How depression pills can wreck your sex life: Fresh warning for patients

Sex problems are a known side-effect of depression pills — but one that affected patients say they weren’t properly warned about by their doctors.

Worse, for some, these problems can last for years, even after they’ve eventually come off their medication.

Yet campaigners say patients’ complaints have largely fallen on deaf ears, with the medical profession and drug companies either saying that the symptoms were not connected to the tablets, or assuring patients their problems would disappear once they stopped taking them. 

But, today, in a victory for these very patients and the Daily Mail, the European Medicines Agency (EMA) has announced it’s now advising that a commonly prescribed group of depression pills — namely, selective serotonin re-uptake inhibitors (SSRIs) — should carry warnings about the risk of longer term enduring sexual dysfunction. 

Update: The European Medicines Agency has announced it’s now advising that a commonly prescribed group of depression pills — namely, selective serotonin re-uptake inhibitors (SSRIs) — should carry warnings about the risk of longer term enduring sexual dysfunction

At the moment, SSRI patient information leaflets warn about the possibility of short-term sexual problems, but not that there can be long-term issues or that these may persist, even after the medication has been stopped.

The EMA’s move has been welcomed by patients and experts who’ve supported them — as Katinka Blackford Newman, a documentary filmmaker and author of The Pill That Steals Lives, explains: ‘The EMA decision will help get this information about the risk of sexual problems — short- and long-term — out there. This is a victory for campaigners, who have been lobbying so hard on this.’

She added: ‘It’s been fantastic that the Daily Mail listened to stories of people who have suffered as a result of antidepressant use. I’m incredibly grateful to the news-paper for being brave enough to publicise these issues, at the time when patients were being told any sex problems were as a result of their depressive illness and not the pills.’

SSRIs are prescribed to an estimated five million Britons for depression and anxiety. They include paroxetine (brand names, Paxil, Seroxat), fluoxetine (Prozac), sertraline (Zoloft), citalopram (Celexa), escitalopram (Lexapro) and vortioxetine (Trintellix).

These drugs are a lifesaver for many people. However, the risk of sexual problems has been downplayed or ignored say campaigners — one 2001 study estimated that 50 per cent of those taking SSRIs are affected to some degree, although product leaflets suggest just 10 per cent experience some temporary loss of sexual function.

There has been no acknowledgement of the risk of long-term and, sometimes, permanent, problems. Symptoms of Post-SSRI Sexual Dysfunction (PSSD) include failure to become aroused or orgasm, numbness and loss of genital sensation, erectile dysfunction and premature ejaculation.

It’s an issue that Good Health has reported on extensively, as part of our campaign for greater support for patients affected by their prescription drugs.

Did you know? Symptoms of Post-SSRI Sexual Dysfunction (PSSD) include failure to become aroused or orgasm, numbness and loss of genital sensation, erectile dysfunction and premature ejaculation

One who has suffered sexual problems as a result of depression pills is Kevin Bennett. He was prescribed SSRIs for four months at the age of 18.

Now 41, Kevin, who is single and a support worker for disabled people in Surrey Hill, County Durham, became impotent within days of taking SSRIs for anxiety after dropping out of his A-levels. ‘I kept waiting for everything to return to normal after I stopped taking them, but it never did,’ he says.

A locum GP told him it was a symptom of depression and nothing to do with the drug.

‘I didn’t go back to see him again until I was 26,’ says Kevin.

‘I didn’t have sex again until I was 27 after I was prescribed injections of a drug called alprostadil to help me get an erection.’ Kevin had investigations with two urologists and one eventually concluded that his problems could not be attributed to anything other than his course of SSRIs.

‘Had I known that SSRIs were going to permanently ruin my sex life I never would have taken them. People need to know what they are putting themselves at risk of.’

The EMA announcement follows a petition from the patient pressure group RxISK, which campaigns to highlight harmful drug side-effects. The petition called for all SSRIs to carry warnings about sexual dysfunction.

David Healy, a professor of psychiatry at Bangor University and founder of RxISK, says the agency’s decision reflects increasing recognition of the harm that SSRIs can cause.

‘We submitted a petition to the EMA and the U.S. Food & Drug Administration a year ago, calling for these side-effects to be mentioned on drug labels and leaflets,’ he says.

‘There is compelling evidence that SSRIs can cause longstanding sexual dysfunction but, at the moment, this is not mentioned on drug labels or on any of the information leaflets.

‘Within half an hour of taking SSRIs, patients have reported genital numbness — it can be mild, or quite marked; but it just hasn’t been flagged up enough.

