Antidepressants may damage more sex lives

Such sexual symptoms have long been known side effects of the popular Prozac class of antidepressants, but a growing body of research suggests that they are far more common than previously thought, perhaps affecting half or more of patients.

And a handful of recent medical and psychological journal articles document a small number of cases in which sexual problems remain even after a patient goes off the drugs.

"This is such an upsetting issue," said Aline Zoldbrod, a Lexington psychologist and sex therapist. "There are people for whom SSRIs are really life-saving, I think, but the idea that someone would have to choose between getting out of the darkness of depression and having a good sex life is horrible."

Current warnings on the labels of selective serotonin reuptake inhibitors, or SSRIs, cite early studies in which the prevalence of sexual side effects was lower: 4 percent for Prozac, for example, and ranging from 0 to 28 percent for Paxil.

But more recent studies, in which patients were more likely to be asked about specific sexual side effects and thus more likely to report them, suggest that the ballpark range of those affected by SSRIs is between 30 percent and 50 percent, said researchers including Dr. Richard Balon, a psychiatry professor at Wayne State University who studies the symptoms.

That would translate into millions of affected sex lives among the estimated 1 in 8 American adults who have tried these antidepressants in the past decade or so. Some studies have found the range still higher.

In fact, the dampening sexual effects can be so dramatic that in recent years, the antidepressants have become the leading treatment for premature ejaculation, a study last year found, though they are not approved for that use by the FDA.

"I tell patients there's a good chance they may have sexual problems" while on the antidepressants, "with the most frequent being delayed orgasm," Balon said.

Representatives of some of the companies that make SSRIs pointed out that sexual dysfunction is complex to measure. Patients may be reluctant to discuss it, and it is hard to distinguish issues caused by the drug from problems caused by the underlying mental illness, by diseases such as diabetes, or by other medications, they said. The Prozac label states that "There are no adequate and well-controlled studies examining sexual dysfunction" of patients on Prozac.

In the past two or three years, scattered published case reports from around the country have described patients whose sexual symptoms failed to resolve after going off antidepressants.

Dr. Robert P. Kauffman, chair of obstetrics and gynecology at Texas Tech University, has published accounts of three cases in his practice. "It's probably a small number of men and women," he said, "but I really think it deserves investigation."

Psychologist Audrey Bahrick at the University of Iowa said she became concerned when she observed that several clients whom she followed went off SSRIs and "very, very credibly to me, they did not recover" sexually.

Among their symptoms, she said, were "telltale signs" of SSRI-caused dysfunction, unrelated to the known effects of mental illness. They had "pleasureless orgasms," and "genital anesthesia," in which sex feels no more intense than a handshake. She became particularly concerned about adolescents put on antidepressants, whose sexuality might never have a chance to develop normally.

Bahrick began to explore. She found that post-SSRI sexual effects had never been systematically studied, but she came across a Yahoo group called SSRIsex, a support group for people with "persistent SSRI sexual side effects" that now has more than 1,800 members.

Among them was Kevin Bennett, a 30-year-old whose sexual function was normal until he was prescribed Prozac at age 18, and who has been impotent ever since, he says; his doctors can find no alternative explanation.

Both Bahrick and Bennett spoke about SSRI effects at a panel of the American Psychological Association last year.

Still, skepticism among psychiatrists remains. Balon said he has seen no such cases in his practice, though he does not rule out the possibility that the syndrome is rare but real. GlaxoSmithKline, which makes Paxil, "has not identified sexual dysfunction post-treatment as a safety signal," spokeswoman Sarah Alspach said in an e-mail.

Response to "SSRI Birth defects- The facts"

It seems as though my topic focus has shifted a little after researching further. Now leaning more towards the dangers of SSRI rather then the effects it has on brain chemistry. I think somehow the dangers and the brain chemistry part are going to connect, and obviously have something to do with each other. Back to what I found in previous articles, it seems that the pharmaceutical companies aren't focusing in the right area. When meeting your doctor or pharmacists should you have to shake his hand and wonder where his morality stands? Or should you just trust what he says because "he's a doctor". I think pharmaceutical companies should have to reprint there warning label on pill bottles. At the same time I could completely contradict my self...although I haven't looked into this much yet, but when you pick up your prescription pills you get a little booklet type thing that tells you all sorts of things about the drug you are taking. I makes me wonder if people take the time to read these. I understand that getting pregnant is unexpected but I'd also like to know how many of these woman where purposely trying to get pregnant and how many it accidentally happened to. Because if this drug is altering your brain this much don't you think it would alter something growing inside of you?

