What are the risks?
For example, some studies have shown that Prozac and its cousins cause
sexual dysfunction in up to 60% of users, though the drug's manufacturer, Eli
Lilly and Co., says the rate is less than half that. Glenmullen points to a
Spanish study published in the Journal of Sex and Marital Therapy in
1997 as one of the best examples: It examined the effects of Prozac, Paxil,
Zoloft, and Luvox in 344 patients and found that 58% experienced sexual
dysfunction. Weight gain and tremors are other leading side effects.
Carla is one patient who has struggled to find an antidepressant with few
side effects. After her family doctor first prescribed Paxil five years ago,
Carla found herself numb to everything around her. "I sure wasn't depressed
anymore," she says. "I wasn't sad, I wasn't happy, I wasn't
anything." Sex with her husband lost all its appeal. "It's kind of hard
to have sex when you have no physical feelings and no emotional
Alarmed, she went back to her doctor. She next tried Prozac -- that had
problems too -- and finally settled on 50 milligrams of Zoloft each day. Never
once has she gone to a psychiatrist or psychologist during these five years.
Such expense seemed unnecessary; after all, she is taking antidepressants.
Lately, though, she wonders. She's starting to feel depressed again, and her
once-a-day Zoloft doesn't seem to help much. "My biggest frustration is
that I wish I could enjoy sex more," Carla says.
Today, some psychiatrists question whether patients like Carla really need
to take antidepressants for years, or whether a dummy pill or therapy alone
might work just as well. Several recent studies indicate that many of the
beneficial effects attributed to antidepressants can be explained by the
"placebo effect" -- the improvement many people experience when they
believe they're taking medicine.
In the April issue of the journal Archives of General Psychiatry,
researchers analyzed studies of seven new antidepressants, using the Food and
Drug Administration's vast database. Their conclusion? The rates of suicide and
suicide attempts were just as high among patients treated with antidepressants
as for those who took placebos.