Antidepressant toll on sex worse than thought

As time goes on, it seems the benefits offered by modern antidepressants seem to drop while the downsides seem to expand. A story in today’s Boston Globe — excerpted below — suggests that up to half of people who take SSRIs suffer significant sexual side-effects.

Sexual “numbness.” Lack of libido. Arousal that stalls.

Such sexual symptoms have long been known side effects of the popular Prozac class of antidepressants, but a growing body of research suggests that they are far more common than previously thought, perhaps affecting half or more of patients….

Current warnings on the labels of selective serotonin reuptake inhibitors, or SSRIs, cite early studies in which the prevalence of sexual side effects was lower: 4 percent for Prozac, for example, and ranging from 0 to 28 percent for Paxil.

But more recent studies, in which patients were more likely to be asked about specific sexual side effects and thus more likely to report them, suggest that the ballpark range of those affected by SSRIs is between 30 percent and 50 percent, said researchers including Dr. Richard Balon, a psychiatry professor at Wayne State University who studies the symptoms.

That would translate into millions of affected sex lives among the estimated 1 in 8 American adults who have tried these antidepressants in the past decade or so. Some studies have found the range still higher.

Why the rising costs and flattening benefits? Among other things, it’s becoming clear, as the wide use of these drugs runs through time, that many drugs prove less effective and more troublesome when prescribed to sick people (many of whom have other health problems and take other drugs) than when used in clinical trials, which usually take care to use patients with fewer problems. It doesn’t help that drug companies often fail to report or publish their less flattering results — and that they didn’t investigate the sexual side-effects more aggressively during the trials.

In this case the differences between side effects in trials and in real life is startling, both for the scale of the difference and, of course, for the high-impact nature of sexual side-effects. As Aline Zoldbrod, a Lexington psychologist and sex therapist quoted in the Globe article notes:

“This is such an upsetting issue. There are people for whom SSRIs are really life-saving, I think, but the idea that someone would have to choose between getting out of the darkness of depression and having a good sex life is horrible.”

Hat tip: The ever-watchful Furious Seasons

Is Obama for real on health-care reform?

It appears Obama is going to make a health-care system overhaul a top priority in his first year.

from the Tribune:

“The time is now to solve this problem,” Obama said at a Chicago news conference where he announced that former Senate Majority Leader Tom Daschle would head his health-care team. “It’s not something that we can sort of put off because we’re in an emergency. This is part of the emergency.”

And as many have pointed out, his selection of Tom Daschle as Secretary of Health and Human Services shows serious intent as well.

This should be quite interesting to watch. As Obama pointed out, the current recession, which can seem an argument not to take on health-care reform, is also a good argument for doing so. People are losing health-care access along with their jobs, and runaway health-care costs are adding extra strain, and more by the year. Probably just as important is Obama’s recognition that the first year is the time to get big things done — and his seemingly sincere conviction that the combination or rising per-capita expenditures and a growing number of un- and underinsured is a deadly serious problem and a blight on the country. Yet to get something done that is both truly reforming — in the sense of a recognizable reshaping — may well be the most difficult and ambitious thing he hopes to accomplish.

Except for maybe education reform … on which more later.

Blogging with (bad) style

For, well, about 6 months now I’ve been meaning to riff on this riff about internet writing from Steamboats Are Ruining Everything. As I can’t seem to get in tune, or plugged in, or somehting, I’ll just let Steamboats take it away:

If I were to interpret those tugs, I would say that writing on the internet tends to be more popular when it satisfies the reader’s wish to be connected—the wish not to miss out. The writer, too, may have such a wish. I admit that I love it when another blog links to mine; there is great consolation in the feeling of having a posse. And of course many readers online are also writers there. Perhaps these feelings of “groupiness” explain a few more traits of internet style. There is a greater tolerance online for sloppy and inexact writing—not merely for typos but for a generalized kludginess of thought, especially the errors that the usage stickler H. W. Fowler named “haziness,” “swapping horses,” and “unequal yokefellows,” which may all be loosely described as changing your mind about the grammatical structure of a sentence halfway through writing it—and such tolerance is to be expected if people are reading primarily for the sake of a feeling of belonging.

….

This willingness in readers to overlook form raises a question as to whether online writing entertains, in the traditional sense of the word. I am not sure that it does. Reading online does not seem to me to be a pleasure in itself but a response to irritation. That is, it is not like eating an ice cream cone; it is like scratching an itch. I am only reporting on my own feelings here, of course, but while I am doing so, let me report a further kink in them. Between us, my boyfriend and I subscribe to more than a dozen magazines, and if I pick one up, I know instantly that I am goofing off. Online reading, however, fails to set off my leisure detection system.

But reading blogs, in my experience, leaves me more addled and nervous than when I began. This work-like character makes the internet particularly corrosive , by the way, to the productivity of those who work at home, such as writers. Through web browsing, the freelancer communes with the procrastinating office drone—at his peril, because the freelancer receives no weekly paycheck.

The joys of writing about (a great) depression

Amid much good reporting on the current economic mess has been some weird vicarious excitement — the sort of giddy buzz of kids watching a disaster and simultaneously not realizing that it’s real and hoping it gets worse. You see this in the many stories about the Great Depression, the implication being that we’re facing something similar here. A lot of writers seem almost eager to see what such a thing looks like. Is this a longing to be Part of History? Don’t know. But I was glad to see I’m not the only one bothered by this.

