Sexual Dysfunction – the Forgotten Taboo 01/14/2005 By, TX

I originally posted this article in February of 2012 but wanted to re-blog it because I think it is one of the most important articles I’ve found.  I believe that many in the mental health field are well aware that these drugs cause sexual dysfunction, but they choose to ignore the complaints of patients who have lost their credibility through psychotic behavior.  Also, for years I have tried to find studies on the subject, writing to such well-known people as Dr. Thomas Szasz and Dr. Peter Breggin, who cordially answered me but said they could not direct me to any.

Below I have copied and pasted the article in its entirety.  I don’t seem to be able to find it that way online anymore.  It seems to have been tucked away somewhere in a medical journal that is less easy for the public to access.  ~ Linda Kay


“Recent surveys show that people being treated for schizophrenia consider sexual dysfunction to be one of the most intolerable side- effects of antipsychotic medication (Hellewell, 2000; Rethink, 2002). Historically, mental health nurses may have shied away from discussing sexual difficulties, either through embarrassment or for fear that acknowledging a link with medication might affect compliance. A better understanding of anti-psychotic medication and its effects along with a more rational and collaborative approach to treatment can, however, enable nurses to help people overcome medication-induced sexual difficulties. This will, of course, require skill and sensitivity. First, though, they must be armed with an understanding of some of the physiology involved in this problem. This article by Shubalade Smith and Tony Gillam will, therefore, explain the physiological effects of prolactin before going on to explore the implications of this knowledge for mental health nurses

Dopamine is the main prolactin inhibitory factor and most antipsychotic drugs work primarily as dopamine 2 receptor-blocking agents. Prolactin is secreted by the anterior pituitary gland and the control is regulated by the hypothalamus via the secretion of dopamine. Any disruption of the anterior pituitary gland may result in excessive secretion of prolactin, termed hyperprolactinaemia.

This dopamine-blocking property is fairly non-specific with most anti-psychotics, yet it is thought to account for their antipsychotic activity. Thus the desired action of these drugs – blockade of limbic dopamine receptors – is offset by blockade in other areas of the brain accounting for the distressing movement side-effects and the hyperprolactinaemia that are commonly seen with these medications.

Raised prolactin levels

When under the inhibitory control of dopamine, prolactin usually remains within normal limits. However, prolactin increase can be caused by a variety of physiological factors including pregnancy, breast-feeding, stress, pain, following an epileptic seizure and exercise. Prolactin levels also vary during the day, with maximal levels being secreted in the early hours of the morning.

In animals, prolactin is responsible for sexual behaviour. Very little is known about the normal physiological role for prolactin except that it is the hormone responsible for lactation in breast- feeding women.

Hyperprolactinaemia is a concern for mental health nurses because there is a relationship – not necessarily a causal one in all cases – between hyperprolactinaemia and various aspects of physical health. These include:

* Sexual and reproductive dysfunction

* Weight gain

* Breast cancer

* Bone mineral density and osteoporosis

* Cardiovascular problems

Any changes in physical health are likely to impact psychologically and socially on the individual and it is essential that the mental health nurse knows something of the physiological effects of hyperprolactinaemia, which are detailed in turn below.

Anti-psychotics and reproductive function

Hyperprolactinaemia secondary to pathological causes such as a pituitary tumour is commonly associated with sexual dysfunction including low libido, erectile and ejaculatory dysfunction in men, vaginal response abnormalities and difficulty achieving orgasm in women. In addition, hyperprolactinaemia is a common cause of infertility secondary to the hypogonadism (low levels of gonadal hormones, i.e. low oestrogen, progesterone and testosterone) that it can induce. This hypogonadism may increase the risk of low bone mineral density and subsequent osteoporosis. Despite the well- documented effects of raised prolactin, the effects of antipsychotic- induced hyperprolactinaemia are not well known (Biller; 1999 Lim, 1987; Colao et al, 1996)

Recently studies have shown that far from being a benign side- effect of antipsychotic treatment, hyperprolactinaemia may cause profound sexual and reproductive dysfunction in both men and women. It is associated with menstrual irregularities and infertility in women and this puts them at greater risk of osteoporosis (Smith et al, 2002a; Smith et al, 2002b).

The same studies show that patients taking long-term antipsychotic medication have prolactin levels that exceed the upper limit of normal. This finding was more pronounced in women compared with men. When gonadal function was assessed, this gender difference was significantly greater, with 85% of women showing inadequate gonadal function compared with only 6.4% of the men. It is of note that 40% of the women reported normal menstrual cycles, yet only 85% of these were not actually ovulating. Thus even normal periods are not a guarantee of normal reproductive functioning in women taking anti-psychotic medication. For women, there was a significant, inverse relationship between prolactin and endocrine measures. This suggests that hypogonadism is associated with anti-psychotic- induced hyperprolactinaemia. This hypothesis is supported by the lack of correlation between endocrine function and age in women (ibid).

Anti-psychotics and sexual dysfunction

The true incidence of sexual dysfunction associated with anti- psychotic medication may be underestimated because patients, in particular women, may be reluctant to report these events spontaneously (Harrison et al, 1986). As a result, sexual dysfunction is underestimated in the management of patients on long- term anti-psychotic treatment.

A survey by Rethink (formerly the National Schizophrenia Fellowship) found that patients felt sexual dysfunction was one of the most intolerable side-effects of anti-psychotic medication (Rethink, 2002). This is a similar finding to Hellewell et al (2000), who found that patients rated sexual dysfunction as one of the worst side-effects of anti-psychotics, yet mental health professionals rated sexual dysfunction as being much less troublesome to patients than this.

The effects that these medications have on sexual and reproductive function appear to be quite profound, yet studies (Tran, 1997; Beasley, 1997) that rely on spontaneous reporting of these side-effects tend to report low levels of these problems. If patients are asked directly about these side effects, they report high levels of sexual dysfunction and, perhaps more importantly, feel that sexual dysfunction is the most troublesome side-effect of anti-psychotic medication.

