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Re: Meds - what do I try next?

Posted by JohnL on December 16, 1999, at 2:59:48

In reply to Meds - what do I try next?, posted by LisaShh on December 15, 1999, at 20:56:32

> Could anyone suggest the next step for me? Here's what I've tried so far:
> Zoloft 25-50mg wicked bad vertigo, no mood chg
> Prozac 10-20mg insomnia, anorgasmic, no mood chg
> Celexa 20-40mg anorgasmic, no mood change
> Celexa 40mg + Wellbutrin 300mg STILL anorgasmic, but finally some relief from depression
> So, any suggestions for next steps? It would be just lovely if I could actually be rid of depression, and yet manage occasionally to see fireworks again.
> Remeron? TCA's? Nunnery?

Hi Lisa. This is a tough one, huh? Nunnery...too funny! :) Anyway, Dr Bob's tips, Depression Central, and various research abstracts all have approaches to deal with sexual side effects, and here are some of them:

Add Buspar. Can improve all phases of sex. More helpful in women than men.
Add Remeron. It blocks the receptors causing the problem. Is sedating at first, may require patience to adjust.
Take 100mg Serzone as needed a couple hours before sex. Like Remeron, it blocks certain receptors.
Wellbutrin alone.
Serzone alone.
Add a dopamine agonist, such as Amantadine, Bromocriptine.
Selegiline alone.
Gingko Biloba up to 240mg a day. This herbal supplement improved all phases of sex in a research trial of patients experiencing SSRI sexual side effects. In another study at 240mg it also lowered the Hamilton depression scores even lower than they already were with an antidepressant. All the way down to a 4, which is pretty impressive, and equivalent to totally cured.

It seems to me the most straight forward approach would be to drop the Celexa down to 20mg, bump the Wellbutrin up to 400mg. See how that goes in a few weeks. Maybe then drop the Celexa altogether and stay with just Wellbutrin.

Keep in mind any of these approaches may or may not work. 50/50 chance. But different doctors do use these approaches with enough success that they continue using them. Also be aware any approach can take a while, up to a month or two, to notice real benefit. Deciding on what to try first is difficult. But at least there are choices that seem to work. Talk it over with your doctor. Maybe he/she has had luck with a particular approach. Hope these ideas might help. JohnL




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