Physical symptoms. Some patients taking SSRIs develop insomnia, rashes, headaches, joint and muscle pain, stomach upset, nausea, or diarrhea. These problems are usually temporary, mild, or both.
Bleeding problems. A more serious potential problem is reduced blood clotting capacity that increases risk for stomach or uterine bleeding. If patients use SSRIs and NSAIDs (aspirin, ibuprofen, naproxen, COX-2 inhibitors) at the same time, the risk more than doubles, so these drugs must be combined with care.
Sexual effects. For many patients, SSRIs diminish sexual interest, desire,
performance, satisfaction, or all four. Lowering the dose, switching antidepressants, or for men, taking a drug like Viagra can help.
Suicide. The risk that antidepressants will incite violent or self-destructive actions has become the subject of renewed controversy. One reason for concern is the increasing number of children and adolescents receiving prescriptions for antidepressants. When compared with a placebo, all antidepressants, including SSRIs, seem to double the risk of suicidal thinking, from 1%–2% to 2%–4%, in both children and adults.