Sexual dysfunction occurs in almost 50% of patients taking anti- psychotic medication. In men it is most likely to be caused by the autonomie side-effects of the anti-psychotic, unless the man becomes hyperprolactinaemic, in which case, this will override any other causes and be the main cause of his sexual dysfunction. In women, hyperprolactinaemia is the main cause of the sexual dysfunction identified (Smith et al, 2002b).

Anti-psychotics and weight gain

There is evidence to show that hyperprolactinaemia induced by antipsychotic drugs may be one of the causes of weight gain that is seen in patients with chronic psychosis (Baptista et al, 1997a; Baptista et al, 1997b; Baptista et al, 2001). This is thought to be a direct metabolic effect of the hyperprolactinaemia rather than being an indirect effect e.g. via increasing appetite. The consequences of this are that patients may put on weight with certain prolactin-raising antipsychotics even if they have a healthy, balanced diet. This problem may be more noticeable in women. Traditionally, where patients have complained of weight gain, nurses have resorted to encouraging a healthier lifestyle, discussing diet and exercise with the patient, perhaps even making a referral to a dietician. Though a healthier lifestyle can obviously do no harm the frustrating fact remains for both nurse and patient that, despite both parties’ best efforts, this strategy alone may not solve the problem.

Anti-psychotics and breast cancer

There is evidence that patients with breast cancer have hyperprolactinaemia and this is thought to be a consequence of breast cancer cells secreting prolactin ectopically (Bhatavdekar et al, 2000). As yet there is no firm evidence linking hyperprolactinaemia causally to breast cancer in humans, although research in rats shows an increased rate of tumour growth in hyperprolactinaemic animals (Welsch et al, 1975). More research is required to ascertain whether being in a long-term hyperprolactinaemic state, as is the case with many patients with serious mental illness, is associated with a greater incidence of breast cancer.

Anti-psychotics and bone mineral density

Osteoporosis is now recognised as a major health problem world- wide and it is increasing due to greater life expectancy. The risk of osteoporotic fracture in white women at the age of menopause is 30-40%. Over two million people in the UK suffer from osteoporosis now, but that figure could double in the next 20 years. All other conditions associated with chronic states of low blood oestrogen have associated bone loss changes (for example, anorexia nervosa sufferers and post-menopausal women). The Department of Health (1998) recommends that both females with long-term amenorrhoea and hypogonadal males should be considered at high risk of osteoporosis. Disorders where females have never menstruated (primary amenorrhoea) are associated with extreme oestrogen deficiency, severe osteoporosis and high fracture rates (Davies et al, 1995). Disorders with infrequent menstrual cycles ar\e associated with reduced bone mineral density (BMD) (Adami et al, 1998). In situations where prolactin is either pathologically elevated (prolactin-secreting tumours) or physiologically elevated (breast-feeding women), menstruation is suppressed, and BMD is reduced (Caird et al, 1994). It is thus very likely that women on neuroleptic medication with hyperprolactinaemia and hypoestrogenaemia have decreased BMD. Recently this has been confirmed by studies, which show that anti- psychotic medication is indeed associated with low bone mineral density and that prolactin levels are particularly important in this respect (Meaney and O’Keane, 2002; Howes and Smith, 2002).

Anti-psychotics and the cardiovascular system

In pre-menopausal women, oestrogen is known to be cardio- protective, i.e. it reduces the likelihood of a cardiac event such as a myocardial infarction. This cardio-protection is lost in postmenopausal women who have low levels of oestrogen and their risk of developing cardiac disease increases to a level similar to men. It may be that the hypogonadal state induced by anti-psychotic medication (this refers to long-term antipsychotic administration i.e up to one year) represents a chronic loss of oestrogen and thus a chronic loss of the usual cardioprotective factor in females. As yet there has been no formal research into the effects of prolactin- raising anti-psychotics on cardiac function in women. This is an area for concern.

The effects of the atypical anti-psychotics on prolactin secretion

A typical antipsychotic drugs work differently to typical traditional antipsychotics, in that they have high affinity for both serotonergic and dopaminergic receptors. Some of these newer atypical antipsychotic drugs (olanzapine and ziprasidone) cause only transient rises in prolactin. Quetiapine and clozapine are, indeed, prolactin-sparing and therefore much less likely to cause the high levels of prolactin seen with traditional neuroleptics.

Hyperprolactinaemia and its effects on compliance with medication

With the advent of the newer atypical antipsychotic medications, comes the possibility of improving compliance by reducing distressing side effects. Discontinuation of drug treatment in schizophrenia is associated with a 96% chance of relapse at two years (Gitlin et al, 2001). The costs of this in terms of individual, family and social distress, not to mention economic costs, are huge. Even treatment with clozapine, the most expensive atypical anti-psychotic drug is cheaper than the cost of protracted in-patient care (Aitchinson and Kerwin, 1998). Atypical anti- psychotics are as effective as traditional anti-psychotics yet have a better side effect profile. Minimal sustained effect on prolactin is one of the distinguishing characteristics of atypicals.

The fact that conventional neuroleptics cause hyperprolactinaemia means that the propensity for them to cause sexual dysfunction is high. We have seen that patients feel that sexual dysfunction is one of the most unacceptable side-effects of anti-psychotic medication. Unfortunately, patients seem unlikely to spontaneously report sexual difficulties and clinicians seem equally unlikely to ask. The newer atypical anti-psychotic agents tend not to have profound effects on prolactin and are thus less likely to cause chronic hyperprolactinaemia and the reproductive dysfunction associated with it.

