SEROXAT AND OTHER SSRIs

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The Jeopardy of SSRI’s

Posted by shutah on June 14, 2007

HELEN FISHER
Research Professor, Department of Anthropology, Rutgers University; Author, Why We Love
If patterns of human love subtlely change, all sorts of social and political atrocities can escalateSerotonin-enhancing antidepressants (such as Prozac and many others) can jeopardize feelings of romantic love, feelings of attachment to a spouse or partner, one’s fertility and one’s genetic future. I am working with psychiatrist Andy Thomson on this topic. We base our hypothesis on patient reports, fMRI studies, and other data on the brain.Foremost, as SSRIs elevate serotonin they also suppress dopaminergic pathways in the brain. And because romantic love is associated with elevated activity in dopaminergic pathways, it follows that SSRIs can jeopardize feelings of intense romantic love. SSRIs also curb obsessive thinking and blunt the emotions–central characteristics of romantic love. One patient described this reaction well, writing: “After two bouts of depression in 10 years, my therapist recommended I stay on serotonin-enhancing antidepressants indefinitely. As appreciative as I was to have regained my health, I found that my usual enthusiasm for life was replaced with blandness. My romantic feelings for my wife declined drastically. With the approval of my therapist, I gradually discontinued my medication. My enthusiasm returned and our romance is now as strong as ever. I am prepared to deal with another bout of depression if need be, but in my case the long-term side effects of antidepressants render them off limits”. SSRIs also suppress sexual desire, sexual arousal and orgasm in as many as 73% of users. These sexual responses evolved to enhance courtship, mating and parenting. Orgasm produces a flood of oxytocin and vasopressin, chemicals associated with feelings of attachment and pairbonding behaviors. Orgasm is also a device by which women assess potential mates. Women do not reach orgasm with every coupling and the “fickle” female orgasm is now regarded as an adaptive mechanism by which women distinguish males who are willing to expend time and energy to satisfy them. The onset of female anorgasmia may jeopardize the stability of a long-term mateship as well. Men who take serotonin-enhancing antidepressants also inhibit evolved mechanisms for mate selection, partnership formation and marital stability. The penis stimulates to give pleasure and advertise the male’s psychological and physical fitness; it also deposits seminal fluid in the vaginal canal, fluid that contains dopamine, oxytocin, vasopressin, testosterone, estrogen and other chemicals that most likely influence a female partner’s behavior.

These medications can also influence one’s genetic future. Serotonin increases prolactin by stimulating prolactin releasing factors. Prolactin can impair fertility by suppressing hypothalamic GnRH release, suppressing pituitary FSH and LH release, and/or suppressing ovarian hormone production. Clomipramine, a strong serotonin-enhancing antidepressant, adversely affects sperm volume and motility.

I believe that Homo sapiens has evolved (at least) three primary, distinct yet overlapping neural systems for reproduction. The sex drive evolved to motivate ancestral men and women to seek sexual union with a range of partners; romantic love evolved to enable them to focus their courtship energy on a preferred mate, thereby conserving mating time and energy; attachment evolved to enable them to rear a child through infancy together. The complex and dynamic interactions between these three brain systems suggest that any medication that changes their chemical checks and balances is likely to alter an individual’s courting, mating and parenting tactics, ultimately affecting their fertility and genetic future.

The reason this is a dangerous idea is that the huge drug industry is heavily invested in selling these drugs; millions of people currently take these medications worldwide; and as these drugs become generic, many more will soon imbibe — inhibiting their ability to fall in love and stay in love. And if patterns of human love subtlely change, all sorts of social and political atrocities can escalate.


Comment kindly permitted to be included in this item by a friend of mine:

“Good stuff.  Well I know for a fact taht since I’ve been taking my antidepressants I haven’t rarely had any interest in sex or starting a relationship with a male amongst all those other feelings of not feeling anything but numbness, or the inability of being able to cry and all the things that normal people get to do.  Which is part of the reasons why I so want to come off the damn drugs!  I really miss having emotions.”

