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Although an AFD resulted in a merge for this subject, I have recreated the page from a new draft. The reason is that AFD was 9 years ago, and there have been more publications on the topic since, including reviews.
[1][2][3][4] Si I suspect MEDRS is now satisfied.
Graeme Bartlett (
talk)
22:30, 12 December 2022 (UTC)reply
There are numerous indications of serotonergic damage
in humans. In a PET scan study, McCann et al. (1998)
documented a reduced density of 5-HT transporter sites,
which correlated with the extent of past Ecstasy use;
Also this point is different compared to PSSD as PSSD is not dose dependent
I think it's worth including, simply because MDMA represents another case of a serotonergic medication that can cause lasting symptoms similar to PSSD. There doesn't seem to be a 1-to-1 correlation between PSSD and post-MDMA damage, but nonetheless I don't think one can rule out a possible similarity in mechanism.--
Xardwen (
talk)
22:39, 19 February 2023 (UTC)reply
This blog post includes and updates a list of PSSD literature. I believe it could be used on the page since it doesn't make any claims and only is links to articles making it verifiable.
I understand the point of including the number of members on the PSSD forum and Reddit, ostensibly to show how many people the condition effects. However, other pages like
breast cancer do not list the number of subscribers to r/breastcancer or on any breast cancer forums, and I fail to see how the size of the forums are useful information to the topic at hand.
Yoleaux (
talk)
19:22, 4 February 2023 (UTC)reply
I think it's worth including given that PSSD is currently very under-studied, and there aren't really any "official" metrics to point to when trying to estimate how many people suffer from the condition. The two sources cited earlier under the "Frequency of PSSD" heading plus the online survey in the following section are pretty much all we have, and none of these have very large sample sizes. Given the absence of wide-ranging, well-conducted studies, the next best thing would seem to be listing frequency of self-reports, which membership within support groups is somewhat of a proxy for. At the very least, it suggests that there are thousands of individuals across the world who have this problem, as opposed to say tens or hundreds. --
Xardwen (
talk)
22:34, 19 February 2023 (UTC)reply
I think it's the only frequency indicator of this disease right now before more studies are done. Breat cancer don't have this problem since they know relevant frequencies.
FallingPineapple (
talk)
21:37, 21 February 2023 (UTC)reply
Genital Numbness after use of SSRI
There were 2 studies which I currently can't find which are directly linked to PSSD
1- 70-85%(can't remember exact number) of patients within 1 hour of taking SSRI had genital numbness
2- a percentage (although small <10%) had persisting sexual dysfunction in one SSRI trial.
I am concerned about the sourcing of this article, I removed some content that was poorly sourced but it's clear to me that it needs a rewrite to dramatically reduce the amount of unconfirmed speculation in the article and focus on what it says in secondary MEDRS compliant sources. One source I manually checked did not even mention the subject, which is an original research problem. (
t ·
c) buidhe06:31, 18 April 2023 (UTC)reply
You have removed all tertiary references in the guise of removing "excessive quotations" instead of only removing quotations that you seem not to be fit, if the "excessive quotations" were the problem why are you not only removing the quotations but have removed all the tertiary references alongside it?
You have removed majority of recognised standard textbooks/
medical guidelines and position statements from national or international expert bodies such as DSM-5 and BNF in the guise of removing primary sources. (WP:MEDRS). Removal of whole sections with no regard to WP policies are not allowed per
WP:Vandal.
The article still has a lot of primary sources. A bunch of strung together quotations is not allowed per the rules on quotations. (
t ·
c) buidhe14:08, 22 April 2023 (UTC)reply
In this edit
[5] as mentioned in the previous reply, you have removed majority of tertiary sources pretending you're only removing quotations which is against WP:Quote. Since the quotations are from tertiary sources removing the whole section and references to them is against Wikipedia policies.
Instead of only removing primary sources, you've removed majority of WP:MEDRS compliant sources.
