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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 12 of 12. This is the beginning of the thread.
Posted by ed_uk on November 20, 2006, at 15:17:03
"Young people taking antidepressants are at increased risk from self-harm or suicidal behaviour, according to a new analysis that supports previous studies.
It also indicates that fluoxetine, the only antidepressant to be given a favourable risk benefit profile by the Committee on Safety of Medicines for use in children and adolescents, may be no less risky than some other newer antidepressants.
Researchers from the University of Manchester’s biostatistics group examined data collected from randomised placebo-controlled trials of children and adolescents aged six to 18 years treated with fluoxetine, sertraline, citalopram, paroxetine, venlafaxine or mirtazapine.
Self-harm, suicidal thoughts or attempted suicide occurred in 71 of the 1,487 (4.8 per cent) young people treated with antidepressants compared with 38 of the 1,254 (3.0 per cent) given placebo. Expressed differently, this means that 57 young people need to be treated for one additional event to occur.
The researchers observed that fluoxetine was associated with an overall small risk of any event (relative risk 1.6, 95 per cent confidence interval 0.9–3.1). The risk of suicide attempts was similar to but higher than that for paroxetine. However, they warn that the results for individual drugs and events need to be interpreted cautiously because they are based on small numbers with relatively few incidences of adverse events.
The researchers warn that to get an accurate picture of suicidal behaviour prospective studies are needed that do not exclude the most depressed suicidal children (British Journal of Psychiatry 2006;189:393)."
Posted by Quintal on November 20, 2006, at 18:11:19
In reply to New UK study looks at risks of ADs in children, posted by ed_uk on November 20, 2006, at 15:17:03
I've always wondered about the effect SSRIs would have on the sexual development of children as they reached adolescence. I mean most of us here know how effective they are at 'killing' sexuality, so how is a kid going to explore their sexual feelings and participate in the normal dating rituals etc, not to mention masturbation and sex?
What effect would/does this have on their ability to relate to their peers at this level during the teenage years?
Anyone here been taking them since they were a child or know someone who has?
Q
Posted by Phillipa on November 20, 2006, at 23:07:38
In reply to Re: New UK study looks at risks of ADs in children » ed_uk, posted by Quintal on November 20, 2006, at 18:11:19
Starting to sound as if SSRI's may be out in the Uk Love Phillipa
Posted by ed_uk on November 21, 2006, at 14:46:26
In reply to Re: New UK study looks at risks of ADs in children » ed_uk, posted by Quintal on November 20, 2006, at 18:11:19
>Anyone here been taking them since they were a child or know someone who has?
I've been on SSRIs since I was about 14. I *do* think that they have affected my ability to enjoy sex. I have never enjoyed sex, even though I do sometimes have a libido - to some extent. I find it very difficult to consider having a relationship because of this.
Ed
Posted by Quintal on November 21, 2006, at 15:32:30
In reply to Re: New UK study looks at risks of ADs in children » Quintal, posted by ed_uk on November 21, 2006, at 14:46:26
Ed, I took my first SSRI paroxetine at 17 and the anorgasmia scared the hell out of me. I found an email from a guy who had withdrawn and six months later could still not ejaculate. He was asking the manufacturer GlaxoSmithKline when this would correct itself and they totally blanked this question in their reply. That was enough to make me throw the rest of my Seroxat in the bin.
Have you ever withdrawn from them to test your responses or is that not worth the risk? It seems they have had a permanent dulling effect on my ability to feel pleasurable sexual sensations. This ruined the sex life I had when I did finally get my first sexual partner.
I feel a little angry when I think of this since in a way if SSRIs are responsible for this then they have caused permanent (?) harm. Have you heard of 'Post SSRI Sexual Dysfunction?' http://en.wikipedia.org/wiki/Post_SSRI_Sexual_Dysfunction.
Q
Posted by ed_uk on November 21, 2006, at 17:13:44
In reply to Re: New UK study looks at risks of ADs in children » ed_uk, posted by Quintal on November 21, 2006, at 15:32:30
Hi Q
>Ed, I took my first SSRI paroxetine at 17 and the anorgasmia scared the hell out of me
I can orgasm easily on all SSRIs, but have low libido. If I stop the SSRI I orgasm with almost no stimulation (like a rebound effect) but my libido is still quite low. If you're not used to thinking about sex it takes a while to start thinking about it again I suppose.
>It seems they have had a permanent dulling effect on my ability to feel pleasurable sexual sensations
I've been on SSRIs for about 8 years. They haven't caused any physical numbness or anything like that. It's more a case of eating a chocolate bar being more interesting than having sex.
>This ruined the sex life I had when I did finally get my first sexual partner.
