from wall street journal
Love and Medication
By TARA PARKER-POPE, The Wall Street Journal
Have we medicated away romance?
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.
Antidepressants are lifesaving drugs for people with depression. Nearly 123 million prescriptions were written in the United States 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," said 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.
The drugs used to treat depression are known to cause sexual side effects that can interfere with relationships, including lack of desire, arousal problems, inability to achieve orgasm, delayed ejaculation and erectile dysfunction.
Fisher became concerned about the romantic toll of antidepressants when 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," Fisher said.
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.
"These drugs blunt emotions and reduce obsessive-compulsive thinking, but those are also two main characteristics of romantic love," Fisher said.
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