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3 Responses to “The Jeopardy of SSRI’s”

  1. “Foremost, as SSRIs elevate serotonin they also suppress dopaminergic pathways in the brain.”

    Different SSRIs have different side effect profiles with respect to dopamine suppression. In all cases, this effect is limited to specific areas of the brain (which differ depending on the SSRI involved) and is not a global effect.

    “And because romantic love is associated with elevated activity in dopaminergic pathways, it follows that SSRIs can jeopardize feelings of intense romantic love.”

    The study this is based on (which you can read here) involved fMRI scans with the participants, who had been in love for between 1 and 17 months looking at pictures of their partners and of strangers. The study in question does support the hypothesis that dopamine plays a role in early-stage romantic love. To quote from the study: “Thus several lines of evidence from both human fMRI and animal studies support the prediction that multiple reward regions using dopamine could be activated during feelings of romantic love.”

    SSRIs selectively affect dopaminergic pathways; there is no clear evidence to suggest that the specific domaninergic pathways that any given SSRI affects are essential or even involved in the process of romantic love. That’s not to say it’s false – just that there’s no evidence for it. The equivalent study – performing the same fMRI experiment with people who are taking SSRIs – does not appear to have taken place.

    “SSRIs also curb obsessive thinking and blunt the emotions – central characteristics of romantic love. One patient described this reaction well, writing: “After two bouts of depression in 10 years, my therapist recommended I stay on serotonin-enhancing antidepressants indefinitely. As appreciative as I was to have regained my health, I found that my usual enthusiasm for life was replaced with blandness. My romantic feelings for my wife declined drastically.”

    Fisher is tenuously connecting two pieces of evidence here. The fMRI studies on romantic love are about “early stage romantic love”, which is indeed characterised by obsessive thinking. Dopamine-related feelings, like obsession, are not typically characteristic of established relationships and the fMRI studies tentatively support the idea that the regions of the brain involved change over time. Fisher has also stated elsewhere that romantic love is not an emotion, but a drive. Blunting of emotions is also characteristic of depression, so this anecdotal evidence is extremely ambiguous as to whether the effects the patient experienced are to do with the SSRI or the depression.

    A quick search on Medline suggests no studies have been carried out on the long term effects of SSRIs on fertility in either men or women. Fisher notes that clomipramine adversely affects sperm volume and motility. Fair enough, but clomipramine is a tricyclic antidepressant not an SSRI. Why is she referencing a drug outside the class she’s taking issue with? Because there haven’t been any studies about sperm volume and motility with SSRIs. It may be reasonable to suggest that SSRIs may have an effect, but there doesn’t appear to be any evidence at all to suggest this is a significant or long-term effect.

    And so on. Fisher may have a point in all this, but if so, it’s masked behind layers of speculation and founded on evidence that’s flimsy at best. Do SSRI’s have an effect on sexual function? Yes. Do they have an effect on romantic love and long term attachment? Yes. But so do depression and the other disorders SSRIs are prescribed for. I’m all for as much study being done on these drugs as possible, but the evidence should be presented in a way that doesn’t mislead or exaggerate, so that those who need to decide whether to take or prescribe them can make realistic and informed decisions. There’s a word for sentences like this – “And if patterns of human love subtlely change, all sorts of social and political atrocities can escalate” – and it’s “scaremongering”. This kind of sensationalism doesn’t help, except perhaps the careers of those involved.

  2. shutah said

    Thank you for your response to Fisher’s article … I always appreciate a ‘balanced view’. I didn’t intend to ‘scaremonger’ and so I apologise if I offended anyone. I am grateful to you and pleased that readers can see both sides of the coin.

  3. Shutah: I’m not offended and don’t see you as scaremongering here. This is a blog that takes a critical position towards the pharmaceuticals industry, so articles of that nature are to be expected here. The reason I respond to these things in so much depth isn’t because I have a specific agenda. Rather, it’s because I think that propaganda on either side of the argument is a bad thing and would like to see the abundant skepticism towards information from the industry applied equally. Not just towards big pharma, but towards all the people who have an axe to grind at the expense of those who have to make decisions about whether to take or prescribe these drugs.

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