This weeks post was supposed to be just about Sexual Mysteries. What’s in a Touch?
As it was waiting to be posted, a controversy blew up about the International Society of Sexual Medicine and claims by Dr Anita Clayton that there is no such thing as PSSD.
There did not seem to be enough for a post in its own right but equally it seemed to make sense to say something and so a comment was added to an important post about Affective Touch.
Since posting the combined post, many people have been in touch about Dr Clayton and Vortioxetine and all the comments so far have been on this topic which risks drowning out an in the longer run more important message about Affective Touch. So RxISK has opted to take a step never taken before which is to switch the Clayton material into its own post and add the comments linked to this below.
Since posting the material below ISSM have delisted the Clayton video. This may be because of the comments from folk with PSSD – the ones I saw were all reasonable. Or it may be because folk have been in touch with ISSM and pointed out just how wrong and inappropriate this video was.
For those still interested to see the offending video – the link below should still work.
Conflict of Interest Mysteries
It is a pity to distract from the important issues above, but there has been a recent event that has caused a degree of consternation among PSSD folk.
The International Society for Sexual Medicine has just released a brief video on PSSD featuring Cobi Reisman and Anita Clayton.
Cobi gives the standard view, mentioning the Diagnostic Criteria.
Dr Clayton takes a very different appoach. She dismisses PSSD as an entity suggesting folk are depressed and in need of a better antidepressant like Vortioxetine. As it turns out she is an author on this Vortioxetine Paper saying it is better for sexual function than paroxetine. The conflict of interest statement at the end is interesting. She is on more than one Vortioxetine paper in fact.
There are prior RxISK posts about Vortioxetine causing a very SSRI like suicidality – just like paroxetine – See We Should talk about Brintellix.
RxISK also has a growing number of PSSD reports from people taking Brintellix, Trintellix, Vortioxetine – 6 at the latest count.
When we sent a petition to EMA to get a mention of PSSD added to drug labels, EMA exempted Vortioxetine – perhaps because it was relatively recent and on patent so Lundbeck were still making money on it. Perhaps back then – 4 years ago – there were so few Vortioxetine reports. It speaks to the power of companies that they can manage this.
Lundbeck used to described themselves as different to other companies – they were a Foundation. They implied they were more ethical. But with Vortioxetine they have shamelessly tried to exploit the market for SSRIs in children – running a huge trial in the Russian Federation and a range of other out of the way countries where many would be concerned about the quality of the trial data. They didn’t put this not so wonderful drug into trials in Denmark using Danish children.
The message isn’t all grim though. While people like Dr Clayton go around saying Vortioxetine is the next best thing to the Eucharist, she sells the message that the other drugs you might take are not.
Other companies have been in touch with me wondering if I’d endorse their drug and say that unlike others it doesn’t cause PSSD. I have not been willing to do so.
Some time there might finally be a drug that doesn’t cause PSSD, and the company making it will tell Dr Clayton to stress that PSSD is a real and devastating condition that other drugs really do cause – and this is not depression – depression never makes your genitals number. When that day arrives, the world will properly wake up to PSSD. Until then, any talk about PSSD, even if not on message all helps move things forward.
Comments
From M
Vortioxitine ruined my life I have PSSD for years because of this drug. I have been on many antidepressants and had no problems with sexual functioning until I took Vortioxitine
From S
Something else that Dr Clayton doesn’t realise is that many PSSD sufferers have already tried non-SSRI/SNRI antidepressants to no avail. If vortioxetine worked for PSSD, we would already know. I personally have tried it and it did nothing for my mood or sexual function. The only impressive thing about it was that it didn’t have any horrendous side effects that one would see with any SSRI.
It’s very interesting that she is suggesting vortioxetine as a treatment for a condition she doesn’t believe exists!
I think this post is correct though: the biggest PSSD breakthroughs will come when an AD is discovered that doesn’t cause sexual dysfunction. The patent-holding pharmaceutical company would be very wise to spend some money on the catastrophe that is PSSD.
From S
The website for the International Society for Sexual Medicine reveals that their Conflict of Interest Committee is staffed by… Anita Clayton herself!
https://www.issm.info/about/co
The question is: why didn’t they declare her CoIs beneath this video?
From D
I imagine they will respond by saying these are her genuinely held beliefs and this therefore is not a conflict of interest.
D
Ruben says
Dr. Healy,
I appreciate your attention to this matter. The PSSD Reddit and Twitter community worked together to create a powerful outcry.
It has been three years since the EMA acknowledged the persistence of sexual issues post-discontinuation. There is no justification for allowing such a high degree of misinformation to persist.
Let us hope that the ISSM has learned from this experience.
Ruben
Cory says
Thanks for all that you do for the PSSD community. Its very much appreciated.
Sylv says
It should be clarified, that severe depression doesn’t cause numbed genitals only in a drug-naive population which never got treated. If someone had previous exposure to SSRI depression or stress then depression indeed can cause or worse numbed genitals. This is evident from many testimonies and speaks about persistent asymptomatic damage being masked by good mental health. SSRI Damage becomes symptomatic after worsening of mental state. The stress – symptoms severity correlation is true also for akathisia, emotional bluting and tardive dyskinesia. Given the mass usage of SSRI It’s easy for some opinion leaders to push the idea that depression always caused numbed genitals, but the symptom was overlooked in older research / diagnostic system
Dr. David Healy says
S – genital numbness is not and has never been a symptom of depression. People on finasteride and isotretinoin also get this genital numbness and its not part of losing your hair or developing acne either
David
Arjan says
At 1:41 she mentions billions of people, is that accurate?
Sarah Browne says
The comments beneath the video have been turned off.
Dr. David Healy says
If anyone has saved them, we can post them here
D
annie says
These few comments below Dr. Anita’s Video give a fair idea of how welcome her video was
https://www.reddit.com/r/PSSD/comments/139fc7g/what_is_post_ssri_syndrome_and_how_is_it_treated/
Anita Clayton, MD: New Drugs to Treat Sexual Dysfunction in Depression Patients
https://www.youtube.com/watch?v=KNSQSp3ZlsY
2,783 views 31 Jan 2020
She’s been at this awhile…
susanne says
May 10, 2023 at 1:38 pm
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Rob says
From the Vortioxetine paper mentioned: Conflicts of Interest: A.C. (Anita Clayton) reports grants from Endoceutics, Janssen Pharmaceutica, Sage Therapeutics, and Takeda Pharmaceuticals; advisory board or consultant fees from Acadia, Alkermes, Allergan, AMAG Pharmaceuticals, Fabre-Kramer, Lundbeck, Otsuka, Palatin Technologies, S1 Biopharma, Sage Therapeutics, Sprout Pharmaceuticals, and Takeda Pharmaceuticals; royalties or copyrights from Ballantine Books, Changes in Sexual Functioning Questionnaire, and Guilford Publications; and shares or restricted stock units from Euthymics and S1 Biopharma.
P.J., W.Z., and G.N. were employees of Takeda Development Center Americas, Inc., at the time of the study.
Funding: This study was funded by Takeda Pharmaceuticals U.S.A. The sponsor was involved in study design and implementation, analysis and interpretation of the data, writing of the report, and the decision to submit the article for publication.
Medical writing assistance was provided by inVentiv Medical Communications, LLC, a Syneos Health group company, and supported by Takeda Pharmaceuticals U.S.A., Inc.
Andreas says
The video was reposted by ISSM without any changes and with the comments disabled! This is ridiculous..