Are antidepressants taking the edge off love?

Mental health experts like him already fear that, with recent publicity about suicidal risks in adolescents taking antidepressants, people whose lives could be improved or even saved with medications won't take them. Prescriptions for antidepressants for people 18 and younger fell by 20% since the Food and Drug Administration issued a warning in March 2004 that the drugs may increase the risk of suicide, according to research published in the Sept. 2, 2005, issue of Psychiatric News.

If people think the drugs will hamper their ability to find Mr. or Ms. Right, psychiatrists say, even more might avoid the potentially life-saving medications.

Fisher doesn't quarrel with the drugs' benefits for many with chronic, severe depression. But she worries about people who take the drugs to get through a break-up, a death or a job loss, then keep taking them.

"I'm concerned about well-adjusted men and women who go through a crisis and start taking antidepressants," she says. "They continue taking them, not realizing they may be suppressing these other systems."

Physicians, she says, aren't asking enough of the right questions when they ask their patients about side effects. Lack of awareness of a potentially troubling side effect -- becoming blase about romance -- is reminiscent of the years immediately after the first SSRI, Prozac, was approved in 1988.

At that time, reports were that only about 6% of patients suffered sexual side effects, but the low rate is now understood to have resulted because doctors failed to ask questions about sex and patients were reluctant to bring it up. A later analysis put that figure at about 30%, and a 2001 study at as high as 73%. It is one of the top reasons that people stop taking the drugs.

Doctors may be getting savvier about warning patients about the potential for sexual side effects. But most probably are not asking patients if they feel a blunted drive to search for love.

So far, there is no evidence that a dulling of romantic interest is a universal antidepressant side effect. And when it does appear in people who need the drugs to live and function, doses might be adjusted, or medications changed, Fisher says.

Some scientists dismiss Fisher and Thomson's theory. "Antidepressants tend to tone down the emotions. But they don't interfere with the ability to fall in love. No," says Otto Kernberg, director of the Personality Disorders Institute at the New York Presbyterian Hospital and author of six books on love.

But Tuch says the theory is challenging. "I think it's a call to the psychiatric community to study this. She's raised the question. Now it's our responsibility to look into it," he says.

Until more is known, Thomson has some suggestions for people on antidepressants.

"Regularly ask, 'Do I still need to be on them?' If you're having sexual side effects, ask if everything is being done to mitigate them, because those responses might also be linked to unconscious romantic desires.

"And ask yourself, 'How is this affecting my relationships?' "

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susan.brink@latimes.com