Giving patients opportunities to discuss their health beliefs and sharing information about drug effects and side effects may reduce the likelihood of non-compliance with treatment. In addition, the prescribing of medication that is less likely to produce sexual side- effects will go a long way to alleviating a patient’s concerns. It would be helpful if discussion of the patient’s current sexual life became a routine part of the therapeutic intervention, thus establishing that any sexual problems can be discussed with clinicians. Apart from normalising and removing some of the associated embarrassment, this could also help provide a baseline assessment of sexual function and menstrual history prior to commencement of medication.

For patients with suspected hyperprolactinaemic-induced sexual dysfunction, reduction of dose may produce an improvement as this is usually a dose-related phenomenon. An even better option might be to change to a drug less likely to raise prolactin, or to switch to a prolactin-sparing antipsychotic. It is important to remind patients that following a change in medication, particularly to a prolactin- sparing medication, their fertility may return to normal and they will need to decide what they wish to do regarding contraception.

It could be argued that in view of the inevitability of hyperprolactinaemia with conventional neuroleptics and the very high likelihood of a resultant gonadal dysfunction, prolactin-sparing anti-psychotics should be used first-line in all new patients with psychotic illness. This reduces the risk of cardiovascular disease and osteoporosis in a group which is already likely to suffer poorer physical health. It is recognised, for instance, that people with severe mental illness – perhaps because they may tend to smoke heavily, follow a less healthy lifestyle in terms of exercise and diet and present later with physical illness – have extremely high death rates from common physical illnesses like heart disease and cancer (Department of Health, 1992).

Implications for mental health nurses

There is insufficient space in this article to explore the nursing implications of all the possible effects of hyperprolactinaemia. Reproductive function, weight gain, the potential risks of breast cancer and effects on bone mineral density and the cardiovascular system have all been mentioned briefly. This article has emphasised the nurse’s role in relation to sexual dysfunction taking, as its starting point, the disparity between the relative importance placed on this by patients and by nurses (Hellewell, 2000; Rethink, 2002). Compliance with treatment is another important area that has been considered briefly but is worthy of further exploration, particularly in the climate of supplementary prescribing by nurses and the increasingly systematic monitoring of side effects by nurses (using tools such as the Liverpool University Neuroleptic Side-Effect Rating Scale [LUNSERS]).

While sexual function can be seen as a purely biological symptom requiring biological management, mental health nurses are likely, with their bio-psychosocial model of health, to posit the problem in its psychosocial context. This may mean, for example, taking into account questions of sexuality. Psychiatry has a chequered past in matters of sexuality, particularly in its attitude to gay people, and mental health nurses should be aware of this. Homosexuality is no longer – as it once was -viewed as a psychiatric disorder in its own right; however, mental health services are not necessarily neutral in their treatment of gay people. Gay women, for example, have reported that their sexual orientation is ignored, viewed as the cause of their problems or seen simplistically as the result of factors such as sexual abuse (Project for I Advocacy, Counselling and Education [PACE] 1998).

Many mental health nurses will be conscious of a seemingly disproportionate number of patients having been victims of sexual abuse. While it is unlikely to be a new phenomenon in our society, it is only since the late 1980s that sexual abuse has begun to be recognised as more prevalent that had previously been thought. It would seem, from surveys, that one in eight women is a victim of sexual abuse in childhood with the figure rising to as much as 50 per cent in women who use mental health services (Johnstone, 2000). It is not only women who are affected. Men who were sexually assaulted either as children (an estimated one in 20) or as adults (around three per cent) are very much more likely to end up in contact with mental health services (ibid). Great sensitivity is needed when discussing sexual matters as victims of abuse may experience this, not merely as embarrassing or intrusive, but as abusive in itself.

Sexual dysfunction is, in one sense, an individual’s difficulty but, where that individual is in a relationship or seeking to be in a relationship, it becomes a shared difficulty. Patients may want the nurse to discuss the difficulty, and practical solution to it, with their partners present and mental health nurses may find themselves being drawn into sexual health counselling or impromptu conjoint or marital therapy – roles for which they may not feel well equipped.

There are obvious implications for professional training and supervision arising from this. No doubt nurses have always found themselves in therapeutic relationships where patients have confided in them their concerns over intimate physical and psychological problems. In this sense, facilitating discussion about sexual dysfunction is nothing new. What is different is that, given our growing awareness of sexual dysfunction relating to antipsychotics, mental health nurses are now being encouraged to highlight these concerns, and for their responses to be evidence-based. Rather than offering mere reassurance or suggesting the patient sees their GP, the onus is now on the nurse to consider the problem in the light of optimal medication, treatment compliance and the psychosocial context of the patient. Mental health nurses may, therefore, increasingly need not only good information about medication and its side effects, including hyperprolactinaemia, but a greater willingness to discuss sexual matters. Training and supervision will, in turn, need to address sexuality, how to support victims of abuse and how to work, not only with individuals but, at times, with individuals and their partners, whilst maintaining professional standards of confidentiality.

There is also a question of matching the gen\der of the nurse to that of the patient. This is not to say that all female patients should have female nurses and all male patients male nurses. First, this is probably unmanageable in most adult mental health services. second, there are female patients (even some who have suffered sexual abuse) who prefer to talk to a male mental health nurse, while female nurses may not always feel comfortable dealing with male patients’ complaints of sexual dysfunction. A sensible approach would be, at the least, to take into consideration the needs and preferences of patients and to attempt to be flexible in allocating individuals to different members of the team.


As with most questions in mental health care, in response to the problem of sexual dysfunction there is both a simple and a complex answer. At its simplest, the mental health nurse’s intervention might involve reassuring the patient that there is something that can be done to help. Since it appears that the side-effect of sexual dysfunction is dose-related in many cases it follows that a reduction in dosage or switching to an anti-psychotic that has less prolactin-raising effects would improve the situation.

