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A clinical review of antidepressants, their sexual side-effects, post-SSRI sexual dysfunction, and serotonin syndrome

27 July 2023
Volume 32 · Issue 14


Depression and anxiety are common, with one in six people experiencing symptoms in any given week. Of these people, 8.32 million are prescribed antidepressants. People living with HIV are likely to experience psychiatric disorder, with one in three experiencing depression and anxiety, and being at greater risk of developing post-traumatic stress disorder. Sexual side-effects of psychotropic medication are very common, cause distress, and can persist even after the medication has been withdrawn. Antidepressants are powerful drugs and can have severe interactions with many other substances. This article seeks to raise awareness of sexual side-effects of psychotropic medications and draw attention to ethical issues related to post selective serotonin reuptake inhibitor sexual dysfunction (PSSD). Additional risk factors and interactions between psychotropic medications and recreational drugs are identified. Recommendations are made to improve care and clinical outcomes through the development of therapeutic alliances.

Statistics indicate that one in six people over the age of 16 experience symptoms of common psychiatric disorders such as anxiety or depression in any given week (Baker, 2023). According to the annual report by the NHS Business Services Authority (2022) 8.32 million people have been prescribed antidepressants. This represents a significant proportion of the UK population. These figures undoubtedly impact on people with HIV: according to statistics from the Terrence Higgins Trust (2022), people living with HIV are twice as likely to experience depression as the general population. It is estimated that one in three people living with HIV experience depression (Terrence Higgins Trust, 2022), and the approximate global prevalence of post-traumatic stress disorder (PTSD) in people living with HIV is 28% (Tang et al, 2020).

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