Persistent Sexual Side Effects After Discontinuation of SRIs: Protocol for a Scoping Review of Symptoms and Birth-Assigned Sex Comparisons

Treatment-emergent sexual dysfunction occurs in up to 70% of individuals treated with selective serotonin reuptake inhibitors (SSRIs), a common class of antidepressants used to treat a wide spectrum of mental illnesses. In most cases, sexual effects resolve shortly after medication discontinuation; however, in some cases, treatment-emergent sexual symptoms persist chronically after treatment cessation. This phenomenon, termed “post-SSRI sexual dysfunction” (PSSD), can occur after treatment with any serotonin reuptake inhibitor (SRI). The pathophysiology of PSSD, and its distinction from that of temporary SRI-induced sexual dysfunction, are poorly characterized. Clinically, this is a condition that is rarely discussed when SRI treatment is initiated and under-recognized when it occurs. Understanding how to counsel about, recognize, and treat PSSD in individuals of all sexes is important to ensure that patients can meaningfully consent to taking SRIs and receive help if PSSD develops. Currently, the knowledge gaps in research and in practice are significant. We intend to perform a scoping review to synthesize the most up-to-date and comprehensive evidence on PSSD with a particular focus on differences by birth-assigned sex. Synthesizing existing evidence is important to provide the most up-to-date and comprehensive evidence to clinicians in the present, and to serve as a basis to guide future, much-needed primary research studies.