At a more complex level, broaching the subject of sexual dysfunction may lead to the patient (perhaps with their partner) wishing to talk about sexual difficulties generally, their anxieties about sex and relationships, or their past experiences. It may be that mental health services need to be more sensitive and more flexible to meet this need. Initiatives such as the Access, Booking and Choice (ABC) Programme, led by NIMHE and the Modernisation Agency, are intended to support local services to meet NHS Plan delivery priorities. These include improving people’s choice and the experiences of those using services. Change can take place at a service level. At the same time, mental health nurse training and supervision may need to be enhanced in some of these areas if nurses are to feel confident and competent at helping people with this sometimes ‘forgotten’, sometimes ‘taboo’ aspect of their lives.


Adami S, Zamberian N Castello R, Tosi F, Gatti D and Moghetti P (1998) Effect of hyperandrogenism and menstrual cycle abnormalities on bone mass and bone turnover in young women. Clinical Endocrinology (48) 169-173

Aitchison KJ and Kerwin RW (1998) Cost-effectiveness of clozapine. A UK clinic based study. British Journal of Psychiatry (171) 125-30

Baptista T (a), Molina MG, Martinez JL, de Quijada M, Calanche de Cuesta I Acosta A, Paez X Martinez JM, Hernandez L (1997) Effects of the antipsychotic drug sulpiride on reproductive hormones in healthy premenopausal women: relationship with body weight regulation. Pharmacopsychiafry 30 (6) 256-62

Baptista T (b), Alastre T, Contreras Q, Martinez JL, Araujo de Baptista E, Paez X Hernandez L (1997). Effects of the antipsychotic drug sulpiride on reproductive hormones in healthy men: relationship with body weight regulation. Pharmacopsychiatry 30 (6) 250-5

Baptista T, Lacruz A, Meza T, Contreras Q, Delgado C Mejias MA, Hernandez L (2001) Antipsychotic drugs and obesity: is prolactin involved? Canadian Journal of Psychiatry 46 (9) 829-34

Biller BM (1999) Hyperprolactinaemia. Iniernational Journal of Fertility and Women’s Medicine 44 (2) 74-7

Bhatavdekar JM, Patel DD Shah NG, Vora HH, Suthar TP, Ghosh N, Chikhlikar PR and Trivedi Tl (2000) Proiactin as a local growth promoter in patients with breast cancer: GCRI experience. European Journal of Surgical Oncology 26 (6) 540-7

Caird LE, Reid-Thomas V, Hannan WJ, Gow S and Glasier AF (1994). Oral progesterone-only contraception may protect against loss of bone mass in breast-feeding women. Clinical Endocrinology (41)739- 45

Colao A De Rosa M, Sarnacchiaro F, Di Sarno A, Landi ML, lervolino E, Zarrilli S, Merola B, Lombard! G (1996) Chronic treatment with CV 205-502 restores the gonadal function in hyperprolactinaemic males. European Journal of Surgical Oncology 135 (5) 548-52

Davies MC, Gulekli B, and Jacobs HS. (1995). Osteoporosis in Turner’s Syndrome and other forms of primary amenorrhoea. Clinical Endocrinology (43) 741-6

Department of Health (1992) The Health of the Nation: a strategy for health in England. London, HMSO

Department of Health (1998) Clinical Guidelines for Strategies to Prevent and Treat Osteoporosis. London, HMSO

Gitlin M, Nuechterlein K, Subotnik KL, Ventura J, Mintz J, Fogelson DL, Bartzokis G and Aravagiri M (2001). Clinical outcome following neuroleptic discontinuation in patients with remitted recent-onset schizophrenia. American Journal of Psychiatry 158(11): 1835-42

Harnson WM, Rabkin JG, Ehrhardt AA, Stewart JW, McGrath PJ, Ross D and Quitkin FM (1986) Effects of antidepressant medicafion on sexual function: a controlled study. Journal of Clinical Psychophamiacology 6 (3) 144-9

Hellewell J (2000) Tolerability and patient satisfaction as determinants of treatment choice in schizophrenia: A multi national survey of the attitudes and perceptions of psychiatrists towards novel and conventional antipsychotics. Presented at the 13th European College of Neuropsychopharmacology Congress, 9-13 September 2000, Munich, Germany

Howes O, Smith S (2002). Hyperprolactinaemia caused by antipsychotic drugs. Endocrine antipsychotic side effects must be systematically assessed. British Medical Journal 324 (7348) 1278 Johnstone L (2000) Users and abusers of psychiatry (2nd edition). Eondon, Routledge

Lim VS (1987) Reproductive function in patients with renal insufficiency. American Journal of Kidney Disease 9 (4) 363-7

Meaney AM and O’Keane V (2002) Prolactin and schizophrenia: clinical consequences of hyperprolactinaemia. Life Science 71 (9) 979-92

Project for Advocacy, Counselling and Education [PACE] (1998). Diagnosis: Homophobic. The experiences of lesbians, gay men and bi- sexuals in mental health services. London, Project for Advocacy, Counselling and Education [PACE]

Rethink (2002). A Question of Choice. Available at:

Smith S (a), Wheeler MJ, Murray R and O’Keane V (2002). The Effects of Antipsychotic-induced Hyperprolactinaemia on the Endocrine Reproductive System. Journal of Clinical Psychopharmacology 22 (2) 109-14

Smith S (b), O’Keane V and Murray R (2002). Sexual Dysfunction in patients taking conventional antipsychotics. British Journal of Psychiatry (181) 49-55

Welsch CW, Louks G, Fox D and Brooks C (1975) Enhancement by prolactin of carcinogen induced mammary cancerigenesis in the male rat. British Journal of Cancer 32 (4) 427-31

Full Time: The Forgotten Taboo – antipsychotic-induced hyperprolactinaemia and its implications for mental health nursing

Authors: Shubalade Smith Is clinical senior lecturer and honorary consultant psychiatrist, the Institute of Psychiatry. Tony Gillam is clinical team leader, South Worcestershire early interventton service

MHN Vol 25 No 1 pp 6-9

Copyright Community Psychiatric Nurses Association Jan 2005

Source: Mental Health Nursing

Taken from NetDr Health News:”

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Alternative Mental Health – Alternative to Meds Center Program Overview

This video showed up in my Facebook memories today. I just added it to my Vlog on my YouTube channel, “LindaKay1948”.

