Assessing Sexual Symptoms and Side Effects in Adolescents

• adolescence
• SSRI
• sexual side effects
• sexual symptoms
• TADS
• CAMS

In a recent clinical research meeting, an incident was discussed involving an adolescent boy who was part of a trial investigating pediatric anxiety and taking a selective serotonin reuptake inhibitor (SSRI) for the first time. His therapist noticed he was shutting her out in therapy and did not want to take his medication any longer. The therapist was confused, because the boy’s anxiety appeared to be lessening. During his next meeting with the study psychiatrist (a man), the patient confessed that he was worrying whether he would ever have sex, given that his previous frequent sexual thoughts and feelings had disappeared since he began taking the medication. After the patient’s self-prompted report, the psychiatrist and therapist were able to work together to address the patient’s loss of libido. The fact that the patient had to offer this information on his own accord makes it likely that others, who might be less comfortable discussing sexual issues, might discontinue the medication without addressing this issue with their practitioners.

As researchers embarking on new translational research in the area of mood and anxiety disorders and SSRI treatment in children and adolescents, we found ourselves examining the side effect profiles of children and adolescents treated with SSRIs. Through our review of the literature we discovered that a profound piece of information was missing: the assessment or screening of sexual behavior and dysfunction, resulting in missing evidence-based knowledge about these issues in the adolescent population. This was concerning given the high prevalence of sexual side effects …

Address correspondence to Amir Levine, MD, Division of Child and Adolescent Psychiatry, Department of Psychiatry, Columbia University, and New York State Psychiatry Institute, 1051 Riverside Dr, Kolb Annex Unit 78, New York, NY 10032 E-mail: ama146{at}columbia.edu