Sexual Side Effects of Antidepressant Medications: An Informed Consent Accountability Gap
- 310 Downloads
Sexual side effects of antidepressant medications are far more common than initially reported, and their scope, quality, and duration remain poorly captured in the literature. Antidepressant treatment emergent sexual dysfunctions may decrease clients’ quality of life, complicate psychotherapy, and damage the treatment alliance. Potential damage to the treatment alliance is greatest when clients have not been adequately informed of risks related to sexual side effects. It had previously been assumed that sexual side effects always resolve shortly after medications are discontinued. Emerging evidence, however, suggests that in some individuals, sexual dysfunction side effects may persist indefinitely. The authors argue that all psychologists should be well-informed about sexual side effects risks of antidepressant medications, should routinely conduct a pre-medication baseline assessment of sexual functioning, and take an active role in the informed consent process.
KeywordsAntidepressant sexual side effects SSRIs Sexual dysfunction Iatrogenic Informed consent
- American Psychiatric Association. (2000). Practice guidelines for the treatment of patients with major depressive disorder (revision). The American Journal of Psychiatry, 157(Suppl 4), 1–45.Google Scholar
- American Psychological Association board of Educational Affairs. (1995, December). Final report of the BEA working group to develop a level I curriculum for psychopharmacology education and training. Washington DC: Curriculum for Level I training in psychopharmacology.Google Scholar
- Antonuccio, D. O. (2007, April). Informed parental choice about anti depressants for their children. American Society for the Advancement of Pharmacotherapy Tablet, 8(1), 1, 6–7.Google Scholar
- Bahrick, A. (2006, September). Post SSRI sexual dysfunction. American Society for the Advancement of Pharmacotherapy Tablet, 7(3), 2–3, 10–11.Google Scholar
- Burt, C.W., McCaig, L. F., & Rechtsteiner, E. A. (June, 2007). Ambulatory medical care utilization estimates for 2005. Advance Data from Vital and Health Statistics, Number 388. Retrieved from http://www.cdc.gov/nchs/data/ad/ad388.pdf. Accessed Jan 7, 2008.
- Cohen, D. (2004, May). Needed: Critical thinking about psychiatric medications. Keynote Address, 4th International Conference on Social Work in Health and Mental Health. Quebec City. Retrieved from http://www.ahrp.org/about/CohenPsychMed0504.pdf.
- Cohen, D., & Jacobs, D. (2000, Winter). A model consent form for psychiatric drug treatment. Journal of Humanistic Psychology. Retrieved from http://ssri-research.com/informed_consent.
- de Jong, T. R., Snaphaan, L. J., Pattij, T., Veening, J. G., Waldinger, M. D., Cools, A. R., et al. (2006). Effects of chronic treatment with fluvoxamine and paroxetine during adolescence on serotonin-related behavior in adult male rats. Eur Neuropsychopharmocological, 16(1), 39–48.CrossRefGoogle Scholar
- Goode, E. (2004, February). Stronger warning is urged on antidepressants for teenagers. New York Times, p. A12.Google Scholar
- Hu, X. H., Bull, S. A., Hunkeler, E. M., Ming, F., Lee, J. Y., Firemen, B., et al. (2004). Incidence and duration of side effects and those reported as bothersome with selective serotonin reuptake inhibitor treatment for depression: Patient report vs. physician estimate. Journal of Clinical Psychiatry, 65(7), 959–965.PubMedCrossRefGoogle Scholar
- Johnson-Greene, D. (2007). Informed consent: Too much of a good thing or not enough? Commentary: Evolving standards for informed consent: Is it time for an individualized and flexible approach? Professional Psychology: Research and Practice, 38(2), 183–184.Google Scholar
- Kafka, M. P. (1996). Therapy for sexual impulsivity: The paraphilias and paraphilia-related disorders. Psychiatric Times, XIII(6). Retrieved from http://www.psychiatrictimes.comp960627.html.
- Kauffman, R. P. (2008). Persistent sexual side effects after discontinuation of psychotropic medications. Primary Psychiatry, 15, 24.Google Scholar
- Kauffman, R. P., & Murdock, A. (2007). Prolonged post-treatment genital anesthesia and sexual dysfunction following discontinuation of citalopram and the atypical antidepressant nefazodone. The Open Women’s Health Journal, 1, 1–3.Google Scholar
- Montejo-Gonzalez, A. L., Llorca, G., Izquierdo, J. A., Ledesma, A., Bousono, M., Calcedo, A., et al. (1997). SSRI-induced sexual dysfunction: Fluoxetine, paroxetine, sertraline, and fluvoxamine in a prospective, multicenter, and descriptive clinical study of 344 patients. Journal of Sex and Marital Therapy, 23(3), 176–194.PubMedGoogle Scholar
- Raz, A. (2005). Perspectives on the efficacy of antidepressants for child and adolescent depression. Public Library of Science: Medicine, 3(1), e9.Google Scholar
- Safarinejad, M. R. (2007). Safety and efficacy of escitalopram in the treatment of premature ejaculation: A double-blind, placebo-controlled, fixed-dose, randomized study. Journal of Clinical Psychopharmacology, 27, 444–450.Google Scholar
- Weintraub, N., Cohen, D., Klipper-Aurbach, Y., Zadik, Z., & Dickerman, Z. (2002). Deareased growth during therapy with selective serotonin reuptake inhibitors. Archives of Pediatrics and Adolescent Medicine, 156(7), 696–701.Google Scholar
- Wise, E. H. (2007). Informed consent: Too much of a good thing or not enough? Commentary: Informed consent: Complexities and Meanings. Professional Psychology: Research and Practice, 38(2), 183–184.Google Scholar
- Zajecka, M. D., Mitchell, B. S., & Fawcett, J. (1997). Treatment-emergent changes in sexual function with selective serotonin reuptake inhibitors as measured with the Rush Sexual Inventory. Pharmacology Bulletin, 33(4), 755–760.Google Scholar