‘The general message from doctors has been that this happened to a minority of people — five out of 100 in clinical trials — and that these sexual problems were very short-term.

‘Another argument was that depressed people tend to lose their sex drive anyway — but in drug trial data I have had access to as an expert witness, even the healthy volunteers taking the medication reported problems with their sex drive, and that is without prompting.’

Professor Healy says that, back in 1991, a doctor wrote to the Medicines & Healthcare Products Regulatory Agency (MHRA), the UK watchdog for medicines and medical devices, reporting a case of post SSRI sexual dysfunction.

‘In the early 2000s, there were a number of case reports from doctors who had experienced the problems themselves — and they still had sexual difficulties ten years after stopping their SSRIs,’ says Professor Healy.

‘We know that blocking sodium currents (which all SSRIs do) can cause gential numbness. We don’t know why the effects become long lasting in some.

‘Sometimes people are told it’s their mood disorder coming back — but, if you recover from depression, your sex drive and ability to orgasm returns. Yet, after taking SSRIs, this doesn’t always occur.’

CAN MAGIC MUSHROOMS TREAT DEPRESSION?

Psilocybin is one of several psychedelic drugs that have recently reemerged from the shadows with promises to treat mental illnesses and addictions.

Portrayals in stone carvings and rock paintings that predate recorded history suggest people discovered the hallucinogenic powers of ‘magic’ mushrooms as early as 9000 BC. 

The fungi were once the centre piece of religious ceremonies.

In 1959 a chemist at the pharmaceutical company Albert Hofmann identified and separated out the psychoactive compound in mushrooms, known as psilocybin.

Between 1961 and 1965, Sandoz sold the compound as a psychotherapeutic medicine called Indocybin. 

It was quickly discontinued when it was widely misused to ‘trip’ or hallucinate.

Psilocybin has since been tightly regulated in the US where it is treated as equally illicit to heroin.

Fresh, but not dried, magic mushrooms were legal in the UK until the Drugs Act 2005 made them Class A.

But as depression continues to surge, scientists are looking for inventive options to treat the disorder.

Psilocybin is a similar shape to the ‘feel good’ neurotransmitter serotonin and binds to some of the same receptors in the brain. 

It appears in brain scans to treat depression by making the amygdala more responsive to emotions.

And patients are better able to process these feelings and feel relief from their symptoms weeks later. 

Other research suggests the drug ‘resets’ neural circuits that create negative feedback loops in patients’ brains. 

Another problem that campaigners believe is also associated with the medication, is persistent genital sexual arousal disorder, first reported in the Journal of Sex & Marital Therapy in 2008. Professor Healy says RxISK has received reports of long-term sex problems after taking SSRIs from up to 500 patients.

He says: ‘Huge numbers are potentially affected by these side-effects. Around seven million people are on antidepressants, mostly SSRIs, and 80 per cent are on these drugs for more than a year — and we don’t know how many of them will ever get their normal sexual function back.

‘Some may not have made the connection between the drugs and their symptoms, and have been told their sex problems are a sign of their depression returning.’

Professor Healy adds: ‘My biggest concern right now is for teenagers. So many are prescribed antidepressants that they may never know what normal sexual function is.’

Professor Healy has praised the Daily Mail for getting the issues associated with SSRIs — including withdrawal symptoms and addiction — into the spotlight.

‘The Daily Mail has done more than any other newspaper to highlight these problems and has campaigned most effectively on this. It has listened to patients when the medical profession didn’t,’ he says.

Katinka Blackford Newman, who herself experienced short-term sexual dysfunction while taking the medication, adds: ‘At the time, I felt totally disbelieved, but the fact that the Daily Mail believed me gave me the confidence to campaign to help others.’

‘I know of many who have suffered long-term sexual problems after taking antidepressants — there have even been suicides as a result of this. One man left a note saying he was ending his life because he could no longer have sex after taking SSRIs.’

One man who spoke to Good Health on condition of anonymity said he’d experienced problems just 48 hours after his first dose of SSRIS, developing genital numbness — seven years later, the sensation has still not come back.

‘It was like losing one of my senses overnight,’ recalls the 31-year-old landscape gardener from Lincolnshire. ‘I stopped taking the pills, but my GP persuaded me to restart them, telling me what I experienced was not connected. It took me three years to get anyone to take me seriously. I’m left not able to feel love or any emotional connection or to become sexually aroused.’

‘It’s disgusting that these side-effects have been swept under the carpet for so long.’

 

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