There’s a center in Arizona that offers alternatives to drugs when it comes to helping people with mental health.

First of all, they run tests for things like heavy metals and nutritional deficiencies that might be causing problems for the client. Then they offer chelation therapy, talk therapy, natural foods, and meaningful activities in an agrarian environment. They also help people wean off psychiatric drugs.

Perhaps I would still be working in the field of mental health if I’d had the opportunity to do it in an alternative program such as this one. It may be more expensive than conventional treatments, and I don’t know whether most insurance would cover it.

Here’s the link where you can find more info:


…and here’s the link to the video:



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Mad In America: Inappropriate Use of Antipsychotics on Adults with Intellectual and Developmental Disabilities

This is  so sad.  I’ve worked with disabled adults and children and hated to see them given so many drugs.

(Click on text to read article.)

“Recent data, published in The Canadian Journal of Psychiatry, finds that a large proportion of adults with intellectual and developmental disabilities (IDD) are prescribed antipsychotic drugs. Researchers found this to be the case for both those who have been diagnosed with psychiatric disorders and those without any documented diagnosis…..

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Antidepressant drugs made woman believe she had killed her own children … Hallucinations, crushed libido, side effects galore

Back in 2009 I contacted a man on YouTube who said his name was Kevin.  He had bravely posted a video about persistent sexual dysfunction from SSRIs.  In it he wore a red shirt and went under the user name of “ManFromUK”.

In the video he spoke of his own loss along with the complaints of over a thousand members in a support group for people suffering from seemingly permanent sexual dysfunction.  They were suffering not only from ED, but both men and women were experiencing genital anesthesia long after taking, and then discontinuing, SSRIs.  He said that he had come to the U.S. and spoken about this health issue at a large gathering of the American Psychological Association.

I messaged him, asking if he knew of any support groups for those who suffered such losses from antipsychotics.  He said he didn’t know of any, but referred me to the SSRI group.  Even though I have never taken SSRIs, I was admitted to the group and have been following it ever since.  When I last looked there were almost 4,000 members.  Here is the link:

I wonder if this article mentions the same Kevin:


Antidepressant drugs made woman believe she had killed her own children … Hallucinations, crushed libido, side effects galore

Antidepressant drugs made woman believe she had killed her own children … Hallucinations, crushed libido, side effects galoreWhen you read the side effects on a package of antidepressants – or any medication, for that matter – it’s easy to brush them off out of a desire to start feeling better quickly. Problems like fatigue, nausea and decreased libido are just words on a page and easy to dismiss … until they happen to you.

If you or a loved one is thinking of taking these medications, you might want to read the story of Katinka Blackford Newman first. Her experience illustrates the very ugly side of these drugs that few people talk about, and shows how it can impact real people in a way that those package inserts can never truly convey.

Her story is one that a lot of people can relate to. The sleepless nights and tumult of going through a divorce led her doctor to prescribe the antidepressant escitalopram. Just a few hours later, the psychosis set in, and she hallucinated that she had killed her own children. When she was brought to the hospital, the doctors did not realize she was having an adverse reaction to the antidepressants, and gave her even more pills. (RELATED: Find more news about medical violence at

She describes the next year as a nightmare, saying she was so sick she could barely even leave her house. Unable to sit still, she felt suicidal and lost her relationship with her children. She says the drugs made her an “overweight, dribbling wreck, unable to finish a sentence.” When a different hospital took her off all five medications a year later, by what she describes as “a stroke of luck” when her private insurance ran out, she felt reborn, and was back to her usual self within weeks, working as a filmmaker and preparing for a half-marathon.

One part of her life that did not go back to normal right away, however, was her interest in sex. Although her libido did eventually return, she is now drawing attention to the many people who experience sexual dysfunction as a result of taking antidepressants. In some cases, normal sexual function never returns after discontinuing the drugs.

Most people experience genital numbing within half an hour of taking a pill, and a study in the Journal of Clinical Psychiatry involving nearly 1,000 people, estimates that nearly 60 percent of those taking the most popular SSRIs experience sexual side effects.

This problem is so widespread that it even has a name, Post SSRI Sexual Dysfunction (PSSD). It can affect men and woman alike. One man, Kevin Bennett, has shared his story in hopes of sparing others what he suffered after starting Prozac for anxiety when he was 18. He says he become completely impotent within four days. He thought the side effect was only temporary at first. After quitting the medication cold turkey, however, side effects like drowsiness subsided, but his sexual function never returned to normal.

Bennett even went so far as to write a letter to the drug’s manufacturer, Eli Lilly, to ask for advice about the problem, which was preventing him from having normal relationships. The Big Pharma firm responded that Prozac was not the problem and he should consult his GP. This was in 1997; the drug now carries a warning that sexual dysfunction can persist even after stopping treatment, so it’s clear the company was not being honest with him.

After seeing a slew of doctors including neurologists, radiologists, urologists and endocrinologists, it became apparent that his body was working normally and that the Prozac was the culprit. A muscle relaxant injection just before intercourse is the only way he can perform, a situation he describes as “humiliating.”

Even if you can live without sex, the other side effects of SSRIs are just as bad, if not worse. The prospect of becoming suicidal is perhaps the most disturbing of all. Before mindlessly filling a prescription from your doctor for antidepressants, research the side effects carefully and look into alternative coping mechanisms like cognitive behavioral therapy, exercise, yoga and meditation.”

