Antidepressant side effects: Has the Romance Gone? Was It the Drug?

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Antidepressant side effects: Has the Romance Gone? Was It the Drug?Disease pharm

| Psychiatry

 

Has the Romance Gone? Was It the Drug?

By ANAHAD O'CONNOR

 

Published: May 4, 2004

Source: New York Times

For most people taking antidepressants, the risk of a diminished sex drive may

seem like a worthwhile sacrifice for the benefits from the drugs.

 

Up to 70 percent of patients on antidepressants report sexual side effects, yet

the number of Americans who take the drugs has ballooned since Prozac was

introduced in the late 1980's. Last year, studies show, doctors in the United

States wrote 213 million prescriptions for antidepressants.

But what if the sexual side effects of the drugs, often considered little more

than a nuisance, had more serious consequences, impairing not only sexual desire

in some people, but also the ability to experience romance? The question, which

experts are beginning to ask, was at the center of a talk this weekend at the

annual meeting of the American Psychiatric Association in New York. Dr. Helen E.

Fisher, an anthropologist at Rutgers, presented findings that suggest, she says,

that common antidepressants that tinker with serotonin levels in the brain can

also disrupt neural circuits involved in romance and attachment.

 

" We know that there are real sexual problems associated with serotonin-enhancing

medications, " said Dr. Fisher, author of " Why We Love: The Nature and Chemistry

of Romantic Love " (2004). " But when you cripple a person's sexual desire and

arousal, you're also jeopardizing their ability to fall in love and to stay in

love. "

 

Dr. Fisher and a colleague, Dr. Anderson J. Thomson Jr., have studied the brains

of people in love and pored over research from the last 25 years on the

neurological basis of romance. Three brain systems, all interrelated, the

researchers say, control lust, attraction and attachment. Each runs on a

different set of chemicals. Lust is fueled by androgens and estrogens.

Attachment is controlled by oxytocin and vasopressin. And attraction, they say,

is driven by high levels of dopamine and norepinephrine, as well as low levels

of serotonin. As a result, they say, increasing levels of serotonin with

antidepressants can cripple the sex drive but also set off an imbalance among

the three systems.

 

Drs. Fisher and Thomson are submitting a scientific paper on the subject for

publication this year.

 

" There are two lines of evidence on this, " Dr. Thomson, a psychiatrist at the

University of Virginia, said. " The first is the well-documented frequency of

sexual side effects. But when you actually talk to patients who have diminished

libido and you ask how it affects them, you discover that it has an enormous

impact on their romantic lives. "

 

Often, the change is subtle. Drs. Fisher and Thomson point to case studies of

people who gradually find their emotions blunted and their ability to see

attractive features in others lost. The researchers also point to more extreme

cases like people who say losing their sex drives caused romantic feelings

toward longtime spouses to evaporate suddenly.

 

" Everyone is distinctly different, " Dr. Fisher said. " Some people are so

securely attached that this isn't going to change things for them. But people

should be aware that these drugs dull the emotions, including the positive ones

that are central components of romantic love. "

 

 

 

 

 

 

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