When did it begin?
Post-SSRI Sexual Dysfunction (PSSD) officially made its debut in the peer-reviewed medical literature in 2006. Case reports were published that identified treatment-emergent sexual dysfunction that persisted after the antidepressant was stopped. The condition was given a name and its features were defined.
This new literature also noted the significance of a study dating back to 1999 by Montejo et al. It appears to be the first published clinical trial to have captured the persisting sexual side effects that SSRIs can cause. However, this wasn’t the purpose of the study and it seems that little was made of the finding at the time.
Between the efforts of drug companies to manage concerns about sexual side effects, through to the wider problem of doctors failing to engage with patients on the subject of treatment-related issues, it’s unsurprising that the condition took such a long time to appear in the medical literature.
We know that even today, people who are diagnosed with PSSD can discover that their doctor hasn’t reported it to the country’s drug regulator, and that their diagnosis can appear somewhat buried in the medical records. There remains a very real sense that PSSD is something that health professionals don’t like to talk about.
Who was talking about it?
Even though the condition didn’t appear in the medical literature until 2006, could it have been mentioned earlier in another type of publication?
We certainly know the condition was being seen in clinical practice. We also know that people were reporting it.
A paper by Hogan et al noted that the Medicines and Healthcare products Regulatory Agency (MHRA) in the UK had received over 200 reports of persistent sexual side effects linked to SSRIs prior to the condition appearing in the literature, and without any public awareness of the issue.
If people were going to the trouble of reporting it to a country’s drug regulator, perhaps someone affected or someone in the health profession was also concerned enough to write about it – though it obviously wouldn’t have been called PSSD at the time.
It’s worth noting that while the problem is most commonly associated with SSRIs and SNRIs, it can also happen with some tricyclics that act as serotonin reuptake inhibitors. It’s therefore possible that something may have even appeared in print prior to the introduction of the SSRIs, although this is less likely as it wasn’t until the marketing of the SSRIs that the use of antidepressants became commonplace.
Were you there?
Perhaps you were working as a healthcare professional or medical researcher in the early 2000s, 1990s or 1980s and remember reading or hearing about the problem. Perhaps you wrote an article that appeared in a magazine, newspaper or some other publication. Maybe you mentioned it in a book that is no longer in print.
Are there any doctors or researchers who attempted to publish an article or case reports, but were turned down by a medical journal?
It would be interesting to hear from anyone working in psychosexual therapy. With the explosion of antidepressant use in the last two decades, they will undoubtedly be seeing patients with medication-related problems. It would be interesting to know when PSSD first came onto their radar.
On March 11th 2014, the Dutch newspaper Volkskrant featured an article about PSSD on its front page, prompted by a report about the condition from Lareb, the Netherlands Pharmacovigilance Centre. Is there a chance that the problem was mentioned in a European magazine or newspaper prior to 2006?
If you are aware of such material, we would like to hear from you. Please either leave a comment at the end of this post, or you can contact us through the website.
It would be interesting to fill out some of the early history of PSSD. Who knows what we might discover?