Antidepressants, electroshock, so-called psychedelic-assisted psychotherapy, and even inpatient stays in psychiatric facilities carry far more risks for women, who are inadequately warned of the risks, research shows.
by CCHR National Affairs Office
The U.S. Department of Health and Human Services (HHS) recently announced efforts to de-emphasize the prescribing of psychiatric drugs for mental health conditions and shift the standard of mental health care toward more holistic approaches, such as family support, nutrition, and physical activity. This is good news for women, who are at an even greater risk of adverse effects from psychiatric drugs and practices than men in today’s mental health system.
In a 2024 survey, three in ten women (29%) aged 18 and older in the U.S. reported they received mental health services in the previous 12 months. This represents a 70% increase over the past 20 years. Half (52%) of the women receiving mental health services were given a prescription for a psychiatric drug.
Many of those prescriptions were for antidepressants, the most prescribed class of psychiatric drugs. About twice as many women as men are prescribed antidepressants, according to government data, placing women at higher risk of the adverse effects of the drugs. Use is highest among the most vulnerable women, aged 60 and older.
Researchers over the past few years have questioned the effectiveness of antidepressants. One recent review of data from antidepressant clinical trials submitted to the U.S. Food and Drug Administration from 1979 to 2016 found that antidepressants are no more effective than placebo (dummy pills) for 6 out of 7 people (85%) using them.
Another review of evidence on antidepressants concluded the benefits of the drugs are barely distinguishable from placebo and possibly without any importance to the average patient with major depression. The researchers in the review recommended that “antidepressants should not be used for adults with major depressive disorder before valid evidence has shown that the potential beneficial effects outweigh the harmful effects.”
Those potential harmful effects include anxiety, panic attacks, insomnia, hostility, impulsivity, mania, emotional numbing, stroke and heart disease, sudden cardiac death, osteoporosis and bone fractures, sexual dysfunction that can be permanent, suicidal thoughts and actions, violence and withdrawal symptoms that can be severe and long-lasting.
Studies have found that 25% to 80% of antidepressant users – men and women – have their sexual function impaired in some way by the drugs, but women experience more severe symptoms than men. Symptoms of sexual dysfunction include lack of sexual drive, lack of sexual sensation, and problems with sexual performance. A large proportion of women experience multiple symptoms, most commonly reporting problems with sexual desire (72%) and sexual arousal (83%). The sexual difficulties may persist long after the drugs are stopped and can be permanent.
This sexual dysfunction could well be a contributing factor to the falling U.S. birth rate. The Centers for Disease Control and Prevention (CDC) recently announced that the birth rate fell to an all-time low of 1.6 births per woman, having fallen by 23% since 2007. Over roughly the same time frame, the number of Americans on antidepressants rose by 36% – from about 33 million to 45 million – with many users experiencing the symptoms of sexual dysfunction.
As for violence, research indicates young women using antidepressants are at an even greater risk of committing violent acts than other users. Among the 1% of SSRI antidepressant users convicted of a violent crime over a 3-year period, the risk of a violent crime conviction was 19% higher when they were using antidepressants than when they weren’t. However, for young women aged 15 to 24, that risk was 75% higher.
The increased potential for committing acts of violence by those using and withdrawing from antidepressants is detailed in the Citizens Commission on Human Rights (CCHR) documentary, Prescription for Violence: Psychiatry’s Deadly Side Effects, which can be streamed online at no cost.
More fundamentally for antidepressants, a landmark 2022 study determined there is no scientific basis for the theory of a chemical imbalance in the brain causing depression – a supposed brain imbalance which antidepressants were prescribed to fix. The never-proven, now debunked theory was widely promoted for decades in psychiatric and other medical journals, leading to an explosion in prescriptions written for antidepressants in the United States. Today, one in nine Americans (11%) use antidepressants, and two out of three of them are women.
Risks to pregnant women and their newborns from antidepressants
Prenatal exposure to antidepressants is linked to higher risks of harmful effects for both pregnant women and their newborns.
Adverse birth outcomes, such as preterm birth, low birth weight, and the increased risk of newborns needing neonatal intensive care, have been linked to antidepressants, regardless of the type of antidepressant prescribed, the duration of use, or the trimester(s) of exposure.
