Sad couple

Do Antidepressants Cause Sexual Dysfunction? Medical Experts Issue New Warnings

Imagine being prescribed a drug by your doctor in good faith, only to discover that it cost you your ability to make love, forever? It’s hard to conceive of isn’t it? Yet for decades it appears this has been the tragic fate of tens of thousands of men and women the world over. 

SSRIs Under The Spotlight

A group of antidepressants, known as SSRIs, are now under the spotlight of a world renowned team of medical experts who seek to...

Other Drugs Under Investigation

Isotretinoin, a drug used in the treatment of acne.

Also,

Finasteride,  which is prescribed for male pattern baldness.

“There is a striking consistency to the clinical picture across sufferers affected by SSRIs, Finasteride (Propecia) or Isotretinoin (Accutane).

The classic cases have profound erectile or lubrication dysfunction, severe loss of libido, an inability to orgasm, and a weird and disturbing genital numbness.

The problem can start as early as a week after exposure to the drugs. Once established, it appears for at least some people to last forever – certainly 5 or 10 years is commonplace."

RxISK.org

Dr David Healy, RxISK.org

The main driver behind this initiative is Dr. David Healy, a Professor of Psychiatry at North Wales Department of Psychological Medicine and former Secretary of the British Association for Psychopharmacology.

Dr Healy is also the author of over 200 peer-reviewed articles  and 20 books, CEO and principal founder of Data Based Medicine Americas Ltd. who in 2012 launched the website https://rxisk.org/

"RxISK is a free, independent drug safety website to help you weigh the benefits of any medication against its potential dangers.”

On the RxISK.org site you’ll discover some startling facts about prescription drugs and their largely unreported side effects. 

Drug Groups That Can Cause Sexual Problems

In the video below, Professor Healy highlights the many drug groups that can cause acute and chronic sexual problems. Along with the Legacy Problems that 3 groups of drugs, including SSRIs, Finasteride and Isotretinoin can have on sexual function. (Legacy problems are problems that only happen after you stop the treatment or that get worse after you stop the treatment.)  

PGAD Impacts More Women Than Men

Sexual dysfunction arising from the use of these drugs affects both men and women. Although Persistent Genital Arousal Disorder (PGAD) impacts more women than men and sounds horrific. This short video describes this condition, and the desperate measures women have taken in seeking relief. 

Enduring Sexual Dysfunction After Treatment

The International Journal Of Safety In Medicine published ‘Enduring sexual dysfunction after treatment with antidepressants, 5α-reductase inhibitors and isotretinoin: 300 cases’ by Healy, Le Noury and Mangin in 2018. 

"The objective was to investigate clinical reports of post-SSRI sexual dysfunction (PSSD), post-finasteride syndrome (PFS) and enduring sexual dysfunction following isotretinoin."

“While reports of certain issues were unique to the antidepressants, such as the onset of premature ejaculation and persistent genital arousal disorder (PGAD), there was also a significant overlap in symptom profile between the drug groups, with common features including genital anaesthesia, pleasureless or weak orgasm, loss of libido and impotence.

Secondary consequences included relationship breakdown and impaired quality of life.”

Petition To The EMA & FDA

In 2018, a team of 22 medical experts submitted a petition to the European Medicines Agency (EMA) and the Food and Drug Administration (FDA) in the US. calling for an immediate revision of all SSRI and SNRI product labels.

In essence, for warnings and precautions to be added to these along with a requirement that manufacturers inform health care providers that “the drug has serious adverse reactions associated with its use, and poses a significant public health concern”.

“The data make it clear that SSRIs and SNRIs are potent disruptors of sexual function, and that adverse sexual effects can sometimes persist for years or indefinitely after discontinuation of the drug.

In some cases, these effects only emerge or worsen when the drug is withdrawn. It also appears that post-treatment problems can occur after only a brief exposure to the drug.”

EMA Acknowledges Persistent Sexual Dysfunction After SSRIs & SNRIs

Following an extensive review, the EMA’s safety committee, Pharmacovigilance Risk Assessment Committee (PRAC) arrived at a conclusion...

"On Thursday 16 May, PRAC concluded that sexual dysfunction, which is known to occur with treatment with SSRIs and SNRIs and usually resolves after treatment has stopped, can be long-lasting in some patients, even after treatment withdrawal.”