You're welcome to write encyclopedic prose and cite any medrs compliant sources. What I removed was not that. (
t ·
c) buidhe17:07, 22 April 2023 (UTC)reply
You have deleted all references from
DSM-5,
BNF, references to
NHS statement, Textbook of Rare Sexual Medicine Conditions which are all WP:MEDRS compliant. Your edits were against
WP:BABY and WP:QUOTE
Sources which are compliant with
WP:MEDRS as mentioned below.
"reliable, third-party, published secondary sources (such as reputable
medical journals), recognised standard textbooks by experts in a field, or
medical guidelines and position statements from national or international expert bodies."
Please review
WP:ONUS. Even if all content has wp:medrs compliant sources (it does not) that would not guarantee coverage in the article. Wp:baby is an essay, please stop bringing it up as though it is a guideline or backed by consensus. (
t ·
c) buidhe19:16, 23 April 2023 (UTC)reply
It's not clear to me that rxisk is a reliable source in general. What evidence is there that it has a reputation for accuracy? For healthcanada, just cite healthcanada.
No, I do not agree that the content cited to the medrs sources should be restored. Just because the sources are OK does not mean that the content was encyclopedic. (
t ·
c) buidhe21:49, 23 April 2023 (UTC)reply
Regarding content not being encyclopedic. I notice you've removed the whole BNF section
in your edit. Can you write an encyclopedic version of the BNF section for instance so it'd be clear what type of content would suffice? If only the 1 line quote was removed would you consider it encyclopedic?
Per WP:blogs
"Self-published expert sources may be considered reliable when produced by an established
subject-matter expert, whose work in the relevant field has previously been published by
reliable, independent publications"
It is written by a subject expert who's published multiple times in prestigious journals regarding the same subject. Since the information is off reporting nature mirroring healthcanada information it can be used. per WP:MEDRS
FallingPineapple (
talk)
23:40, 23 April 2023 (UTC)reply
If so then there's no need for attribution. Just find a source that explicitly says a certain drug can cause PSSD and put it in wikivoice without mentioning various medical agencies. (
t ·
c) buidhe00:30, 24 April 2023 (UTC)reply
I just looked for multiple medications on Wikipedia, and they have written about blackbox warnings on their Wikipedia pages, your examples seem to be suffering from selection bias. Hence your argument is WP:! .
FallingPineapple (
talk)
00:21, 24 April 2023 (UTC)reply
Blackbox warnings may be included in articles on a specific medication—but this article is not about a specific medication, but rather a drug induced condition. (and are the BNF warnings black box? all medications have warnings and side effects). Just because content may be WP:DUE in one article does not make it WP:DUE in another. If we're going to have information about which drugs have warnings attached, I think it would be better to present that in a list of medications i.e.
Medication 1 (agency 1, agency 2)
Otherwise I don't see how this type of content could be WP:DUE. Also, I am not sure in this case if citing sources that don't explicitly mention PSSD could be original research. (
t ·
c) buidhe00:27, 24 April 2023 (UTC)reply
BNF warnings are within the BNF reference book and their website + on the medication leaflets etc
User buidhe is removing entire WP:MEDRS sources from
NHS,
European Medicines Agency and Psychological textbooks repeatedly even after being warned about his/her violations of WP:BABY.
You've been removing tertiary sources despite being told not to multiple times, you revert changes that introduce the removed tertiary based on an strawman of existence of sources which do not exist in the edit. Please read the change logs before undoing again! You're reverting only based on assuming what's going to be in the article.
In case you decide to remove tertiary sources again, you need to explain your reasoning.
"A general misunderstanding of the Help:Reverting (WP:REVERT) process and Wikipedia:Reverting (WP:RV) essay as meaning "undo anything that is not perfect":
An editor determines a portion of another contributor's edit needs to be deleted, but removes the entire contribution instead of just the portion that needs to be deleted."
Stop removing WP:MEDRS sources, if you find any problematic parts they should be removed, compliant sources should not be removed based on
WP:BABY. If you have a problem with the information from governmental bodies you need to make that clear with better sources instead of removing them with no reason.