The risk of newborns needing some type of neonatal therapy is 23 times greater for babies born to mothers who used antidepressants or other psychiatric drugs affecting the central nervous system compared to babies born to mothers who did not use the drugs, research indicates. Six in ten newborns (62%) born to mothers using these drugs experienced adverse neonatal symptoms that include respiratory distress, circulatory distress, hypothermia, and feeding problems. This has led some researchers to advise that tapering and discontinuing antidepressants before or early in pregnancy are worth attempting, to prevent withdrawal symptoms in newborns.
Research has also linked antidepressant use during pregnancy to certain birth defects in the digestive, respiratory and nervous systems of the offspring, as well as altered brain development in the fetus.
Adam Urato, MD, chief of maternal-fetal medicine at MetroWest Medical Center in Framingham, Massachusetts, says there is “widespread scientific agreement” that SSRI antidepressants influence fetal brain development, and that long-term studies have shown higher rates of speech and language difficulties, autism and depression in children exposed to antidepressants before birth. He expressed concern that SSRI prescribing information “does not make clear that SSRIs alter fetal brain development.”
“Many, many studies show an impact on the developing brain,” Dr. Urato explains. “We can see it on prenatal ultrasound. The ultrasound studies show SSRI-exposed fetuses have different movement and behavior patterns. After birth, the newborn babies can have jitteriness, breathing difficulties, and higher rates of admission to neonatal intensive care unit.”
“What are we waiting for before we warn the public?” he asks. “Never before in human history have we chemically altered developing babies like this, especially the developing fetal brain. And this is happening without any real public warning.”
After giving birth, antidepressant-using mothers are also known to face the higher risk of potentially fatal postpartum hemorrhage, the leading cause of maternal death.
For all these risks to mothers and their babies, antidepressants may not even be effective in preventing the most serious postpartum depressive symptoms – and may even make the symptoms more likely. A 2020 study found that 22% of women who used antidepressants during pregnancy experienced frequent thoughts of self-harm during the year after giving birth, as compared to 15% of women who did not use antidepressants.
Women more likely to experience the most damaging effects of electroshock
Two of every three patients receiving electroconvulsive therapy (ECT), or electroshock, are women, especially older women. ECT may be recommended by medical providers after two antidepressants fail to relieve an individual’s depression, despite a growing body of research finding that antidepressants themselves may be at fault by providing little, if any, benefit that is meaningful to the average depressed patient.
ECT involves psychiatrists shooting typically 70 to 120 volts of electricity through brain tissue to produce an epilepsy-type seizure. After 85 years of performing electroshock, psychiatrists still cannot explain how this procedure is supposed to work to treat depression or other mental health conditions, how much voltage to use, or how often and how many sessions of ECT to administer. It is trial and error with human lives.
Because ECT machines were in use before the U.S. Food and Drug Administration (FDA) was granted authority by Congress in 1976 to regulate medical devices, the machines have never been required to prove safety or efficacy, and so are not approved by the FDA.
The known risks of electroshock include memory loss, brain damage, cardiovascular complications, breathing complications, prolonged or delayed seizures, manic symptoms, worsening psychiatric symptoms, and death.
“The probability of ECT causing one or more of six cardiac events (myocardial infarction, life-threatening arrhythmia, acute pulmonary edema, pulmonary embolism, acute heart failure and cardiac arrest) is between one in 15 and one in 30 patients, and…these cardiac events are a major cause of ECT-related deaths,” according to a 2024 study published in Ethical Human Psychology and Psychiatry.
With these dangerous risks in mind, it is concerning that women receive ECT twice as often as men and are more likely to experience the most harmful effects associated with the procedure, according to a recent international survey of 858 ECT recipients, 73% of whom were women. The results, published in Health Care for Women International, found women fared worse on nearly every measure of ECT outcomes.
Women reported both short- and long-term memory loss, losing their train of thought, difficulty concentrating, sensitivity to light and noise, difficulty driving, difficulty navigating, and fatigue at significantly higher rates than men.
Women faced greater pressure or coercion to consent to ECT than men. Significantly fewer women than men reported that the procedure was voluntary, and significantly more women than men reported they gave consent under pressure.