From Virginia Postrel:

If anyone should fear a Depression, it should be journalists, who are already the equivalent of 1980s steelworkers. But instead, they seem positively giddy with anticipation at the prospect of a return to ’30s-style hardship–without, of course, the real hardship of the 1930s. (We’re all yuppies now.) The Boston Globe’s Drake Bennett asked a bunch of people, including me, what a 21st-century Depression might look like. The results sounded pretty damned good to some people–a sure sign of an affluent society, or at least affluent commentators.

The prospect of a Depression is already creating jobs for (a few) writers. Hodding Carter IV has gotten a book deal described by Publishers Weekly this way:

After 10 years of profligate spending fueled by real estate flips, refinancing and credit card debt, the author will write about living on what he actually earns. In order to do so, he and his family of six will mine cost-saving techniques from the Great Depression and the first cookbook in America, and stay within their budget, whether that means growing their own food or bartering for things they need. Carter is writing a column based on his experiences for Gourmet.

If that last line doesn’t bring a smile to your face, you really are depressed.

As Postrel notes in wrapping up, “It’s not a Depression, folks, and it wouldn’t be nearly as fun to think about if it were.”

Postrel also has a nice column in the Atlantic about a lab study of economic bubbles.

More pebbles: items I (wanted to but) didn’t get to

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Boing boing spots Virgin Mary in MRI

Jonah Lehrer on Governor “Show Me the Money” Blagojevich, greed, and a version of the ultimatum game called — I love this — the dictator game. “When the dictator cannot see the responder – they are isolated – the dictator begins acting with the kind of unfettered greed expected by economists.” (Special bonus: Andrew Sullivan’s Quote of the Day is also about Blagojevich.)

Daniel Carlat on “It’s not about Goodwin. It’s about disclosure.”

The Extensible Obama: How the POTUS-elect will use web tools to power his next presidency. From MIT’s Technology Review.

The Great Beyond: Far East top in science subjects

From The Great Beyond

Far East top in science subjects

Researchers in the US have released the latest figures comparing the maths and science abilities of 4th- and 8th-grade students in countries across the globe.

Far Eastern countries dominate the top tens, with Singapore top for science in both 4th and 8th grade. In maths, Hong Kong tops the 4th grade scores, with ‘Chinese Taipei’ leading the 8th. (Image right shows the percentage of fourth-grade students who reached the TIMSS advanced international benchmark in science in the top ten countries. See full graph.)

As the New York Times points out, this should worry the US as these subjects “are crucial to economic competitiveness and research”.

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“It was good to see that the United States has made some progress in math, but I was surprised by the magnitude of the gap between us and the highest performing Asian countries, and that should cause us some concern,” Ina Mullis, of the International Study Center at Boston College that directs the study, told the paper.

Say that again.

More at the Great Beyond

Why we still need newspapers

From Knight Science Journalism Tracker:


Phil. Inquirer: Four part series disembowels the Bush White House version of the EPA

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Many reporters have dived pretty deep into the legal and regulatory changes wrought at the EPA in the last eight years and into the scientist-administrator Stephen Johnson who imposed them at the behest of the George W. Bush administration… But no other newspaper that the Tracker knows of has torn into the agency with as thorough, focussed and full-hearted a pummeling as seen in the Philadelphia Inquirer for four days this week. ….

Sometimes it’s good to let one’s anger show and these reporters do. The pace, enthusiasm, and rhythm of the prose is like that of a flogging of a misbehaving crewman in an old Royal Navy sailing ship.

Oh, that Lucky Jack should have such luck.

Tom Friedman on (not) bailing out Detroit

I frankly don’t know what the right call is on bailing out Detroit. On one hand, smart people are saying that not doing so could dangerously deepen the recession. On the other, if business idiocy had a three-strikes policy, these companies would be doing life. While going to school in Ohio car country in the late 1970s, I got a glimpse of the pain that area felt when the industry collapsed because it failed to adjust to a world that wanted smaller, better cars; tremendous unemployment rates, lots of idle people, most of them decent as hell, wishing they had something constructive to do. It was a monumental failure and a ghastly betrayal.

That the auto industry would repeat the same mistake (again, multiple times) so soon and so spectacularly almost defies belief. Do these people deserve another shot? Should we fool ourselves they can learn enough to turn these companies around? Evidence suggests otherwise. Their failure to learn brings to mind that Simpsons episode in which Bart — or is it Homer?– keeps reaching for a treat even though he gets shocked every time. Incapable of even the simplest conditional learning.

Anyway, Friedman, whom I often find a bit hard to take, frankly, articulates nicely here the sense that trying to save these companies would be throwing good money after bad:

Our bailout of Detroit will be remembered as the equivalent of pouring billions of dollars of taxpayer money into the mail-order-catalogue business on the eve of the birth of eBay. It will be remembered as pouring billions of dollars into the CD music business on the eve of the birth of the iPod and iTunes. It will be remembered as pouring billions of dollars into a book-store chain on the eve of the birth of Amazon.com and the Kindle. It will be remembered as pouring billions of dollars into improving typewriters on the eve of the birth of the PC and the Internet.

I’ll be deeply surprised if he’s wrong.