Let's talk about the potential long term side effects of antidepressants (SSRIs)

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Depression is a serious mental health condition that affects millions of people worldwide. Luckily, there are a variety of treatment options available to help those struggling with depression, including therapy, lifestyle changes, and medications. One of the most common medications prescribed for depression are selective serotonin reuptake inhibitors (SSRIs), which work by increasing levels of serotonin in the brain. However, while SSRIs are generally considered safe and effective, there are some potential long-term side effects that patients should be aware of.

First, let's talk about some of the most commonly prescribed SSRIs. You've probably heard of Prozac, Zoloft, Paxil, Celexa, and Lexapro - they're some of the most commonly prescribed medications for depression. They're often considered a first-line treatment because they're effective and relatively easy to tolerate. However, it's important to note that different SSRIs can work differently for different people. Some people may respond better to one SSRI over another, so it's important to work with your doctor to find the best medication for you.

Now, let's talk about the potential long-term side effects of SSRIs. One of the most commonly reported side effects is sexual dysfunction. This can include decreased libido, difficulty achieving orgasm, and erectile dysfunction. While these side effects can be frustrating, it's important to note that they're usually temporary and can often be managed by adjusting the dosage or switching to a different medication.

Another potential side effect of long-term SSRI use is weight gain. This is because SSRIs can affect the way your body processes certain hormones and neurotransmitters, which can lead to an increase in appetite and a decrease in metabolism. However, it's important to note that not everyone who takes SSRIs will experience weight gain, and that lifestyle factors like diet and exercise can also play a role.

One potential long-term side effect of SSRIs that is less commonly discussed is the risk of bone loss. Studies have shown that long-term use of SSRIs can lead to a decrease in bone mineral density, which can increase the risk of fractures and osteoporosis. This is particularly concerning for older adults who may already be at risk for bone loss.

So, what can you do to mitigate the potential long-term side effects of SSRIs? First, it's important to work with your doctor to find the right medication and dosage for you. They can also monitor you for potential side effects and make adjustments as needed. Additionally, making lifestyle changes like maintaining a healthy diet and exercise regimen can help offset some of the potential weight gain associated with SSRIs. Finally, if you're concerned about the potential risk of bone loss, make sure to talk to your doctor about getting a bone density test and taking steps to maintain bone health.

While SSRIs are generally considered safe and effective for the treatment of depression, it's important to be aware of the potential long-term side effects. By working with your healthcare provider and supporting yourself with healthy lifestyle considerations, you can help mitigate these risks and continue to manage your depression effectively. Remember, depression is a treatable condition, and there is no shame in seeking help.

References:

  1. Santarelli L, Saxe M, Gross C, et al. Requirement of hippocampal neurogenesis for the behavioral effects of antidepressants. Science. 2003;301(5634):805-809.

  2. Frodl T, Jäger M, Smajstrlova I, et al. Effect of hippocampal and amygdala volumes on clinical outcomes in major depression: a 3-year prospective magnetic resonance imaging study. J Psychiatry Neurosci. 2008;33(5):423-430.

  3. MacQueen GM, Yucel K, Taylor VH, et al. Posterior hippocampal volumes are associated with remission rates in patients with major depressive disorder. Biol Psychiatry. 2008;64(10):880-883.

  4. Warner-Schmidt JL, Duman RS. VEGF as a potential target for therapeutic intervention in depression. Curr Opin Pharmacol. 2008;8(1):14-19.

  5. Clayton AH, Pradko JF, Croft HA, et al. Prevalence of sexual dysfunction among newer antidepressants. J Clin Psychiatry. 2002;63(4):357-366.

  6. Serretti A, Chiesa A. Treatment-emergent sexual dysfunction related to antidepressants: a meta-analysis. J Clin Psychopharmacol. 2009;29(3):259-266.

  7. Montejo AL, Llorca G, Izquierdo JA, Rico-Villademoros F. Incidence of sexual dysfunction associated with antidepressant agents: a prospective multicenter study of 1022 outpatients. Spanish Working Group for the Study of Psychotropic-Related Sexual Dysfunction. J Clin Psychiatry. 2001;62 Suppl 3:10-21.

  8. Kanakam N, Raipally JR. Long-term sexual dysfunction following selective serotonin reuptake inhibitor (SSRI) antidepressant use: a narrative review. Sex Med Rev. 2021;9(1):38-46.

  9. Csoka AB, Bahrick A, Mehtonen O-P. Persistent sexual dysfunction after discontinuation of selective serotonin reuptake inhibitors. J Sex Med. 2008;5(1):227-233.

  10. Richards JB, Papaioannou A, Adachi JD, et al. Effect of selective serotonin reuptake inhibitors on the risk of fracture. Arch Intern Med. 2007;167(2):188-194.

  11. Haney EM, Chan BK, Diem SJ, et al. Association of low bone mineral density with selective serotonin reuptake inhibitor use by older men. Arch Intern Med. 2007;167(12):1246-1251.

  12. van den Brand MW, Pouwels S, Samson MM, et al. Use of antidepressants and bone mineral density in older adults: the B-PROOF study. J Bone Miner Res. 2017;32(4):718-726.