Healthy Habits: "Kids, Meds and Sexual Side Effects: A Harmful Combination?"

This is a piece written by Kaitlin Bell Barnett, a freelance writer whose articles have appeared in numerous national and regional newspapers and magazines, including the Boston Globe, New York Observer, Atlanta-Journal Constitution, and Prevention Magazine. 

In a recently escalating debate over whether antidepressants are effective and worth the risks, the anti-medication side often cites the drugs' notorious sexual side effects as a major strike against them. Studies show that at least 30 to 40 of adult using SSRIs - antidepressants like Prozac, Zoloft and Lexapro - experience side effects such as loss of libido, problems with arousal and trouble orgasming, and the overall number may be much higher.

But the drugs' large cohort of young users tend to get left out of the debate. Just under 4 percent of teens ages 12 to 17 and just over 4 percent of young adults ages 18 to 24 take antidepressants, according to the Centers for Disease Control and Prevention. And other medications that are increasingly prescribed to young people can also cause sexual side effects, notably certain mood-stabilizing drugs intended to even out the highs and lows of bipolar disorder.

If young people experience the samevsexual effects from these drugs as adults - and we can only assume that they do, although a comprehensive 2004 review of the scientific literature found a shocking lack of studies - we have to wonder: what are the effects on their long-term psychological development? After all, sexual experiences in pre-adolescence, adolescence and even young adulthood have a profound impact on identity development.

But doctors, not to mention clinical researchers who conduct formal studies of drug effects, simply aren't bothering to ask young people about how the drugs affect them sexually. That 2004 review, for example, found just one case report of erectile dysfunction in a teenager - even though SSRIs are widely known to cause this side effect in adults.

I began taking SSRI antidepressants as a 17-year-old and don't recall a doctor mentioning the possibility of sexual side effects until I was in my mid-20s. The young people I interviewed for my book, Dosed: The Medication Generation Grows Up, about coming of age on psychiatric medications, didn't recall their doctors broaching the topic, either. One has to wonder if doctors - and perhaps parents, too - just aren't that concerned about the sexual effects in young people because they see teenage sexuality as something to be contained, rather than nurtured.

Some of my interviewees didn't experience particularly troubling sexual side effects - or didn't think the side effects they did experience caused lasting hang-ups. But a few others said it did affect their long-term psychosexual development: it made them more self-conscious, inhibited or anxious in sexual situations.

Adults, especially doctors and other professionals, owe it to medicated young people to warn them about the possibility of such side effects and to discuss other treatment options, both pharmacological and non-pharmacological, as well as ways to mitigate the side effects. Granted, this subject is probably the last thing a teenager wants to discuss with any adult. But it's worth giving young people as much information and guidance as possible early in their medication careers so that years down the road they don't end up concluding that a drug that was supposed to help them caused lasting psychological damage.