The physiological mechanisms are primarily inferred, but there’s not necessarily anything wrong with that.
It is well known that SSRI drugs severely disrupt the sleep cycle. Even small doses have been shown to reduce the duration of REM sleep by 30-50%. As many of you know, it’s during REM sleep that your body releases large amounts of anabolic hormones, particularly testosterone and growth hormone. Thus, we can infer that any drug which impairs REM sleep may consequently impair the secretion of anabolic hormones. And that’s just one possible mechanism. You have to appreciate that the endocrine system is intimately related to the central nervous system, and that many of the relevant physiological processes, especially those which occur in the pineal gland, depend on serotogenic pathways- which SSRIs blatantly disrupt.
Admittedly there has not been a great deal of research on this subject- they certainly didn’t bother to study it during the FDA clinical trials- so it’s easy for psychiatric apologists to dismiss these concerns as unscientific. However, there is at least a small body of research to support the notion that SSRIs may impair physical development. Several small studies have shown that people taking SSRIs have low testosterone levels (although causation was not necessary established), and at least one case study has clearly demonstrated that SSRIs impair GH secretion in children, with subsequent growth attenuation.
Decreased Growth During Therapy With Selective Serotonin Reuptake Inhibitors
Naomi Weintrob, MD; Daniela Cohen, MD; Yaffa Klipper-Aurbach, MSc; Zvi Zadik, MD; Zvi Dickerman, MD
Arch Pediatr Adolesc Med. 2002;156:696-701.
Background There is no information on the effects of selective serotonin reuptake inhibitors (SSRIs) on growth and puberty in children. We examined growth and growth hormone secretion in 4 children treated with SSRIs for various psychiatric disorders.
Design Case study.
Participants Four children (3 boys) aged 11.6 to 13.7 years with obsessive-compulsive disorder or Tourette syndrome.
Main Outcome Measures Growth, pubertal progression, and hypothalamic pituitary function.
Methods The patients were treated with SSRIs for 6 months to 5 years (dosage, 20-100 mg/d). All were regularly examined for changes in height and bone age and for pubertal progression. They also underwent evaluation of somatotrophic axis and hypothalamic-pituitary axis function.
Results All 4 patients had growth attenuation. Three of them exhibited growth retardation at a pubertal stage when a growth spurt was anticipated. Three had a decreased growth hormone response to clonidine hydrochloride stimulation and 2 to both clonidine and glucagon stimulation, and 1 had decreased 24-hour secretion of growth hormone that normalized when therapy was stopped. The rest of the endocrine evaluations were within reference ranges in all patients. At follow-up, 2 patients were being treated with somatropin while continuing SSRI therapy, and the other 2 resumed normal growth after discontinuation of therapy.
Conclusions A decrease in growth rate, possibly secondary to suppression of growth hormone secretion, may occur during SSRI therapy. As the use of this group of drugs is expected to increase in the young age groups, larger studies are warranted to investigate their effect on growth and growth hormone secretion.