Antidepressant Sexual Side Effects Patients Were Never Told About

A short documentary from Swedish broadcaster SVT has put antidepressant sexual side effects back in public view, with patients describing how desire and sensation faded after they started medication, according to Daily Northern's coverage of the SVT documentary. The programme follows people who say the drugs helped their mood while changing their sex lives, and who say doctors rarely raised the subject before prescribing.

More than a million people in Sweden collected at least one antidepressant prescription last year, according to the report. Research and experts consulted by SVT put antidepressant sexual side effects at roughly one-third to one-half of people treated with SSRI or SNRI medicines, with some studies reporting higher rates. Psychiatrist and associate professor Mikael Tiger said antidepressants can affect different kinds of motivation, including sex drive.

What patients told SVT

Amanda, aged thirty-six, has taken antidepressants for ten years and says her sex drive changed considerably. "There is no drive any more," Amanda said in the SVT documentary. Another woman, who asked to remain anonymous, said she struggled to reach orgasm and had reduced sensation. "Masturbating was about as sensitive as sitting and poking your elbow," she told SVT.

Several people told SVT that the medication had helped them but that its side effects affected their relationships and lives. One man said a lack of desire made relationships difficult after he took antidepressants for eleven years. A woman said she and her partner could not have sex during the years when they had hoped to have children, and that it was now too late for them to have children of their own. Some patients said they had not been told about the possible side effects before starting treatment. Others described doctors as uninformed or surprised when they sought help. Psychiatrist Behroz Dehdari said doctors should provide better information, take patients' concerns seriously and review treatment regularly, adding that lost sex drive can have serious consequences for romantic relationships.

Britain's boxed warning on antidepressant sexual side effects

Britain's drug regulator acted earlier this month, before the documentary aired. On October 15, the Medicines and Healthcare products Regulatory Agency announced new safety steps for all antidepressants, including a boxed warning in patient leaflets, a patient card and a safety handout, according to the agency's Drug Safety Update. Leaflets for some antidepressants will name post-SSRI sexual dysfunction, known as PSSD, and explain that antidepressant sexual side effects may continue after treatment stops. The update names citalopram, fluoxetine and sertraline among the affected medicines, and follows a review prompted by concerns from patients and families that leaflet wording did not clearly explain that suicidal thoughts and sexual problems could continue after treatment ended.

The agency's chief safety officer, Alison Cave, said the measures aim to improve the prominence and clarity of existing warnings. The regulator also stressed that the changes aim to make warnings clearer, and that patients should speak to a healthcare professional before stopping an antidepressant. A review from 2019 in Britain and the European Union had already found that antidepressant sexual side effects could persist after stopping certain medicines, and that finding guided the current step.

News from Europe reported that the BBC spoke to more than a hundred people who have used or are using antidepressants, and that all of them reported side effects of some kind. GP and sexual medicine expert Dr Ben Davis said there is evidence that up to eight in ten people given antidepressants suffer from sexual difficulties, according to the same report. The BBC coverage shows how common antidepressant sexual side effects are, even as estimates vary widely. One man, Connor, speaking under a pseudonym, said his sex drive disappeared within a day of his first sertraline pill, and that numbness persisted twelve months after he stopped, according to the report. He is one of more than a thousand people in the PSSD Network, an online community raising awareness of the condition.

What doctors should tell patients

GPs should discuss antidepressant sexual side effects when starting or changing the dose of an antidepressant, and tell patients to seek urgent medical attention if they notice new or worsening suicidal feelings, according to Pulse Today's report on the guidance. GPs will also be asked to give patients a safety leaflet at the first consultation for new patients, or the next consultation for existing patients. The leaflet is intended to explain the benefits, risks and alternatives for antidepressants, and it is due early next year.

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For patients, the practical change is simple: antidepressant sexual side effects will now appear in a boxed warning at the top of the leaflet, on a card in the pack, and in a safety sheet handed over at the first consultation. Revised leaflets are expected electronically from October, with paper copies in packs to follow within months.