SSRI Side Effects: Harvard Mental Health Letter discusses the real risks of antidepressants

Harvard Mental Health Letter
  • Bleeding problems. A more serious potential problem is reduced blood clotting capacity that increases risk for stomach or uterine bleeding. If patients use SSRIs and NSAIDs (aspirin, ibuprofen, naproxen, COX-2 inhibitors) at the same time, the risk more than doubles, so these drugs must be combined with care.
  • Sexual effects. For many patients, SSRIs diminish sexual interest, desire, performance, satisfaction, or all four. Lowering the dose, switching antidepressants, or, for men, taking a drug like sildenafil (Viagra) can help.
  • Suicide. The risk that antidepressants will incite violent or self-destructive actions has become the subject of renewed controversy. One reason for concern is the increasing number of children and adolescents receiving prescriptions for antidepressants. When compared with a placebo, all antidepressants, including SSRIs, seem to double the risk of suicidal thinking, from 1%–2% to 2%–4%, in both children and adults.

    • Regular follow-up and close monitoring are important. Also, patients should be warned that there is a slight chance they will feel worse for a while, and that they should let their prescribing clinicians know immediately if they begin to feel worse or develop new symptoms, especially after changing the medication or the dose.

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