Sources include:

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Monica’s Story: The Aftermath of Polypsychopharmacology, by Monica Cassani ~ November 12, 2012

“The tragedy is that during all those years of being drugged during the prime of my life I felt purposeless, flat, barely alive and sexless.”

I recently contacted the doctor who is responsible for my iatrogenesis — the doctor who grossly over-medicated me and made me ill. I’ve been corresponding with him for several years now, but this was the first telephone conversation I’ve had with him since telling him what his drug cocktail did to me. He rarely says much in response to my emails where I link to the articles I’ve written casting large shadows on the “treatment” he gave me. So I called him and left a voicemail that I might talk to him.

When he returned my call a few days later, we talked for perhaps a half hour. I always liked this man when I was his patient and now that I’ve worked through most of the rage of having been harmed by his treatment, I still like him. His intentions were good. I’m clear on that. I do not think this relieves him of responsibility, but it does relieve me from hating him which simply isn’t good for my soul. Still, I simultaneously appreciate Dr. David Healy’s insight about patients succumbing to Stolkholm Syndrome and have made the same observation about myself. I contain multitudes. There is nothing easy about emotionally processing what happened to me and what continues to happen to so many others.

So my conversation with the man who practiced wild, untested poly-pharma on me was actually quite civil and I felt it was productive too. He listened and shared his view too. He did not always agree, but he was clearly listening.

I want to share a bit of the conversation. He has a hard time believing that what happened to me is routine, that it happens to many patients. He grants me my experience, though, like a good shrink. He believes me when I tell him both that my mind is clear now and that I’ve been gravely harmed by the drugs. I’m not sure he thinks he’s responsible, but he doesn’t challenge my experience. The phrase cognitive dissonance comes to mind. How do they do this? I don’t claim to understand.

So he said something suggesting what happened to me isn’t the norm. That he sees medications working wonders all the time. I challenged him like this, “Dr. M, when you were treating me you thought I was one of your successes, right?” He said, “Yes.” And I responded with, “Well, you were wrong. My life was miserable. I lived in a drugged haze. I slept and worked because that is all I had time to do. I had no passion for what I did and I just lived by going through the motions, flat and empty. My life was hell. I liked you and you needed to believe that I was okay…I tried to please you like a “good patient.” Still if you’d paid attention you know that I was always asking to be put on disability. That’s because it was insane for me to work 8 hours a day when I required 12 hours of sleep because of the heavy sedation. It was also dangerous for me to drive on that pharmaceutical cocktail yet I needed to drive to keep my job. If you had really paid attention you would have known my life was miserable. And I promise you, you have other patients just like me.”

I’m sharing that vignette as an opening because I think most doctors hear stories like mine and think that they are not the ones perpetrating such injury. My doctor is a very well-reputed psychiatrist in the Bay Area, CA. He’s well-known and well-regarded. He is a typical psychiatrist and typical psychiatrists are causing grave harm every day all over this country and throughout a good part of the world. He still seems to believe that I’m an anomaly and that somehow I’m not his problem. Yes, cognitive dissonance.

So I was on a six drug combination including every class of psychiatric drug at high doses that required over six years of withdrawal. I was left severely ill, afflicted by a severe iatrogenic illness: “Withdrawal syndrome” for lack of a better name. The name makes it sound like something that might last days or weeks but it’s crippled my life for years. Those of us who become this sick (I’ve networked with thousands of folks in withdrawal now) are subject to dangerous care and outright denial of our experience by medical doctors and the medical establishment in general.

What possesses a doctor to prescribe such a cocktail? I don’t think I’ll ever know, but I can tell you how it happened.

The drugs never did “work” and in retrospect they made me much worse… in fact they caused the chronic illness I am now living with. It became clear to me when I was unable to continue working about fifteen years into the (heavy) drugging as my mind and body simply stopped cooperating under a fog of neurotoxic chemicals. I knew I had to try to free myself from them.

So, how did it all begin? After an illicit drug-induced mania I triggered in college, psychiatry got a hold of me. I was told that I was bipolar and would be sick for the rest of my life. One doctor, in fact, told me I would die if I did not take medication for the rest of my life. Having suffered repeated traumas in my life the additional trauma I was subjected to in the psychiatric ward took its toll. I gave in to what they told me, they scared me good including threats to send me to a state hospital for permanent residence. It’s clear to me now this was used only to terrorize me into submitting to drug treatment, it was not a threat that would have been carried out, but I did not know that then.

The truth, however, is that I had a history of trauma that needed tending to, not any sort of brain disease as mental illness is popularly understood. The years of heavy drugging, in the end, is the only thing that made me truly sick. That is, psychiatric and physical symptoms caused by the drugs I was being given for “treatment.” My original diagnosis, bipolar disorder, given as a life sentence never really had much credibility. The tragedy is that during all those years of being drugged during the prime of my life I felt purposeless, flat, barely alive and sexless. I went from being a fit and toned athlete to being 100 lbs over-weight and unable to exercise much at all due to the sedation and nausea. Yes, I had long-term chronic nausea as an adverse effect of the Lamictal. I went through the motions of living while in a fog.

Now, drug-free, I’m quite often too ill to leave my home but my mind is crystal clear. I am motivated and productive, the author and editor of a popular mental health blog that offers alternatives to psychiatry. Having been both a professional in the mental health system and a victim of the same system, I have some interesting and uncomfortable insights into the standard of care. I’m passionate about my work. I have more of a life than I ever had on drugs even while able-bodied and even though now my life is painfully limited in ways it’s hard to convey to those who’ve never experienced such illness and isolation.

In retrospect I see now how one drug led to the next. The “mood-stabilizers” which left me depressed led to the antidepressants which left me with insomnia and agitation which led to the benzos for sleep. They still didn’t get rid of the agitation which led me to the antipsychotics (which made everything worse and in fact my doc kept adding Risperdal milligram by milligram until I was on 11 mg for my akathisia which I now know is CAUSED by the Risperdal—he was treating a symptom with the very drug that was causing the symptom!! My akathisia ceased when I finally got off the Risperdal. We always called it “anxiety”, but it was akathisia.