I don't have a partner at the mo. I don't think I could satify someone because I just wouldn't be interested enough. I might start having sex then two minutes later I'd be wanting to go watch TV or something.
Ed
Posted by Quintal on November 21, 2006, at 18:05:35
In reply to Re: New UK study looks at risks of ADs in children » Quintal, posted by ed_uk on November 21, 2006, at 17:13:44
>I can orgasm easily on all SSRIs, but have low libido. If I stop the SSRI I orgasm with almost no stimulation (like a rebound effect) but my libido is still quite low. If you're not used to thinking about sex it takes a while to start thinking about it again I suppose.
That's a real problem for me, but there may be a physical reason for it. I've taken SSRIs on and off for about 7 years and have noticed a definite rebound in libido after stopping them, but that soon fades and I reach a level not much better than on meds. I suppose my libido *may* have declined anyway since I was 17 but not that much.
Have you tried dopamine agonists to treat the low libido Ed or does it not bother you? I had success with Solian (an unexpected bonus), but I wonder if the elevated prolactin level it often causes may cause sexual dysfunction itself long term? I would like to try cabergoline, but how do you rate my chances with a pdoc hostile to all possible euphoriants in the UK?
I think bromocriptine, and the antihistamine cyproheptadine have also been used successfully to treat SSRI sexual dysfuction? GP would not prescribe bupropion off licence.
Q
Posted by Phillipa on November 21, 2006, at 18:24:17
In reply to Re: New UK study looks at risks of ADs in children » ed_uk, posted by Quintal on November 21, 2006, at 18:05:35
I used to do malpractice cases as an RN expert witness when still working. A lawsuit can be initiated if the condition is permanent and irreversable. Love Phillipa
Posted by Quintal on November 21, 2006, at 18:32:16
In reply to Re: New UK study looks at risks of ADs in children » Quintal, posted by Phillipa on November 21, 2006, at 18:24:17
The problem with is finding objective proof and evidence. How can you do this with something as subjective as libido? It's too easy to deny and trivialize.
Q
Posted by ed_uk on November 22, 2006, at 16:44:40
In reply to Re: New UK study looks at risks of ADs in children » ed_uk, posted by Quintal on November 21, 2006, at 18:05:35
Hi Q
>I've taken SSRIs on and off for about 7 years
How old are you Q? 24?
>Have you tried dopamine agonists to treat the low libido Ed or does it not bother you?
No, I haven't. The low libido doesn't bother me that much but I would prefer to have a normal libido. I don't think any doc in the UK would be willing to prescribe a dopamine agonist for me.
>I had success with Solian (an unexpected bonus), but I wonder if the elevated prolactin level it often causes may cause sexual dysfunction itself long term?
Loss of libido is common with Solian. I definitely think it could be a problem.
>I would like to try cabergoline, but how do you rate my chances with a pdoc hostile to all possible euphoriants in the UK?
Cabergoline is unlikely to be euphoric, but I still don't think your pdoc would prescribe it. AFAIK, off label use of dopamine agonists is almost unheard of in the UK. Cabergoline is also very expensive, which is a big issue in the cost-conscious NHS :(
>I think bromocriptine, and the antihistamine cyproheptadine have also been used successfully to treat SSRI sexual dysfuction?
Apparantly so. Cyproheptadine can cause a lot of drowsiness though. I have taken cypro myself and can tell you that there is no way I could ever have sex after taking a cypro!
Take care
Ed
Posted by Quintal on November 23, 2006, at 11:38:37
In reply to Re: New UK study looks at risks of ADs in children » Quintal, posted by ed_uk on November 22, 2006, at 16:44:40
Hi Ed,
Yes, I'm 24.
>Cabergoline is unlikely to be euphoric, but I still don't think your pdoc would prescribe it. AFAIK, off label use of dopamine agonists is almost unheard of in the UK. Cabergoline is also very expensive, which is a big issue in the cost-conscious NHS :(
I'm guessing dopamine agonists may be euphoric for me because I had that reaction to Solian. I doubt the NHS would fund cabergoline treatment too. I wonder if I could get a pdoc to write out a private prescription? I've had other meds this way (Xanax), but that still leaves the expense.
How would you rate the sedative effect of cyproheptadine? Stronger than promethazine or diphenhydramine? May I ask why you tried it?
Q
Posted by ed_uk on November 25, 2006, at 14:47:26
In reply to Re: New UK study looks at risks of ADs in children » ed_uk, posted by Quintal on November 23, 2006, at 11:38:37
Hi Q!
I tried cyproheptadine for insomnia. It was sedating but not as much as promethazine. I didn't like it though, it made me feel a bit depressed. Definitely not good for my libido!
Ed
This is the end of the thread.
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