Women also reported being less informed before treatment about the risk of long-term or permanent memory loss, despite women being more likely to suffer that loss. Male psychiatrists in particular were significantly less likely to tell women that ECT can cause long-term or permanent memory problems or heart problems.
Electroshock is “something done, predominantly, by men to women”
For more than two-thirds (68%) of the ECT survey respondents in the U.S., the psychiatrist was male and the recipient female. “ECT seems to be something done, predominantly, by men to women,” researchers involved with the survey wrote.
Citing a number of studies showing this sexist bias, the researchers added, “Misogyny within psychiatry has a long and well documented history.”
Evidence of this dislike of or prejudice against women may be found in the section of the survey that gave respondents the opportunity to describe their ECT experience in their own words. Many women wrote about being traumatized or re-traumatized by electroshock, with some comparing it to rape:
- “Severe trauma from the experience.”
- “Triggered past experience of abuse.”
- “Retraumatized. Held down and body ‘done to’ against my will.”
- “I felt violated in a way that shouldn’t be possible…Over time I came to see that this was just another rape, but of my mind.”
Others reported that ECT terrified them and that they still carry that fear:
- “Terror of experiencing it again.”
- “I woke up in one session unable to move or breathe. Terrifying.”
- “I live in fear of this happening to me again.”
Lead author of the study, John Read, Ph.D., a psychology professor at the University of East London, summed up the use of electroshock on women this way: “Our findings show that women not only receive ECT more often but are also more likely to suffer its most damaging effects. These patterns cannot be dismissed as coincidence. They reflect systemic biases in psychiatry and underline the urgent need for a trauma-informed, feminist perspective on mental health care.”
Women more likely to suffer sexual victimization in the mental health system
Sexual abuse and sexual assault are well-known risks in mental healthcare settings. Mental health service users report disproportionately high rates of sexual violence victimization. The perpetrators may be psychiatrists, psychologists, therapists, mental health staff, or other patients. Not surprisingly, the victims are more likely to be women than men.
Sexual contact between mental health practitioners and their patients is considered unethical by medical and psychological professionals’ associations and is a crime in many states, in recognition of the psychological vulnerability of mental health patients.
Sexual misconduct by psychiatrists is also reportable to state medical boards, which can discipline them or report them to law enforcement. One review of clinical and research data found that while only 6% of physicians nationwide were psychiatrists, 28% of physicians disciplined for sexual offenses by their state medical boards were psychiatrists. Psychologists and social workers were as likely as psychiatrists to be sexually involved with their patients. Among therapists, 7% to 10% of male therapists and 1% to 3% of female therapists admitted having sexual relations with their patients.
Sexual abuse and sexual assault committed by other patients or staff is another well-recognized risk in mental health facilities. A 2023 a review of the medical literature concerning sexual incidents in inpatient psychiatric settings found that from 5% to 45% of patients experience sexual violence during their inpatient admission.
Sexual incidents are carried out predominately by males, with females more likely to be the person affected. Almost all incidents (95%) were allegedly committed by other patients, with 5% reportedly committed by a member of staff.
A 2026 review of prior studies found that sexual abuse of psychiatric inpatients by staff was reported by a range of 0%-21% of participants in the various studies under review.
Being subjected to sexual abuse in a setting that is supposed to be therapeutic and safe can be deeply traumatizing or re-traumatizing to patients. This is especially true for patients who have been involuntarily committed to the psychiatric facility, depriving them of the option of leaving an unsafe situation.
Proposed psychedelic therapy poses risk of sexual assault of women
In 2024, the U.S. Food and Drug Administration (FDA) rejected an application for approval of the psychedelic drug MDMA, commonly known as ecstasy or molly, as treatment in so-called psychedelic-assisted psychotherapy for PTSD.
A briefing document prepared by FDA staff prior to the rejection lists the more common adverse effects experienced by participants in the controlled clinical trials of MDMA, including increased heart rate and blood pressure, heart palpitations, blurred vision, nausea, abdominal pain, fatigue, headache, dizziness, jitters, tremor, sensation of pins and needles, involuntary eye movement, anxiety, nervousness, insomnia, restlessness, intrusive thoughts, nightmares, and flashbacks.