That big cocktail of drugs left me sedated and lethargic. No surprise. The next step was stimulants. Addiction and dependence to benzos also leads one to needing more and more drug to get the same “therapeutic effect.” And so my dose continued to increase. Unfortunately I’ve learned this happens to way too many people, some of whom never even realize it. Drugs leading to more drugs leading to more drugs. And once in the trap it’s almost impossible to see clearly. To realize what is going on is difficult and perhaps sometimes impossible.

I’ve been free of this massive cocktail of drugs for over two and half years now. The sad part is the greatest amount of suffering I’ve ever endured in my life has been a result of my body adjusting to no longer having neurotoxic drugs in my system. Medically-caused harm and a term that often sounds Orwellian to those of us who experience the protracted version: withdrawal syndrome. It totally fails to capture the grave disability some of us experience.

Still, I have not one moment of regret for having freed myself from these drugs because my mind is clear! I have a clarity of mind that is so beautiful I can cry if I spend time thinking about it. My clarity was stolen from me for almost half my life. I have it back and even impaired as I am, unable to leave the house most of the time, I am grateful.

I once made a list of the myriad insults my body and mind endured. It included over 50, mostly disabling symptoms. What is most astonishing is that I am exponentially better now and don’t experience the bulk of these symptoms anymore, but I’m still very very sick. This, again, is something very few people can conceive of. It’s mind-boggling to me as well and I’ve experienced it.

The fact is our bodies and minds are intrinsically driven to seek wellness and mine is no exception. I am on a path towards wholeness. I don’t imagine it will stop now. There is no going back.

(Read more about Monica in one of my previous blogs ~ LindaKay1948):

If I Had Remained Med Compliant… by Monica Cassani

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Benzo Awareness Day: Psych drugs cause harm (VIDEO)

Here is someone whose award-winning blog I have followed for years. Monica Cassani is someone who has overcome great suffering from psychiatric meds. This amazing lady painstakingly withdrew from all classes of them after she had become overweight, bed-ridden, non-verbal and unable to sit up for two years, and had been home-bound for five. She is now drug-free, healthy, and happy again.

(July 11th, let us unite with all who’ve been harmed by psychiatric drugs)

For more information visit:

*it is potentially dangerous to come off medications without careful planning. Please be sure to be well educated before undertaking any sort of discontinuation of medications. If your MD agrees to help you do so, do not assume they know how to do it well even if they claim to have experience. They are generally not trained in discontinuation and may not know how to recognize withdrawal issues. A lot of withdrawal issues are misdiagnosed to be psychiatric problems. This is why it’s good to educate oneself and find a doctor who is willing to learn with…

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Torturing new mothers and then wondering why they get mentally ill.

This is the essence of what happened to me as a young mother:

“Torturing new mothers? Who does that? Well, as a society, we all do. I’m not kidding, I’m perfectly serious, and I’m going to stop mincing my words and say it how it is. We torture mothers.

Sleep deprivation is a method of torture that has been used for at least 500 years, and is still used today. It was used extensively in Guantanamo Bay. The difference between sleep deprivation in Guantanamo bay and in new mothers is that no-one is systematically and intentionally hurting new mothers. But the effect is the same. Sleep torture is designed to create psychological changes, which are supposed to encourage the victim to submit, to lose their sense of reality, and to talk.

Chronic sleep deprivation is not good for you. It leads to cognitive impairment, anger and irritability, anxiety, and even psychosis.  Yes, you read that right. Chronic sleep deprivation is known to cause psychosis. Puerperal psychosis in new mothers is not common thankfully, but it is dangerous.  I’ve been lucky enough to attend a few study days on perinatal mental health recently, and they have all included really valuable talks by people who have recovered from severe postnatal depression, post traumatic stress disorder and psychosis. What I noticed was that they all had one thing in common . They all mentioned lack of sleep as a factor in their illness. The lovelySinead Willis talked about “lack of sleep started to catch up with me….I couldn’t sleep more than an hour at night and I became very disorientated”. One of the effects of sleep deprivation is disorientation, or a feeling of “altered reality”. At another talk I was lucky enough to hear, the mother told us that she hadn’t slept at all for the first three days of her baby’s life, but no one noticed, because she was in a private hospital room on her own. She developed psychosis within a matter of days.  Elaine Hanzak, author of “Eyes without sparkle” talks about the fact that during her treatment, she would look forward to her Electro-Convulsive Therapy sessions, because “they have to put you to sleep first….bliss”.

Chronic sleep deprivation is when you have no opportunity to make up your sleep debt. You go on, night after night, suffering from not enough sleep. Acute sleep deprivation is when you lose sleep for one night, but you can then catch up. Even acute sleep deprivation has a marked effect on our mental health. In one study by Walker and colleagues, healthy young students were split into two groups. One group were sleep deprived, the other group slept normally.  The next day, both groups were shown disturbing, upsetting and gory pictures. The researchers found that there were significant differences in the brain activity of the two groups, as measured by MRI scans. The sleep deprived group showed reactions similar to anxiety reactions. Their amygdala lit up like an alarm bell to the disturbing images, firing off stress hormones, whilst the normal group’s brain showed a more balanced reaction, with the parts of the brain that “panic and worry” being balanced by the part of the brain that “reasons and rationalises”. In the sleep deprived group, their ability to process and mediate the anxiety was damaged.

People have always thought that anxiety and depression causes disturbed sleep. But this research suggests that lack of sleep can cause anxiety.  All on its own, and in only one night.  Whilst new mums aren’t shown disturbing images by scientists, they do have disturbing images all of their own. Worries and concerns about the baby, feelings of guilt, not being good enough, intrusions of hurting the baby, concerns about baby’s feeding, and so on. And of course, once anxiety sets in, it becomes more difficult to sleep, increasing the chances of depression setting in, and a vicious cycle begins with a force of its own.

