Furious Seasons

January 21, 2009

Anti-Depressants Good For Post-Coital Blues

At times, I've been deeply critical of some of psychiatrist Richard Friedman's work in the New York Times, but a column of his published Jan. 19 continues to intrigue me. The basic premise is that Friedman ran into a couple of otherwise-healthy patients who reported experiencing intense bouts of depression after sex (yikes). Friedman found little evidence of how to handle such cases in the medical literature--apparently such cases are rare--so he hypothesized that perhaps the patients were undergoing some kind of neurochemical change in their brains that caused the brief depressions.

He gave each an SSRI--he doesn't identify which--and it seemed to help the depressions abate. Friedman is quick to note that SSRIs commonly lead to sexual dysfunction, but he's intrigued by how these two outlier cases turned out. So am I. Even though I generally regard SSRIs as garbage and the chemical imbalance theory of depression as an unproven guess, I've never denied that there's a group of people for whom these drugs are worthwhile. How large that group is is hard to say--my hunch has usually been around 10 percent to 20 percent of people with depression--and who knows if people with post-coital blues would all respond similarly to an SSRI, but it sure is interesting.

Posted by Philip Dawdy at January 21, 2009 11:25 AM

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Comments

Intriguing.... but what's the point of medicating a BRIEF and predictable episode of depression?

Posted by: Jamie at January 21, 2009 11:49 AM

Were the subjects men, women or both?

It might shed some light on the depression after sex....no?

Posted by: susan at January 21, 2009 12:01 PM

I have the solution:
The world population is bipolar and with all the troubles in the world we are all suffering PTSD.
By law everybody has to have an AD, an antipsychotic and a mood stabilizer.

Wow!
I don't know what to say about all this nonsense.

Posted by: Ana at January 21, 2009 01:49 PM

Philip,
Was this a one-shot thing or did he put them on say, a low-dose ongoing regimen? If the former, I'd vote for placebo. I'd probably vote for placebo with the latter, actually, given the dismal performance of most anti-depressants.
Sherry

Posted by: Sherry at January 21, 2009 01:58 PM

I vote for "This is normal for some people!" as well as "Feeling loads of energy!" is normal for others!

What on earth is normal?
Some women complaim their partners fall asleep. What drug should they take?

Posted by: Ana at January 21, 2009 02:47 PM

I still think this wreaks of narcissism on Friedman's part, arbitrating what's normal and what isn't and using meds to bring an experience down to what he can tolerate. There are two alternatives to meds as I see it. One is some cognitive behavioral therapy to see if the crash or whatever it is can be modulated by how the lover talks to him or herself after the experience. The second is that there might really be some sexual -- or more likely relationship issue -- that accounts for the reaction. Sure it's a "quirk of biology" but it's still some kind of signal to change something.

Posted by: Sara at January 21, 2009 03:10 PM

this is ludicrous and criminal...many people have issues around sex...PSYCHOLOGICAL issues...they're rampant...

to even consider using a drug for a brief and remitting period of depression brought on by sexual activity is horrible.

why you want to give Friedman the benefit of the doubt is beyond me.

the fact that perhaps antidepressants occasionally alleviate depressive symptoms is not reason enough in this instance.

Posted by: Gianna at January 21, 2009 03:17 PM

Well, if the SSRI's don't work there's always Abilify.

Posted by: Lisa at January 21, 2009 06:07 PM

It's interesting to note that the countries that have the highest prescription rate for ssri's are also the countries that had the biggest financial collapse at the end of last year. Happy people giving out mortgages willy nilly and creating complex and fragile financial structures?

Posted by: Lilian Nattel at January 21, 2009 07:56 PM

Maybe it's a hormonal fluctuation, or a bad relationship not addressed, whatever the case I feel sorry for them, that would be depressing!

Posted by: Stephany at January 21, 2009 10:33 PM

What was the old saying? "If it hurts, you are doing it wrong."

Posted by: MedsVsTherapy at January 22, 2009 09:45 AM

Peace be with you

I would be curious to know if exercise or any other non-invasive therapy was attempted before the drug was prescribed?

love eternal
tad

Posted by: tad at January 31, 2009 08:59 AM