Worse harms can occur with the uncontrolled, unlawful use of MDMA, a situation which likely to develop if FDA grants approval of the drug. Those more serious harms include agitation, confusion, depressed level of consciousness, hallucinations/delusions, delirium, psychosis, rapid or irregular heartbeat, heart attack, cardiac arrest, cerebral hemorrhage, aortic dissection, respiratory arrest, and sudden death, according to the FDA.
Beyond all these potential harms is the increased risk of sexual assault. MDMA (ecstasy) is known as a date rape drug. MDMA and other psychedelics are known to lower inhibition and increase sexual desire in those under the influence of the drugs.
In fact, even under the carefully controlled conditions of the MDMA clinical trials, a female trial participant was allegedly sexually assaulted by the two therapists who remained in the room with her to deliver the therapy part of the MDMA procedure while she was under the influence of the drug. Two therapists is an FDA requirement meant to ensure safety during the clinical trials, but allegedly did not.
As Nese Devenot, a researcher at Johns Hopkins University, told NPR, the model of psychotherapy while a patient is under the influence of MDMA “incentivized boundary violations.”
The results of a 2025 survey indicate sexual assault is a very real risk during the use of psychedelics. Of the roughly 2,000 adult survey respondents who reported any past 12-month psychedelic use, one in fourteen (7%) reported sexual assault while they were under the influence. The rate was higher for women (8%) than for men (7%), and significantly higher for students (20%) and young people aged 18-24 years (15%). The actual rates may be even higher, as some survey respondents chose not to answer the survey’s sexual assault questions.
Among those survey respondents reporting sexual assault during psychedelic use, 40% classified the perpetrator as the “provider, facilitator, or guided leader.” This finding has clear implications for psychedelic-assisted psychotherapy, where therapists may spend hours with individuals under the influence, supposedly to facilitate or guide the psychedelic experience. Because the FDA has no authority to regulate psychotherapy, any FDA approval of psychedelics will leave the psychotherapy part of the procedure wide open.
Race and ethnicity are additional risk factors. The survey found that 16% of Black/African American, 17% of Hispanic/Latino, and 16% of Asian survey respondents reported experiencing sexual assault while under the influence of psychedelics, twice the rate of Whites (8%).
Black women face systemic racism in the mental health system
Black women seeking mental health treatment face the systemic racism that psychiatrists and psychologists admit is still deeply embedded in their mental health practices.
In 2021, the American Psychiatric Association detailed psychiatrists’ long history of promoting “scientific racism,” admitting that “these appalling past actions, as well as their harmful effects, are ingrained in the structure of psychiatric practice and continue to harm…psychological well-being even today.”
That same year, the American Psychological Association laid out the details of “the role of psychology…in promoting, perpetuating, and failing to challenge racism, and the harms that have been inflicted on communities of color as a result.”
Evidence of that racism can be found in current government data, which reveal that African Americans receive disproportionately more diagnoses of mental disorders related to disruptive, defiant, and psychotic behavior, such as attention-deficit hyperactivity disorder (ADHD), schizophrenia, and oppositional defiant disorder (ODD).
Blacks are overly prescribed antipsychotic drugs, with Black men more likely to be prescribed excessive doses. Blacks are more likely than Whites to be involuntarily committed to a psychiatric facility and more likely to be physically, mechanically, or chemically restrained and for a longer time.
The shift in the mental health standard of care will benefit women
Current psychiatric drugs and practices present far greater risks to women than men. With the HHS efforts to de-emphasize the prescribing of psychiatric drugs, to ensure consumers receive full disclosure of the potential risks of psychiatric drugs and psychiatric procedures like electroshock, and to shift the mental health standard of care toward more holistic and more effective approaches, women will likely benefit more than men from the reduced risks and safer options for restoring and maintaining good mental health.
The sexual victimization of women in mental health settings must be addressed with stronger laws and more enforcement of the laws, as well as raising public awareness of the law to encourage more reporting of the sexual incidents occurring in mental healthcare.
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Anyone wishing to discontinue or change the dose of an antidepressant or other psychiatric drug is cautioned to do so only under the supervision of a physician because of potentially dangerous withdrawal symptoms or other complications.
