JR, Allue B, Saez C, Mezquita B, Galvez I, Pacheco L, de Miguel E. Sexual dysfunction with antidepressive agents. Effect of the change to amineptine in patients with sexual dysfunction secondary to SSRI. Actas Esp Psiquiatr. 1999;27:23-34. PMID 10380144.
^ a b Csoka AB, Shipko S. Persistent sexual side effects after SSRI discontinuation. Psychother Psychosom 2006;75:187-8. PMID 16636635.
^ Bolton JM, Sareen J, Reiss JP. Genital anaesthesia persisting six years after sertraline discontinuation. J. Sex Marital Ther. 2006;32:327-30. PMID 16709553.
^ Kauffman RP, Murdock A. Prolonged Post-Treatment Genital Anesthesia and Sexual Dysfunction Following Discontinuation of Citalopram and the Atypical Antidepressant Nefazodone. The Open Women’s Health Journal. 2007;1:1-3.
^ Csoka AB, Bahrick AS, Mehtonen O-P. Persistent Sexual Dysfunction after Discontinuation of Selective Serotonin Reuptake Inhibitors (SSRIs). J Sex Med. 2008; 5:227-33.
^ Goldmeier D, Leiblum SR. Persistent genital arousal in women - a new syndrome entity Int J STD & AIDS 2006; 17:215-6. PMID 16595040.
^ Goldmeier D, Bell C, Richardson D. Withdrawal of selective serotonin reuptake inhibitors (SSRIs) may cause increased atrial natriuretic peptide (ANP) and persistent sexual arousal in women? J Sex Med. 2006;3:376. PMID 16490037.
^ Leiblum SR, Goldmeier D.Persistent genital arousal disorder in women: case reports of association with anti-depressant usage and withdrawal.J Sex Marital Ther. 2008;34:150-9 PMID 18224549.
^ Adson DE, Kotlyar M. Premature ejaculation associated with citalopram withdrawal. Ann Pharmacother. 2003;37:1804-6. PMID 14632589.
^ Hines RN, Adams J, Buck GM, Faber W, Holson JF, Jacobson SW, Keszler M, McMartin K, Segraves RT, Singer LT, Sipes IG, Williams PL. NTP-CERHR Expert panel report on the reproductive and developmental toxicity of fluoxetine.NIH Publication No. 05-4471. 2004;1-211.
^ Maciag D, Simpson KL, Coppinger D, Lu Y, Wang Y, Lin RC, Paul IA. Neonatal Antidepressant Exposure has Lasting Effects on Behavior and Serotonin Circuitry. Neuropsychopharmacology. 2006;31:47-57. PMID 16012532.
^ de Jong TR, Snaphaan LJ, Pattij T, Veening JG, Waldinger MD, Cools AR, Olivier B. Effects of chronic treatment with fluvoxamine and paroxetine during adolescence on serotonin-related behavior in adult male rats. Eur Neuropsychopharmacol. 2006;16:39-48. PMID 16107310.
^ Maciag D, Coppinger D, Paul IA. Evidence that the deficit in sexual behavior in adult rats neonatally exposed to citalopram is a consequence of 5-HT(1) receptor stimulation during development. Brain Res. 2006;1125:171-5. PMID 17101120.
^ Hansen HH, Mikkelsen JD. Long-term effects on serotonin transporter mRNA expression of chronic neonatal exposure to a serotonin reuptake inhibitor. Eur J Pharmacol. 1998;352:307-15. PMID 9716368.
^ Raap DK, Garcia F, Muma NA, Wolf WA, Battaglia G, van de Kar LD. Sustained desensitization of hypothalamic 5-Hydroxytryptamine1A receptors after discontinuation of fluoxetine: inhibited neuroendocrine responses to 8-hydroxy-2-(Dipropylamino)Tetralin in the absence of changes in Gi/o/z proteins. J Pharmacol Exp Ther. 1999;288:561-7. PMID 9918559.
^ Faure C, Ouissame MF, Nasser H. Long-term adaptive changes induced by serotonergic antidepressant drugs. Expert Rev Neurother. 2006;6:235-45. PMID 16466303.