FallingPineapple (
talk)
16:38, 23 April 2023 (UTC)reply
(News sources may be useful for non-biomedical content, such as information about "society and culture" – see
WP:MEDPOP.)
"Post-SSRI sexual dysfunction - An important iatrogenic condition, recognised by regulators"
1
"The announcement came earlier this week. On June 11, the European Medicines Agency
formally declared that it was recognizing Post-SSRI Sexual Dysfunction (PSSD) as a medical condition that can outlast discontinuation of SSRI and SNRI
antidepressants."
32
There are many other tertiary sources such as "Textbook of Rare Sexual Medicine Conditions, chapter named "Post-SSRI Sexual Dysfunction (PSSD)"
4
The EMA didn't describe PSSD as a "disorder" so I would consider it to fail verification. It said that sexual dysfunction was a possible side effect of ssri usage which is not the same thing as being its own disorder. (
t ·
c) buidhe14:09, 16 July 2023 (UTC)reply
Also the EMA mentions persistent sexual dysfunction after use of SSRI has stopped, it differs from your misinterpretation of it ("possible side effect of ssri usage which is not the same thing as being its own disorder").
FallingPineapple (
talk)
14:22, 16 July 2023 (UTC)reply
The claim that EMA has recognized the diagnosis seems to have been plastered all over the internet in an attempt to validate the diagnosis in the public eye. I think
this exhange is of interest, it is not a MEDRS source, but the claim that "...it is not within the remit of the EMA to classify medical conditions." seems correct. That is not the role of a medical products agency.
Page 449 of the 2013 edition of the DSM-5 states the following: “In some cases, serotonin reuptake inhibitor-induced sexual dysfunction may persist after the agent is discontinued.” (link to a RxiSK post which provides a PDF of the relevant section from the DSM: (Redacted))
Xardwen (
talk)
18:32, 18 July 2023 (UTC)reply
Xarden you have linked an
WP:ELNEVER copyright violation. The DSM is copyrighted, and we cannot accept on Wikipedia a forum post that breaches copyright by publishing a scan of a copyrighted work. Please don't do that again; that forum is not welcome anywhere on Wikipedia as it breaches copyright.
SandyGeorgia (
Talk)
20:58, 18 July 2023 (UTC)reply
Xardwen this
addition is now the third instance of you not understanding the importance of
WP:COPYRIGHT and
intellectual property. First, a Youtube of that nature is
WP:UNDUE in this article, even if it had been a legit BBC YouTube; in that case, it could belong in External links. But it's not a BBC YouTube; who is Tower Ravens and how do they have the copyrights to this segment ? Please take care greater care to respect that when you edit Wikipedia, you have to understand policies, as your edits are immediately live.
SandyGeorgia (
Talk)
22:53, 19 July 2023 (UTC)reply
I think a little background information might help here.
The first thing to know is that the study of what's "a medical condition" (a disease, a disorder, a syndrome, etc.) and what's not is called
nosology. It's a real academic field, and there are some core principles involved:
To be "a medical condition", the first important principle is that it has to be a medical condition, as in just one medical condition. Although there's some level of the usual
Lumpers and splitters debate in the field, they're all united in saying that you can't lump separate things together. (For example:
Da Costa's syndrome is not "a medical condition" because it is actually (at least) three separate medical conditions [PTSD,
mitral valve prolapse, and
ME/CFS, and probably traumatic brain injury as well], with all with completely different causes and somewhat different symptoms.) This situation probably qualifies as a single entity, but of course it's up to the experts, not the Wikipedia editors, to decide that.