This extract from page 5 of the PRAC document ‘PRAC recommendations on signals adopted at the 13-16 May 2019 PRAC’ is the recommendation to Marketing Authorisation Holders of SSRIs and SNRIs in Europe to include the following warnings and precautions on these products…

Summary of product characteristics 4.4.
Special warnings and precautions for use
Sexual dysfunction
Selective serotonin reuptake inhibitors (SSRIs)/serotonin norepinephrine reuptake inhibitors (SNRIs) may cause symptoms of sexual dysfunction (see section 4.8). There have been reports of long-lasting sexual dysfunction where the symptoms have continued despite discontinuation of SSRIs/SNRI.

Package leaflet 2. What you need to know before you take [Invented name] Warnings and precautions Medicines like [Invented name] (so called SSRIs/SNRIs) may cause symptoms of sexual dysfunction (see section 4). In some cases, these symptoms have continued after stopping treatment.

PSSD Now Recognised As A Medical Condition

So after all this time, Post SSRI Sexual Dysfunction (PSSD) is now recognised as a medical condition.

Although...

“The regulators worldwide have had tens of thousands of cases of this problem reported to them over a 30 year period and have done nothing.”  

Professor Healy exposes why, and the cynical reason why it’s only now that PSSD is finally being recognized in this video - Antidepressants & Sex, a Strange Story. 

Journal of the Royal Society of Medicine - Antidepressants And Sexual Dysfunction: A History

In conclusion:

I've been trying to write this post for weeks. Yet putting it off because it's been quite depressing to discover all this. And even more so to sit down and write about it.

Also, I’m aware that there may be some readers currently on one or more of the drugs mentioned that may worry after reading the above, about the effects of coming off them.

I’m truly sorry if this is you, but with knowledge comes a responsibility to pass it on. If what I share here helps one person to avoid the hell that this man describes it will have served a worthy purpose. 

If you believe you may be experiencing a drug side effect from any drug you can get your own free RxISK Report here to find out. 

“The RxISK Report takes 10 minutes to complete and provides you with a RxISK Score indicating how likely it is that your problem is caused by a prescription drug.”

Why Don't Doctors Warn Patients About These Drugs?

How many of those affected by any one of the above drugs would have taken it had they been aware of the potentially ghastly side effects first?

If they'd known there was a possibility that these side effects could be long-lasting, or even permanent?

How many are out there now who may be offered one of these drugs in all good faith by their doctor? Patients who may be unaware of the devastating effects they can cause?

You might well ask “Why don't doctors inform patients that these drugs could potentially end their sexual function?”

Here’s why... 

From the Citizen petition 2018: Sexual side effects of SSRIs and SNRIs. B.7 Conclusion:

"Current labeling does not adequately convey the breadth, severity or potentially permanent nature of the adverse sexual effects from SSRI and SNRI products. In particular, genital anesthesia and pleasureless orgasm should be mentioned specifically because these are highly unusual effects and not typical features of sexual dysfunction.

Neither patients or health care professionals can reasonably be expected to know that the impact on sexual functioning could include profound genital numbness and the loss of ability to experience pleasure during orgasm.

Without adequate warnings about the risk of potentially permanent damage to sexual functioning, patients are being deprived of informed consent. It is currently impossible for patients and health care professionals to weigh the benefits of treatment against the harms. We therefore request that clear warnings are immediately added to all SSRI and SNRI products.”

(Emphasis mine)

While the new warnings by the EMA are a step in the right direction, they clearly fall far short of what's required.

Raising Awareness

So it’s for each of us, armed with the knowledge we have now, to raise awareness of the risk of these drugs to a person’s sexual and relational life. 

Because depression can hit anyone. No-one is immune to it. All it takes is a change in circumstances, which may be totally outside of one’s control, to bring one’s life crashing down around them.

So now that I’ve shared this with you, who will you share it with?

For who can afford not to know about this?

No-one is immune to depression. And everyone should be given the chance to know about the dangers of drugs offered to them for depression, hair loss or acne, before they make the fateful decision to take them.

Because there may be no going back.

So who will you tell, now you know?

Thank you for reading.

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