^ Palotas M, Palotas A, Puskas LG, Kitajka K, Pakaski M, Janka Z, Molnar J, Penke B, Kalman J. Gene expression profile analysis of the rat cortex following treatment with imipramine and citalopram. Int J Neuropsychopharmacol. 2004;7:401-13. PMID 15315716.
^ Kalman J, Palotas A, Juhasz A, Rimanoczy A, Hugyecz M, Kovacs Z, Galsi G, Szabo Z, Pakaski M, Feher LZ, Janka Z, Puskas LG. Impact of venlafaxine on gene expression profile in lymphocytes of the elderly with major depression--evolution of antidepressants and the role of the "neuro-immune" system. Neurochem Res. 2005;30:1429-38. PMID 16341940.
^ Yamada M, Yamada M, Higuchi T. Antidepressant-elicited changes in gene expression: remodeling of neuronal circuits as a new hypothesis for drug efficacy. Prog Neuropsychopharmacol Biol Psychiatry. 2005;29:999-1009. PMID 15975701.
^ Boehm C, Newrzella D, Herberger S, Schramm N, Eisenhardt G, Schenk V, Sonntag-Buck V, Sorgenfrei O. Effects of antidepressant treatment on gene expression profile in mouse brain: cell type-specific transcription profiling using laser microdissection and microarray analysis. J Neurochem. 2006; 97 Suppl 1:44-9. PMID 16515540.
^ Hyman SE. Even chromatin gets the blues. Nat Neurosci. 2006;9:465-6. PMID 16568101.
^ Newton SS, Duman RS. Chromatin Remodeling: A Novel Mechanism of Psychotropic Drug Action (Relates to article by Cassel, et al. FastForward 2 May 2006). Mol Pharmacol. 2006;70:440-3. PMID 16728645.
^ Tsankova NM, Berton O, Renthal W, Kumar A, Neve RL, Nestler EJ. Sustained hippocampal chromatin regulation in a mouse model of depression and antidepressant action. Nat Neurosci. 2006;9:519-25. PMID 16501568.
^ Cassel S, Carouge D, Gensburger C, Anglard P, Burgun C, Dietrich JB, Aunis D, Zwiller J. Fluoxetine and cocaine induce the epigenetic factors MeCP2 and MBD1 in adult rat brain. Mol Pharmacol. 2006;70:487-92. PMID 16670375.
^ Altar CA, Laeng P, Jurata LW, Brockman JA, Lemire A, Bullard J, Bukhman YV, Young TA, Charles V, Palfreyman MG. Electroconvulsive seizures regulate gene expression of distinct neurotrophic signaling pathways. J Neurosci. 2004;24:2667-77. PMID 15028759.
^ Tsankova NM, Kumar A, Nestler EJ. Histone modifications at gene promoter regions in rat hippocampus after acute and chronic electroconvulsive seizures. J Neurosci. 2004;24:5603-10. PMID 15201333.
^ Cohen AJ. Antidepressant-Induced Sexual Dysfunction Associated with Low Serum Free Testosterone. Psychiatry Online 1999.
^ Tanrikut C, Schlegel PN. Antidepressant-associated changes in semen parameters. Urology. 2007;69:185.e5-7. PMID 17270655.
^ Szyf M. Toward a Discipline of Pharmacoepigenomics. Current Pharmacogenomics 2004;2:357-377.
^ Lacasse JR, Leo J. Serotonin and Depression: A Disconnect between the Advertisements and the Scientific Literature. PLoS Medicine 2005;2:e392.
^ Moncrieff J, Cohen D. Do Antidepressants Cure or Create Abnormal Brain States? PLoS Medicine 2006;3:e240.
^ Damsa C, Bumb A, Bianchi-Demicheli F, Vidailhet P, Sterck R, Andreoli A, Beyenburg S. "Dopamine-dependent" side effects of selective serotonin reuptake inhibitors: a clinical review. J Clin Psychiatry. 2004;65:1064-8. PMID 15323590.
^ Keltner NL, McAfee KM, Taylor CL. Mechanisms and treatments of SSRI-induced sexual dysfunction. Perspect Psychiatr Care. 2002 Jul-Sep;38(3):111-6. PMID 12385082.