This piece from the article(below) should be placed on every pill bottle, as well as the pharmacists/ doctor mentioning to you these side effects.

"Heart defects are also associated with SSRI birth defects, namely Zoloft, Celexa, Prozac and Paxil. In 2005 the FDA issued a public health warning regarding Paxil, based on findings from 2 studies which showed up to a 2 times greater risk of having a baby with a heart birth defect while on Paxil. In conjunction with the warning, the FDA placed Paxil in its second highest category of drugs known to cause birth defects."


Another question of mine is does it only effect the baby if you're taking it during the gestation period or does it also have a long term effect...say you've been taking it since you were 20 and you're now 23 and ready to have a baby. Is it going to effect them in any way?

SSRI Birth Defects – The Facts

SSRIs – or selective serotonin reuptake inhibitors--are a class of drug used to treat depression. Lexapro, also known generically as escitalopram oxalate, is an SSRI. The manufacturer of Lexapro, Forest Pharmaceutical, downplays the drug's dangers. Nowhere on its website is there any warning of possible side effects if taking the drug while pregnant, even though SSRIs have been linked to serious birth defects in babies.

On July 19, 2006, the Food and Drug Administration (FDA) released a Health Advisory to alert the public to the risks associated with taking SSRIs while pregnant. The advisory was based on a study published in the New England Journal of Medicine that found that mothers who took SSRIs like Lexapro during the second half of their pregnancy were 6 times more likely to have a baby with Primary Pulmonary Hypertension in the Newborn (PPHN) than those who did not take SSRIs late in pregnancy.

Heart defects are also associated with SSRI birth defects, namely Zoloft, Celexa, Prozac and Paxil. In 2005 the FDA issued a public health warning regarding Paxil, based on findings from 2 studies which showed up to a 2 times greater risk of having a baby with a heart birth defect while on Paxil. In conjunction with the warning, the FDA placed Paxil in its second highest category of drugs known to cause birth defects.
Most recently, a study published in the November 2008 issue of the British Journal of Clinical Pharmacology, reported a 3 times greater risk for heart defects in babies born to mothers taking either Prozac (fluoxetine) or Paxil. The study looked at babies born to 800 women who said they took either drug during the first trimesters of their pregnancies. Comparison was then made to 1,400 expectant mothers who were not on antidepressants of any kind.

Given this information Ann has good reason to be suspicious as to the cause of her son's heart defect and pulmonary hypertension. "My daughter is as healthy as can be. Then they put me on lexapro, and my son was born with these health problems," she said. If you were Ann, what conclusions would you draw?

Response to "antidepressants being conducted in secret"

This article was very informational I would have never expected some of the things I read. A lot of what I read was generally about the same thing, which was parents being upset with doctors for not being given correct warning as to how these drugs will effect there chilred along with confidentiality. This left me not much room to say much with out repeating myself. while reading this article I came across this "In another case a 14-year-old girl became suicidal after taking Zoloft. Her parents said they were not warned this might happen nor told to monitor her for symptoms of suicidal thoughts or self-harm." after reading this i was very shocked that parents were not notified about possible side effects. This is a serious drug that can, and does alter brain chemistry. It seems to me pharmaceutical companies care more about the money they will be making then the well being of those who are consuming the drugs. Along with doctors trying to keep confidentiality but in turn parents being upset with them for not sharing this serious information. I'm caught between sides because moraly I think its a doctors right to keep things condential but at the same time if its putting some one in harms way then shoulndt that bond of confidentiality be broken?

A good start - but incomplete!

Emily - a good beginning, but you need to work on citations, notes, responses. . .see me if you have questions. Fourth article is due this Friday, December 19.