‘Something So Sacred Has Been Taken Away from Me’

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By Moira Wyton, Local Journalism Initiative Reporter

Emily had taken the antidepressant Citalopram since she was 17, before sex even entered the equation for her. After five years, she’d had enough.
Like about 65 per cent of people who take selective serotonin reuptake inhibitors, or SSRIs — some researchers believe the number is even higher — Emily experienced the side-effect of low libido.
But for a while that seemed worth it for relief from her moderate depression. She took the small pinkish pill each day, and life seemed to get a bit better.
Then at 23 in 2019, Emily told her doctor the sexual dysfunction was depriving her of connection and confidence in her life. Her depression had not improved enough to justify the side-effects, she said, and she would focus on managing it with lifestyle changes and talk therapy.
But within weeks of stopping her daily dose, Emily, a university student on Vancouver Island, woke up to a much worse outcome than she had been aware was even possible. Her genitals were completely numb.
“There was like a vitality that was gone in my body,” said Emily, whose name has been changed to protect her privacy. “My energy source had been cut off, there was no erotic sensation anywhere... my clitoris was like a knuckle.”
She panicked and booked a doctor’s appointment. But the doctor dismissed her concerns as psychological and told her the symptoms would go away on their own. “They couldn’t do anything about it and never heard of it.”
Two years later, she is still numb.
SSRIs and SNRIs have helped millions of people with anxiety and depression since the late 1980s and are often considered first-line drug choices for people who want medication-supported treatment.
About 8.6 per cent of Canadians — 3.3 million people — took some form of antidepressant in 2019, a number that insurance companies say has increased in the pandemic.
“Medications like antidepressants have had profoundly beneficial impacts on people’s lives. No one wants them to be removed,” said Jonny Morris, CEO of the Canadian Mental Health Association in B.C. “What [patients] are calling for, and we support too, is the expressed and informed consent around meds that can have profound impacts on people’s lives.”
Emily is one of what could be thousands of Canadians suffering from post-SSRI sexual dysfunction, a rare and likely underreported potential side-effect syndrome of SSRI medications that is slowly gaining recognition from health-care providers, pharmaceutical companies and the Canadian government.
Underreporting due to shame and stigma make it difficult to estimate how many people experience post-SSRI sexual dysfunction in Canada, but conservative estimates say as many as 10,000 people — one per cent of Canada’s nearly one million SSRI users — could experience this if they discontinue use.
The federal government quietly acknowledged the rare risk of PSSD in a January report that followed freedom of information requests from Emily and other advocates, as well as reports of adverse events collected by experts at the Rxisk platform.
The report from Health Canada said it will ensure manufacturers update safety information for SSRIs and the similar serotonin-norepinephrine reuptake inhibitors, or SNRIs, to include the “potential risk of long-lasting (possibly weeks to years) sexual dysfunction despite discontinuation of SSRIs or SNRIs.”
It followed a similar acknowledgement two years earlier from the European Medicines Agency that “there have been reports of long-lasting sexual dysfunction where the symptoms have continued despite discontinuation of SSRIs/SNRIs.”
But eight months later, there is no update from Health Canada on what steps have been taken to implement the recommendation and warn patients of the potential risk. Two media requests from The Tyee were unanswered.
Emily and dozens of other sufferers say Canada needs to...continued.

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