title: 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.
abstract: Treatment of paroxetine-induced penile anesthesia in Post SSRI Sexual Dysfunction (PSSD) by Low-power Laser Irradiation (LPLI) is unknown in medical literature. The aim of the current article is to report partial efficacy of LPLI for paroxetine-induced persistent penile anesthesia. We report on a male patient who presented with a history of reversible loss of smell, taste and skin sensitivity occurring within a week after start of 20mg/day paroxetine-hemihydrate for a depressive period. Concurrently, patient suffered from penile anesthesia, scrotum hypesthesia, anejaculation and erectile difficulties with normal sexual desire. During 2.5 years of paroxetine treatment and throughout 2 years after paroxetine discontinuation, genital and sexual complaints persisted. Penile anesthesia was treated by LPLI with single and multi diode pulsed laser probes. After 20 LPLI-treatment sessions of 15min each, patient reported partial return of penile touch and temperature sensation. Clinical improvement of glans penis sensitivity was reported to 20% and 40%, compared to pre-paroxetine treatment penile sensitivity during erect and flaccid states, respectively. However, anejaculation and erectile difficulties remained unchanged. Briefly, in the current patient with early onset of PSSD, LPLI treatment reduced paroxetine-induced penile anesthesia. It is hypothesized that SSRI treatment induces disturbances of transient receptor potential (TRP) ion channels of mechano-, thermo- and chemosensitive nerve endings and receptors resulting in the penile anesthesia in PSSD. It is further hypothesized that there are two types of PSSD, one of which occurs soon after the start of SSRI treatment.
authors.affiliation: Division of Pharmacology, Utrecht Institute for Pharmaceutical Sciences, Faculty of BetaSciences, Utrecht University, Universiteitslaan 99, 3584 CG Utrecht, The Netherlands; Private Practice Psychiatry and Neurosexology, Amstelveen, The Netherlands. Electronic address: md@waldinger.demon.nl.
authors.forename: Marcel D
authors.initials: MD
authors.lastname: Waldinger
authors.affiliation: Medisch Centrum Buitenveldert, Amsterdam, The Netherlands.
authors.forename: Ruben S
authors.initials: RS
authors.lastname: van Coevorden
authors.affiliation: Department of Internal Medicine and Endocrinology, Reinier de Graaf Groep of Hospitals, Delft-Voorburg, The Netherlands.
authors.forename: Dave H
authors.initials: DH
authors.lastname: Schweitzer
authors.affiliation: Department of Neuroscience, Section Anatomy, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.
authors.forename: Janniko
authors.initials: J
authors.lastname: Georgiadis
mesh_terms: D000328:Adult; D006801:Humans; D028022:Low-Level Light Therapy; D008297:Male; D017374:Paroxetine / Q000009:adverse effects; D010413:Penis / Q000187:drug effects / Q000378:metabolism* / Q000528:radiation effects*; D012735:Sexual Dysfunction, Physiological / Q000139:chemically induced / Q000378:metabolism* / Q000532:radiotherapy*; D050051:Transient Receptor Potential Channels / Q000378:metabolism*
chemical_list: D050051:Transient Receptor Potential Channels; D017374:Paroxetine
keywords: Low-power laser irradiation; Paroxetine; Penile anesthesia; Post SSRI sexual dysfunction; TRPV1; Transient receptor potential