A knottier problem is adverse effects that persist as long as the patient takes the medication, such as sexual dysfunction and sleep disturbances. Also particularly troubling are those, like weight gain, that don't even develop until late in treatment. Vivid dreams and nightmares also occur. With ongoing treatment, increasing numbers of patients report lethargy and fatigue, he said. Sexual dysfunctions are among the most distressing SSRI side effects.
Patients experience sexual arousal when they yawn, often progressing to orgasm.
This is probably underreported. Perhaps the most unexpected SSRI-related problem to emerge has been weight gain, which often begins only after several months of therapy. Because this runs counter to the image of the drug, many physicians and patients are unprepared to deal with it. These observations do contrast with what the clinical trials submitted to the Food and Drug Administration by pharmaceutical companies show, Dr. Sussman said. It would be nice if these long-term side effects were studied in clinical trials comparing different antidepressants.