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Research on Depression in the Workplace.

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Literacy is a luxury that many of us take for granted. That is why SADAG created SPEAKING BOOKS and revolutionized the way healthcare information is delivered to low literacy communities.

The customizable 16-page book, read by local celebrity audio recordings, ensures that vital health and social messages can be seen, heard, read and understood by everyone across the world.

We started with books on Teen Suicide prevention , HIV, AIDS and Depression, Understanding Mental Health and have developed over 100+ titles, such as TB, Malaria, Polio, Vaccines for over 45 countries.

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That's the question being asked by scientists who study romantic love and relationships and the chemical beginnings of both in the brain. The focus is on the widespread prescribing of antidepressants, which are designed to affect brain chemicals associated with depression. While it's long been known that antidepressants can interfere with a person's sex life, the latest research questions whether tinkering with brain chemicals can take an additional toll, blunting emotions and interfering with intense romantic love and long-term attachment.

To be sure, antidepressants are life-saving drugs for people with depression. Nearly 123 million prescriptions were written in the U.S. for popular antidepressants last year, including Eli Lilly's Prozac, GlaxoSmithKline's Paxil and Wyeth's Effexor.

The concern is that antidepressant users often aren't aware of the emotional and physical side effects and don't know they may influence their thinking about love and marriage.

Antidepressants "can jeopardize your feelings," says Rutgers University anthropologist Helen Fisher who conducted brain studies of love. "You are tampering with the mechanisms that can help sustain feelings of romantic love and deep feelings of attachment."

Antidepressant makers say depression, not the drugs used to treat it, is the real cause of relationship and emotional problems experienced by users. "Patients who suffer from depression aren't in a position to make decisions about partners and life choices," says John Plewes, medical adviser to Eli Lilly. These drugs "allow the person to experience normal emotions when they get better from depression."

Studying the connection between depression, love, sex and antidepressant treatment is difficult. Depression itself can interfere with relationships and sex. Relationship problems can trigger depression. And the drugs used to treat depression are known to cause sexual side effects that can interfere with relationships, including lack of desire and arousal problems, inability to achieve orgasm, delayed ejaculation and erectile dysfunction.

Dr. Fisher became concerned about the romantic toll of antidepressants as she began studying the brains of people in love using a magnetic resonance imaging scanner. While in the scanner, patients saw a picture of their sweetheart, performed a math task to "cleanse" the brain of romantic emotion, and saw a photo of a "neutral" person, an acquaintance who didn't trigger any positive or negative feelings.

Researchers then compared the three brain images, crossing out what they had in common. "What you are left with is the brain in love," Dr. Fisher says. And a brain in love lights up an MRI scan in key areas that involve dopamine production and reception. Dopamine is a brain chemical connected with movement, emotion, motivation and feelings of pleasure.

Popular antidepressants essentially work by increasing the levels of another brain chemical, serotonin. But an April 2005 study in the medical journal Neuron showed that serotonin drugs not only affect serotonin levels in mouse brains, but they also "hijack" dopamine signaling as well. That means brain transmitters that are supposed to carry dopamine around the brain, appear to end up carrying serotonin as well.

The relationship between dopamine and serotonin in the body is complex, and nobody knows exactly how this affects patients, but "emotional blunting" may be one result. A 2002 report on patients using serotonin drugs in the International Journal of Neuropsychopharmacology noted that 80% of patients reported less ability to cry, worry, become angry or care about others' feelings. "These drugs blunt emotions and reduce obsessive-compulsive thinking, but those are also two main characteristics of romantic love," Dr. Fisher says.

In addition to the obvious toll sexual side effects can take on a relationship, the lack of sex means key brain chemicals involved in love and long-term attachment aren't released. All of this can make it tough to fall in love and stay in love while on an antidepressant, says Andy Thomson, staff psychiatrist at the University of Virginia student health services. Dr. Thomson says a young patient who had started antidepressant use in his teens, became aware that he hadn't any romantic inclinations only after he stopped taking the drugs.

A female patient in her 30s was considering a divorce because she felt she no longer loved her husband. Dr. Thomson changed her medications and lowered her dose, and the woman's romantic feelings for her husband returned. "She realized she still loved her husband, and now they've got two kids and a good marriage," Dr. Thomson says.

One solution is to take an antidepressant that can be stopped intermittently for "drug holidays" without losing effectiveness, says Dr. Thomson. Forest Pharmaceutical's Lexapro sometimes can be stopped on a Friday and resumed on a Monday, which increases the patient's sexual interest on the weekends.

Some doctors give patients bupropion, sold under the brand Wellbutrin by Glaxo, which has been shown to have a lower rate of sexual side effects and is sometimes used as a treatment for sexual dysfunction. For menopausal women, sometimes estrogen and testosterone drugs, such as Solvay Pharmaceutical's Estratest, are prescribed.

Dr. Thomson emphasizes that antidepressants are necessary for many patients, and patients vary in how they respond to the drugs. However, he says patients need to be aware how the drugs can affect emotions, sex drive and relationships. If you're taking an antidepressant and develop marital or romance problems, "don't immediately assume it's you or the relationship," Dr. Thomson says, "because it may be the drug."


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