With all this in mind, is it any wonder that we have such high rates of anxiety, depression, and psychosis postnatally? Women usually give birth overnight, sometimes over two or three nights. They are then put in a busy maternity ward with lights on, other women and babies crying, constant interruptions from staff and so on. Or they are sent home alone with just a very tired husband. Either way, they have a baby with them, who they need to keep alive, learn to feed, and look after. On no sleep.  Then, when the father goes back to work after his 2 weeks of paternity leave, it is perfectly acceptable in our society for her to say “I’ll do the night feeds, because you have to work all day”. She isn’t understanding the value, the necessity, of her sleep for her mental health. Neither is the father, or the health visitor, or society in general.   Her sleep debt builds, increasing the risk to her mental health.

In other cultures, mums are made to rest, recuperate, stay in bed, and do nothing but get to know baby. They are fed, washed, pampered with hot stone massages, and so on. Almost all non-westernised cultures have a ritual similar to this, which lasts about 40 days.  In the West, mums are not made to rest. They are expected to go on as normal, with the washing, the school run, losing baby weight, going shopping and so on.  Mums are told “sleep when baby sleeps”. However, this simply is not good enough. Because mum needs to eat, and she needs to shower, and she needs to get dressed sometimes, and she needs to go to see the health visitor and have baby weighed, and baby might only sleep for 20 minutes at a time. Then, when dad goes back to work, it gets even more chronic, because she offers to do the night feeds so that he can get up and work the next day. The importance of her physical and emotional health is ignored, at a high cost to the devastation that perinatal mental illness causes, and a high cost to the NHS.

Let’s stop torturing mothers. Let’s stop ignoring the problem of expecting new mums to get back to normal. They are not normal, they are super important, and we need to value them and treat them with the greatest respect, if we don’t want them to break into a million pieces, shattering the lives of all those around them. The NHS needs to prioritise maternal mental health, not just with adequate treatment facilities once the damage is done, but also with prevention in the first place. Proper paternity leave, decent postnatal wards with midwives who have time to care, regular home visits, continuity of care. Change needs to happen in attitudes as well. We need to start telling other people how important it is, to look after mum. Encourage partners to “put mum to sleep”. Tuck her up in bed with a chamomile tea (or a G and T) and tell her to stay there. Turn the lights off for her, bring her an extra pillow, tell visitors to go away because she is sleeping, bring the baby to her when he or she needs a feed. The cost of not doing so, could be her mental health.”

Mia Scotland, Clinical Psychologist, Author of “Why Perinatal Depression Matters”

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FDA: Antidepressant Trials Have Not Adequately Reported Sexual Dysfunction Side Effects

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“A group of US Food and Drug Administration scientists held a forum to discuss how to better evaluate side effects of sexual dysfunction associated with antidepressant drugs during clinical trials, and published their report in the Journal of Clinical Psychiatry.

“Sexual dysfunction is an important side effect of serotonergic antidepressants,” they wrote. “However, sexual dysfunction is often underestimated in clinical trials submitted in support of drug approval. This is because such assessments are based mainly on unsolicited reporting.”

The authors reported on the FDA’s current efforts to develop methodologies for more accurately capturing the scope and severity of sexual dysfunction side effects occurring in trials of new antidepressants.”

‘Trouble is, when people DO report sexual dysfunction after being given psychiatric drugs, they are often ignored.  In my case, after being given an antipsychotic, the credibility of what I said was gone.  I didn’t even know whether there were others suffering like I have been until I found a support group on Yahoo in 2009.  

To put it bluntly, I haven’t been horny in almost 32 years.  I discontinued haldol when I was 35.  I’m 67 now.  (I have never taken SSRIs.)  

My biggest concern is for the CHILDREN being given psychiatric drugs. Will they be able to experience normal puberty?  I think we will have a growing number of people who are asexual.  We will also have more people put on welfare because they’ve been harmed and disabled by the drugs and can no longer work.

(I have adult friends who have taken SSRIs and have reported sexual dysfunction, NOT ONLY ED, but LOSS OF LIBIDO and GENITAL NUMBNESS, PERSISTING YEARS AFTER TAKING AND THEN DISCONTINUING THEM.  They are some of the people I’ve come to know through a Yahoo support group with 3,721 members.)

For some young people, this may be a permanent condition.

For some, it may be a reason they are committing suicide.

 ~ Linda Kay

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The Mental (Illness) system and thoughts on alternatives: a collection

How can we call it our Mental “Health” system, when so many people are being injured and left disabled by it?

“It is no measure of health to be well-adjusted to a profoundly sick society.” – Jiddu Krishnamurti

Lunatic-AsylumI can’t call the current system of care a “mental health system” when it’s so clearly one that generates, encourages and sustains mental illness. And so I’ve often referred to it as a mental illness system. Here I’m underscoring that as it’s important that we make big changes if we want to help not only the most vulnerable people in our society, but also society itself. We create one another. None of this happens in a vacuum.

Below is a list of posts from Beyond Meds that look at the system from many different perspectives. It will become one of the main drop-down navigation menu tabs at the top of the page. It will replace the Professional/Patient Divide tab and will be called Mental Illness System. The contents of it will include those…

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Antipsychotic-induced Sexual Dysfunction Under-reported

Here’s a post from Mad in America mentioning studies involving structured interviews or questionnaires that result in many more patients reporting sexual dysfunctions from neuroleptics (or so-called “antipsychotics”).

Researchers [from the Netherlands] “found that a comparison of different antipsychotics showed high frequencies of sexual dysfunction for risperidone and classical antipsychotics, and lower frequencies for clozapine, olanzapine, quetiapine, and aripiprazole.”‘


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