Patients taking antidepressants are being warned to be wary of side effects that could leave them “asexual” even after stopping use – a problem that could affect millions of Britons.
Selective serotonin reuptake inhibitors (SSRIs), the most common class of antidepressant drug in the UK, are used by one in eight Britons (8.6 million in total) who suffer from mental health problems such as anxiety and depression .
Common SSRIs prescribed in the UK include citalopram, fluoxetine and sertraline, sometimes known by the trade names Cipramil, Prozac and Lustral, but researchers have linked their use to long-term and even permanent sexual dysfunction.
The NHS has warned that side effects such as loss of libido and achieving orgasm, lower sperm count and erectile dysfunction “may persist” after taking them, and patients have described feeling “left out”, relationships torn apart by their use.
Men and women say the side effects of SSRIs have hampered their sex lives, even after stopping the drugs, a condition known as post-SSRI sexual dysfunction (PSSD), which is not officially recognized by UK health authorities.
For millions of people, antidepressants can be a life-saving medication, but the authors of a US petition calling for more warnings on the drugs say it may be “impossible… to weigh the benefits of the treatment against the harms” .
Has your sex drive been hindered by SSRIs? Email jon.brady@mailonline.co.uk
The condition mentioned in the lawsuit is post-SSRI sexual dysfunction (PSSD), which can cause genital numbness, complete loss of libido, erectile dysfunction, and other sexual function problems for years after stopping. the drugs.
Statistics published in the US show that fertility rates have decreased while SSRI prescriptions have increased
Escitalopram, also known by the trade name Lexapro, is one of many SSRI drugs prescribed by the NHS.
Sertraline is also a commonly prescribed SSRI in Britain. Some 8.6 million Britons were prescribed antidepressants last year
The side effects of antidepressants affecting men and women have been well known for decades, following the first trials in the 1980s, but the use of these drugs has become widespread for the treatment of depression, anxiety and other mental health conditions.
One London student, who spoke on condition of anonymity, previously told the Mail that his genitals had been left “basically inanimate” after he started taking the SSRI escitalopram.
He said: “This area of my life used to be a lot of fun and now it’s a source of anxiety and has become a dark place in my head.”
“I feel like someone went into my brain with a scalpel, carved away some bits, and left me with this strange, numb, sexless person.
“No doctor will even consider that it could be related to the SSRI.”
Rebecca Graham, a British woman in her 40s, said she had “given up on the idea of having children” but had been “turned on” by doctors because they refused to believe that SSRIs were causing numbness below the waist.
“I feel like I’ve been castrated,” he added.
Despite this, medications are easily prescribed to Britons as they try to overcome these conditions, which affect between four and 10 per cent of people in England over their lifetime, according to the Mental Health Foundation.
Dr. Ben Davis, an expert in sexual medicine, said antidepressants are often prescribed quickly, perhaps too quickly.
“There are people for whom these are life-saving medications,” he said. bbc news.
‘But the flip side is a 10-minute consultation with someone you’ve never met before, with the pressure of someone who sees 30 people a day.
‘Are good long-term medication decisions made in that environment? I do not think so.’
Warnings have been issued about the long-term use of SSRIs to treat anxiety and depression, with some reporting side effects even after stopping taking them.
Advocacy groups such as PSSD Network have called for better recognition of the condition and better support for those experiencing a loss of libido.
But their campaign is limited by a lack of research on the long-term repercussions of SSRI use.
In the United States, a Harvard molecular biologist has filed a lawsuit against the Food and Drug Administration (FDA) for allegedly ignoring requests to warn SSRIs about the long-term and even permanent repercussions of their use.
Dr. Antonei Csoka, an advisor to the PSSD Network, says in his filings that the FDA never followed up on a petition he countersigned in 2018 asking officials to require drug companies to add the alerts to their medications.
He believes that long-term use of SSRIs can rewrite DNA, which in turn can affect genes related to sexual function. But exactly why it happens to some patients and not others is unknown, and research is still lacking.
Dr. Csoka saying: “Without adequate warnings about the risk of potentially permanent damage to sexual function, patients and health care professionals cannot weigh the benefits of using the medications against the potential harms.”
Scientists don’t know for sure how many people are affected by PSSD, although more than half of all antidepressant users have reported some degree of sexual dysfunction while taking them.
And a 2018 review of the scientific literature on PSSD found that about five to 15 percent of people taking antidepressants developed sexual side effects, such as erectile dysfunction and lack of sexual desire, after taking SSRIs and SNRIs.
Patients sharing their stories through the PSSD Network have described a variety of disorders ranging from erectile dysfunction, genital shrinkage and numbness to a lack of sense of attraction to others and an inability to feel pleasure.
One patient had been prescribed several antidepressants at different times when he was 16 years old to cope with the death of his father and was able to stop taking them in his 20s.
Now, at 25 and without taking medication, he has ‘Extreme genital shrinkage and discomfort, I have a neurological dysfunction of the smooth muscle of my penis that causes hypercontraction or a persistent arousal disorder.
“I have constant overactive bladder, urination, I have severe erectile dysfunction and premature ejaculation… I never had any of this before taking the medications.”
And he added: ‘I have seen a urologist specialized in sexual health who recognizes the existence of PSSD; ‘He did an ultrasound on my private parts and told me I have fibrosis, and he said it’s very common to see that in men who take antidepressants for a while.’
Meanwhile, one patient stopped taking her antidepressant three years ago, but said her now sexuality is gone.
She said: “My clitoris feels like a dead lump.”
And a third patient who had been taking Lexapro for about three months said that “asexual now Of medicine.’
He said: ‘I used to be able to look at people I was attracted to and feel something, but now I don’t feel anything, it’s like staring at a wall. Basically, taking away almost all the positive emotions, they went from 100 to maybe less than one, that’s how strong it is.’
He added that the hardest part of the general emotional dullness caused by the medications: ‘When you hug the people you love, your mother, your father, your nephew, you don’t feel anything… You can’t form any emotional bond at all. ‘
Dr. Csoka has been researching antidepressant-related sexual dysfunction since the early 2000s and was one of the first to postulate that the medications, as a side effect of increasing serotonin levels in the brain, caused changes in the DNA that affect the activity of genes that regulate sexual function.
He told the guardian: ‘Several scientists, including myself, have published studies showing that an SSRI can change epigenetics and human cells.
“If that happens, those cells or tissues may not immediately return to the way they were once treatment stops.” It’s like they left a mark there. However, it is still not known precisely what these epigenetic changes are. So what we have to do is narrow it down: what’s going on?
Your demand archived in the United States District Court for the District of Columbia seeks to compel the FDA to issue a decision on the petition.
A 2022 meta-analysis in Frontiers in pharmacology found that SSRIs have “a statistically significant impairment in semen quality, such as sperm concentration, sperm morphology, and sperm motility,” the researchers wrote. However, semen volume was not affected.
But it is not possible to say whether SSRI use is having an effect on Britain’s birth rate.
In England, prescriptions for antidepressants tripled between 1998 and 2018, according to a analytical study of prescription data.
Over the same period, the average number of births per woman in the UK rose from 1.73 to a peak of 1.94 in 2010 and fell to 1.65 in 2018, according to the Office for National Statistics.