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Since 2018 I have been in treatment for a mildly depressive state, with anxiety and hand tremors. The therapy has borne fruit considering that the depression has practically been eradicated, but from time to time the anxiety and tremors persist. Unfortunately, I have had sexual problems for some time, in particular low desire and erection difficulties. possible correlation with therapy? I’m 49 and I’ve never had this kind of problem.

He answers Giancarlo CerveriDirector of the Complex Operational Unit of Psychiatry, ASST of Lodi (VAI AL FORUM)

The most commonly used treatments to treat major depression are selective serotonin reuptake inhibitors (SSRIs) or serotonin norepinephrine reuptake inhibitors (SNRIs). A few are known for both of these drug classes side effectsranging from a general decrease in sexual desire to a more general effect of emotional numbing. The latter condition is described as indifference, detachment, reduced responsiveness, and apathy. People with this type of condition complain of reduced tendency to laugh or cry, less empathy towards others. a condition that resemblesanhedoniais one of the cardinal symptoms of depression, which is expressed in the loss of the ability to experience pleasure.

The difference between the two conditions is mainly due to the fact that anhedonia prevents you from feeling pleasure and positive emotions, while flattening affects all emotions, even negative ones. Furthermore, the former is constitutive of some forms of depression and improves with adequate treatment, while the latter arises following the initiation of antidepressant therapy. If the most common side effects of SSRIs are gastrointestinal disorders (nausea and diarrhoea), sexual disorders are immediately subsequent in frequency and as a reason for the suspension of treatments. In research on the subject, it has been observed that SSRIs can lead to decreased libido, arousal phase disorder, erectile dysfunction and delay in reaching or not reaching orgasm.

In some research such ailments seem to reach a prevalence of 80% of the cases treated. This type of disorder then appears to be highly variable in its expression between males and females. In conclusion, I invite you to discuss these problems with your trusted doctor, as there are effective tools to be able to treat the problem by identifying its causes and modifying, if deemed necessary, the treatment in order to stop any side effects. This procedure can be obtained using antidepressants of other pharmacological classes.