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Take a Pill, Kill Your Sex Drive? 6 Reasons Antidepressants Are Misnamed

Two researchers say calling these medications "antidepressants" may make marketing sense -- but it's not very scientific.

Should a drug that produces sexual dysfunction for the majority of users and which doubles the risk of a suicide attempt be labeled an antidepressant ? No, argues a recent  Scientifica article, “ Relabelingthe Medications We Call Antidepressants." The article's authors,  David Antonuccio, psychologist at the Department of Psychiatry and Behavioral Sciences, University of Nevada School of Medicine, and  David Healy, psychiatrist at the Department of Psychological Medicine, Bangor University in the UK, point out that “to call these medications antidepressants may make sense from a marketing standpoint but may be misleading from a scientific perspective.” They conclude that “it may make just as much sense to call these medications antiaphrodisiacs as antidepressants because the negative effects on libido and sexual functioning are so common.”

If a greater percentage of antidepressant users suffer from sexual dysfunction than are relieved of depression, in a scientific sense, it is not silly to label the medication in terms of the condition that it affects most? And while Prozac, Paxil and Zoloft are antidepressants for some people, for other people they are suicidality inducers, agitation enhancers and mania stimulators.

Antonuccio and Healy  offer six reasons why  Prozac, Paxil, Zoloft, Celexa, Lexapro and other so-called antidepressants should not be labeled antidepressants.

1. An Actual Antidepressant Should Not Interfere with Sexual Functioning

Loss of interest in pleasurable activities such as sex is one symptom of depression, and so it is odd that a medication that results in a loss of interest in sex could be labeled as an antidepressant.

Antidepressant manufacturers estim ate that 2% to 16% of antidepressant users experience sexual dysfunction. However, a 2001 study in the  Journal of Clinical Psychiatry  examined 610 women and 412 men with previously normal sexual functioning who were being treated with antidepressants, and it found that 59% reported sexual dysfunction, 62% of the men and 57% of the women (women reported more severe symptoms). Dysfunctions included decreased libido and inability to have an orgasm . Comparable rates of sexual dysfunction have been found in a  2010 Psychiatry Investigation study.

In antidepressant trials, 30% to 40% of subjects routinely gain relief from depression, and so the percentage of antidepressant users who suffer from sexual dysfunction is higher than the percentage who gain relief from depression.

2. An Actual Antidepressant Should Not Increase Suicidal Thoughts and Attempts

The Food and Drug Administration analysis of antidepressants trials in 4,400 depressed young people found that antidepressants doubled the risk of “suicidality” (suicidal thoughts and suicidal attempts), which occurred in approximately 4% of those taking antidepressants compared with 2% of those taking a placebo. Antonuccio and Healy note that, “While the risk of increased suicidality appears to be relatively low (i.e., two extra suicidal patients for every 100 treated with an antidepressant compared with a placebo) and no patients actually completed suicide in the FDA database of controlled trials, the stakes are clearly high.” The risk is serious enough to warrant FDA “black box warnings” about increased suicidality for patients under the age of 25.

If, for many depression sufferers, one reason to take antidepressants is to prevent suicidal thoughts and attempts, and if antidepressants even slightly increase such suicidality rather than decrease it, does it make sense to label these drugs as antidepressants?

3. An Actual Antidepressant Should Be Clearly Superior to a Placebo

“To be labeled an antidepressant,” Antonuccio and Healy argue, “a medication should be consistently and clearly superior to a sugar pill.” Earlier this year, CBS’ “ 60 Minutes” reported on what antidepressant researchers have long known about antidepressants: placebos do almost as well as antidepressants, even in drug-company studies that are biased toward antidepressants. Antonuccio and Healy state, “To be clear, it appears that many depressed patients improve on antidepressants, but this is also true of those who take placebos.”

Research psychologist Irving Kirsch used the Freedom of Information Act to study published and nonpublished results involving 6,944 patients from the FDA database trials of the six most popular antidepressants (Prozac, Paxil, Zoloft, Effexor, Celexa, and Serzone), and he found that only 43% of the trials favored the antidepressant over placebo.  Kirsch concluded that the impact of antidepressants “are relatively small even for severely depressed patients...the relationship between initial severity and antidepressant efficacy is attributable to decreased responsiveness to placebo among very severely depressed patients, rather than to increased responsiveness to medication.”

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