The other main bit is to sort out is what kind of medical "thing" it is. Generally speaking, this process requires figuring out if there is a known
etiology and a consistent pattern of symptoms. In the real world, the main point of this step is so that when a doctor says the baby has Scaryitis, all the other doctors know exactly what condition was diagnosed, but the part that we care about right now is the categories they think in. If you have a consistent pattern but no known etiology [initially], then it will generally be called a
syndrome. If you have both, it's likely to get called a disease or a disorder. If it benefits from medical intervention but is not generally deleterious (e.g., pregnancy), then it will be called a medical condition (the most generic and inclusive of the labels).
And, very relevantly, depending on the cause, the entity might be labeled a
Complication (medicine) or a
Side effect.
The EMA link provided above recommends that the packages name "symptoms of sexual dysfunction" as a possible side effect of SSRIs and SNRIs. This means that the linked document does not "formally recognize it as a medical condition" or "declare it to be a disorder" or anything like that. They said it was a reported side effect, and did not say that it was a disorder, syndrome, or medical condition.
Second:
The other important thing to understand is that "not a medical condition" does not mean "not real".
Fever is real, but it is technically a
symptom of many medical conditions, rather than a medical condition itself. Vomiting is real, and it is a side effect of many drugs. Hair loss is real, and it is a sometimes permanent side effect of chemotherapy.
Wikipedia tries to be precise when we're writing, so we want to say that PSSD is a real thing that happens to real people in the real world, but we don't want to make claims that are technically not true (e.g., that PSSD is "a recognized medical disorder"). This requires careful writing. For example, instead of writing something technically inaccurate, like "The European Medicines Agency formally recognized Post-SSRI Sexual Dysfunction (PSSD) as a medical condition", we can (and should) write something indisputably accurate, like "the European Medicines Agency required that all SNRIs and SSRIs carry warnings about persistent post-SSRI sexual dysfunction".
WhatamIdoing (
talk)
18:18, 21 July 2023 (UTC)reply
With only nine literature reviews in the last ten years, it would be helpful if someone would get hold of the full text of
PMID34627736SandyGeorgia (
Talk)
I have a PDF of the review above I'm happy to share, how do I go about this?
A few notes from a quick skim: the incidence and prevalence of PSSD is unknown (which doesn't stop the author from saying that it's "rare"), there's the familiar list of symptoms, he argues that it might be unethical to prescribe these drugs without specifically naming this side effect, some of the symptoms of PSSD overlap with symptoms of depression or could be caused by other conditions, and (skipping over the sections on recreational drug use and people with HIV), a bit of
Further research is needed. Overall, there is probably nothing wrong with it, but I would not say that it is an especially impressive review, and we might find the reviews he cites to be more useful.
WhatamIdoing (
talk)
23:19, 2 August 2023 (UTC)reply
I finally got access through TWL, and agree there's not much there to work with, nor anything new, nor much that disagrees with anything we've got. It cites Bala, which we've got. It mentions in passing only
De Luca R, Bonanno M, Manuli A, Calabrò RS. Cutting the first turf to heal post-SSRI sexual dysfunction: a male retrospective cohort study. Medicines (Basel). 2022; 9 (9): 45. 10.3390/medicines9090045
on treatment options that have been studied, but no further content. It says some guidance can be found at:
General Medical Council. Guidance on professional standards and ethics for doctors. Decision making and consent. 2020.
which is a general guide to decision making and consent (best I can tell it never mentions PSSD, but my ctrl-f was choking on the page). But more generally, it is an article whose main aim seems to be to alert the nursing profession that they may encounter this and should be prepared to talk about it wrt informed consent and medications. It mentions advocacy efforts. I don't think any of the content is game-changing, and overall is about informed consent:
"The [General Medical Council 9] gives some guidance on this subject: it states that 'it wouldn't be reasonable' to share every possible risk of harm or side-effect and advises that the consultation should be tailored to each individual, depending on what is important to that person. The [ 9] further advises that any risk of serious harm, however unlikely, 'should usually' be disclosed. Given that antidepressant medication labels carry a warning that PSSD is a possible long-lasting consequence ([16]) and not just a side-effect, there is a strong case for necessary disclosure under the GMC (2023) guidance."