this post was submitted on 21 Oct 2024
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Mental Health

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Mild NSFW warning: this post mentions sexual side effects of medication.

SSRIs are the most common type of antidepressant (examples are Prozac/fluoxetine, Zoloft/sertraline, Paxil/paroxetine).

If you have experience with them, do you think they're a good idea?

I came across a paper about side effects which I haven't heard discussed before. Many people know that SSRIs have sexual effects, but apparently they also affect fertility.

This paper describes SSRIs as "gonadotoxic", leading to effects like "decreased sperm concentration and motility, increased [DNA] fragmentation, and decreased reproductive organ weights".

The paper does say "this effect does seem to be reversible", so if you stop SSRIs, your sex organs should apparently go back to normal. But still, some people are on SSRIs for long periods of time, right?

I would be interested to hear others' thoughts, if you have any.

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[–] [email protected] 0 points 3 weeks ago (1 children)

Conditions that are on the label are the conditions the medication is intended to treat, in this case mild to moderate depression. Off label would be using a medication for something else, like using an SSRI to treat hot flushing in menopause or antipsychotics as a sleeping aid. Technically it may work, but the studies are not there to back it, evidence is poor, so it is not shown to he effective and may have associated harm.

[–] [email protected] 0 points 3 weeks ago (1 children)

Thank you, I wasn’t familiar with the term.

[–] [email protected] 0 points 3 weeks ago* (last edited 3 weeks ago) (1 children)

The reason I mentioned it is because the efficacy isn't there especially with stuff like CPTSD and PTSD. So, you give a patient an antidepressant and you diagnose them with depression so the insurance will pay for it, when the underlying cause is actually childhood trauma and then they get a false hope that the depression medication is going to fix them. And they get misdiagnosed in the process.

All of this is problematic for a number of reasons. And of course if the medication doesn't work the doctor will just say well let's try a different SSRI because often we need to go through three or four of them before we find something that works.

What works best for CPTSD is trauma-informed therapy. Thankfully the medical community seems to be getting wiser. And listening to patients better, at least around here.

[–] [email protected] 0 points 3 weeks ago

I would second this. My partner was on an anticonvulsant for a bipolar diagnosis. Why? Because it is used, at a lower dose, as a mood stabiliser. She had limited effect at the sstandard dosage, so the psychiatrist went up in dose to get an effect.

Ultimately she got off all of the meds and is doing better without them, but that is her and her experience, the meds may be useful for some people and not others.