alt Hacker NewsAll cases are possible with S{S|N}RIs (I am a doctor but I know a little regexp). Patients that took them for two months and never needed again and others that cannot stop them after 20y. The start, the stop and every restart of the drug needs an indication so it should be approached with the same care as any medical decision.
It's not right to call it withdrawal. These drugs are not addictive like benzos or alcohol are. If any symptom reappears it's just that the mental disease most usually changed form after so long time. As for the sexual dysfunction, a common known side effect is that they kill (delay or eliminate) the orgasm. Libido and male erection are affected by so many psycho-social, somatic and genetic factors that it's usually difficult to spot the exact relation with these drugs.
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The sexual side effects can be much much worse, and far more permanent than delayed orgasm or low libido - https://www.pssdnetwork.org
It's also not difficult to spot - the complete removal of libido, sometimes permanently for life, with these drugs has been seen in animal models, and also is not present in other classes of ADs. A lifetime of chemical castration effectively.
Clinicians really have been misinformed about these drugs, the awareness campaigns of the 90s still cast a long shadow, with many not really truly understanding the actual potentially permanent and serious effects of these drugs, or assuming that they're rarer than they are (they aren't rare) - because that's what the pharmaceutical company campaigns have told them.
I was on Cymbalta for a while for non mental health related issues (nerve pain caused by MS).
I absolutely had withdrawal when I needed to go off of it, and I can say with certainty that the mental effects of going off of it were not just the reappearance of the underlying mental health issues since there weren't any. My emotional regulation was in the toilet, I was extremely irritated, I'd cry constantly, I was horny as hell, etc.
> It's not right to call it withdrawal. These drugs are not addictive like benzos or alcohol are.
What does “not addictive” matter? Clearly, SSRIs are something that induce a dependency, because the withdrawal symptoms are horrific. A drug doesn't need to give you a high to create a dependency problem.
> If any symptom reappears it's just that the mental disease most usually changed form after so long time.
How do you know that? This is a problem with some other kinds of psychiatric medications too (certain antipsychotics for example), the reckless assumption that anything that happens after cessation of the drug was just an underlying symptom that the drug had suppressed. That could be the case, but you mustn't just take it for granted.
I think most worrying is the cases where a drug has only a placebo effect until the point of withdrawal. If your underlying bias is towards assuming the drug is effective, then the disaster following withdrawal might make you think the drug was holding it back this whole time. But in fact, the drug may have caused the entire harm.