What are the real risks of antidepressants?

Harvard Health updates its information about the risks of anti depressants.

Though common in use, SSRIs are not without their side effects

Updated: March 19, 2019. Published: March, 2014

Since the late 1980s, America and the world have been enjoying the benefits of the selective serotonin reuptake inhibitors (SSRIs). These antidepressants — fluoxetine (Prozac), sertraline (Zoloft), paroxetine (Paxil), fluvoxamine (Luvox), citalopram (Celexa), and escitalopram (Lexapro) — are among the world’s most widely prescribed medications. The range of their uses has expanded from depression to anxiety, obsessive-compulsive disorder, eating disorders, and many other psychiatric conditions.

These types of antidepressants are generally safe, but no medical treatment is without risk.

SSRI antidepressant side effects

Some patients taking SSRIs develop insomnia, skin rashes, headaches, joint and muscle pain, stomach upset, nausea, or diarrhea. These problems are usually temporary or mild or both. A more serious potential problem is reduced blood clotting capacity because of a decreased concentration of the neurotransmitter serotonin in platelets. Patients are at slightly increased risk for internal bleeding, especially if they are also taking aspirin or another NSAID, such as ibuprofen or naproxen..

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Sexual effects from SSRIs

For many patients, SSRIs diminish sexual interest, desire, performance, satisfaction, or all four. In men, SSRIs can delay or inhibit ejaculation, and in women, delay or prevent orgasm.

Lowering the dose of the SSRI antidepressant may help, although the patient may lose the drug’s benefit. Another solution is adding or substituting bupropion (Wellbutrin), which works by a different mechanism and does not generally cause sexual side effects.

Although none of these types of antidepressants should be stopped abruptly, paroxetine tends to produce the most intense discontinuation symptoms. Here is a place where the longer-lasting drugs have an advantage; some clinicians switch to fluoxetine before gradually lowering the dose.

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