Antidepressants: Myth and Facts

Millions of Americans suffer from depression, anxiety, and other mental health conditions. Selective serotonin reuptake inhibitors (SSRIs) can improve a wide variety of these conditions, making these drugs some of the most widely used. Commonly prescribed SSRIs include Prozac (fluoxetine), Celexa (citalopram), Luvox (fluvoxamine), Zoloft (sertraline), Paxil (paroxetine), and Lexapro (escitalopram).

SSRIs work by blocking a receptor in the brain that absorbs the chemical serotonin. Serotonin is known to influence mood, but the exact way SSRIs improve depression isn't clear. SSRIs have the power to mildly influence mood, outlook, and behavior. Although often positive, these same benefits can also be a cause of concern to many people. Will taking an SSRI change you into someone else?

All medicines have side effects, and depression treatments are no exception. Although generally well-tolerated, antidepressant drugs affect each person differently. Understanding the reality behind SSRI myths can help you know what to expect, if you're taking these medicines.
SSRI Myth or Fact: SSRIs Are Dangerous to Combine With Other Medicines.

It's right to ask questions about possible interactions between your medicines. Although no drug is 100% safe for everyone, SSRIs are among the safest. Rarely do SSRIs interact or cause problems with other medicines.

One important exception: SSRIs can cause dangerously high blood pressure when taken with monoamine oxidase (MAO) inhibitors. These medicines are rarely used, and include Marplan, Nardil and Selegiline. Demerol, a very commonly used pain medication in hospitals after surgeries, has also been reported to cause dangerously high blood pressure when used along with an SSRI.

The antibiotic Zyvox (linezolid) acts similarly to an MAO inhibitor, and also should not be taken with SSRIs.

Bottom Line: SSRIs are safe to take with almost all medicines. Ask your doctor or pharmacist to be sure.
SSRI Myth or Fact: Taking an SSRI Will Change My Personality.

It's true that taking an SSRI changes the chemistry inside your brain. This causes subtle changes in the way you feel, act, and behave.

But you just might like the new you. In one of the few studies measuring personality changes in response to antidepressants, those taking SSRIs felt more emotionally stable, outgoing, trusting, and assertive, and less hostile.

SSRIs are approved by the FDA for anxiety or depression that's severe enough to interfere with normal functioning in life. In that case, you could argue, maybe a minor personality makeover is worth a try.

Bottom Line: Treating depression with SSRIs, therapy or both may mean making changes to who you are.
SSRI Myth or Fact: SSRIs Are Addictive.

SSRIs do not cause addiction in the way cocaine, tobacco, or heroin do. After a period of exposure to SSRIs, however, the brain does adapt and get "used to" the medicine. For this reason, you shouldn't stop taking an SSRI suddenly without talking to your doctor. After completing treatment, the SSRI dose is tapered and stopped, and the brain readjusts.

Bottom Line: SSRIs aren't addictive, but they shouldn't be stopped abruptly either- to avoid bothersome but not necessarily dangerous features of serotonin withdrawal syndrome.

SSRI Myth or Fact: If I Start an SSRI, I'll Have to Take it Forever.

Most people take SSRIs for a limited period of time. General treatment guidelines for depression suggest treatment for at least several weeks after symptoms have improved.

Depression, however, returns periodically in many people. The same is true for many other conditions that SSRIs treat. For this reason, a doctor may recommend long-term treatment as prevention against future episodes or exacerbations of symptoms.

Bottom Line: Most people take SSRIs for a limited period of time. People with relapsing depression might benefit from long-term SSRI use.
SSRI Myth or Fact: Taking an SSRI Will Make Me Fat.

People react to different SSRIs in different ways. Some people taking SSRIs put on pounds -- while relatively fewer people stop overeating and lose weight. In one typical study, about 17% of people taking an SSRI gained enough weight that it bothered them.
SSRI Myth or Fact: An SSRI Will Stop Me From Feeling Anything.

Some people report a general dulling of emotion while taking SSRIs. On the other hand, people whose emotions are shut down by depression describe finally being able to feel again.

These are difficult effects to study and are not followed by the FDA or reported by drug manufacturers. Again, different SSRIs may create different effects in different people.

Bottom Line: Taking an SSRI can change how you experience emotions. If an antidepressant creates unpleasant feelings, you should discuss it with your doctor.
SSRI Myth or Fact: Taking an SSRI Will Ruin My Sex Life.

SSRIs do affect libido and sexual experience in many people. Men often experience delayed ejaculation. Men and women may have a decreased intensity or ability to orgasm. Estimates vary, but research shows between 20% and 45% of people will experience some decline in sexual function. SSRIs can increase sex drive by reducing depression, but they can cause impotence and delayed ejaculation, or eliminate orgasms in women.

Wellbutrin is a non-SSRI depression medicine that does not diminish sex drive or intensity. It can be taken with an SSRI as a way to lower the SSRI dose. This often helps people resume their normal sex lives.

Depression and anxiety themselves put the brakes on many people's sex lives. Some people report that lifting of depression brings back their desire for sex.

Bottom Line: SSRIs commonly cause a decline in sexual function. Talk to your doctor, as there are strategies to deal with this serious side effect.

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