Disinhibition of libido: an adverse effect of SSRI?

Background: The article focuses on adverse drug reactions (ADR) to selective serotonin reuptake inhibitors (SSRI) concerning libido and sexual behaviour: cases of disinhibition of libido observed at the Psychiatric Hospital of Kilchberg near Zurich are described. Method: Within the scope of a drug safety program, the physicians of the hospital are regularly asked about severe and unexpected events under drug treatment. Results: During remission of depression, five outpatients noticed an increase of libido experienced as strange to them, i.e. preoccupation with sexual thoughts, first appearance of promiscuity, of unsafe sexual intercourse, and of excessive pursuit of pornography, respectively, during administration, change in dose or discontinuation of SSRI. Discussion: The case studies suggest that SSRI treatment might be associated with increase and disinhibition of libido. The phenomena are discussed as a ‘selective switch’ into partly manic symptomatology or an induction of mixed states with prevailing sexual symptoms.