Posted by Simcha on August 8, 2001, at 12:33:54
In reply to Re: Sexual Problems on Celexa WellbutrinSR? :-(, posted by paxvox on August 8, 2001, at 11:37:26
> Say Ted,
>
> This sounds kind of "whack" to me. SSRIs can clearly cause sexual side effects when given at "normal" dosage, and almost ALWAYS WILL when given at the higher dose range. Case in point: I took Prozac for 3 years at 20mg. I had a few ejaculatory problems, more of a weird feeling than anything else. However, when it was pushed up to 40mg when I started seeing my Pdoc, it totally wiped out my sexual performance. Now I'm not the expert like Cam W. or SalArmy4me, but I respect their objective reports. Wellbutrin does not cause me any sexual side effects at all, and actually seems to increase my sex drive. WEllbutrin alone can be an effective AD. Why does your Pdoc want the SSRI combo? Has he given you a diagnosis? Look on your "form" you get and see what diagnosis code he is using (if he will not tell you specifically, or you just don't want to ask). Then go to your DSM III or IV and look up the code. E.G. 300.3 is OCD. If your Pdoc is diagnosing you one way, but treating you another, ask why. Some use "other codes" in an attempt to keep your medical records "cleaner" in case someone supenas them, etc...That seems to me to be an old school philosophy that does not address the negative stereotypes well must confront. Or it can be done for insurance purposes, so that the mega-billion dollar companies won't scrutinize your $100 claim. Either way, you have a need to know what he thinks is wrong with you, and his anticipated course of action. Don't be square-pegged by the guy. We all have individual reactions to meds. What may work great for one person may cause terrible problems with others. I have found this to be true subjectively as well as objectively. My 2 cents? It's the Celexa. If you MUST take it, go to the smaller dose range. Wellbutrin should be taken at least 7-8 hours before you want to go to sleep. To my knowledge,it has no untoward effects at up to 300mg per day.
Pavoxx,I hear you.... I do want to reiterate that different meds affect different people differently. I'm still stablizing on my meds. I've only tried the new combo for 2 weeks. I have read here that in order to give a combo a good run you need to give it anywhere from 4-8 weeks unless the side effects are so bad that you need to stop.
A little sexual dysfunction goes with the territory for me anyway. I'm an incest survivor and a sexual compulsive. Sex inside a committed monogamous and loving relationship is very challenging even without the medication. I have to be careful that I don't have a flashback in the middle of sex or that I'm using my partner like a drug.
I'm not sure that the Celexa is causing all of my sexual problems. I seem to be able to masturbate to completion just fine. The trouble lies in the bedroom with my lover. I think that the issues are related more to intimacy issues and my partner's lack of knowledge about what makes me tick sexually. It is fun to experiment so that we get it right someday... ;-)
I do have to say that I know that my pdoc has diagnosed my depression and my sexual OCD. Celexa has been indicated for both issues in many journals that I've read. The Wellbutrin is supposed to counteract any adverse reactions to the Celexa. It is also supposed to lift my mood.
My doc has me taking the Wellbutrin at 3pm so that I might be able to have more oommph in the bedroom. That is 7 hours before bedtime. He does not want to raise my Wellbutrin to 300mg (I'm on 150mg) because that would most likely be way to stimulating for me. I had felt like I was on speed early on with only 100mg of Wellbutrin.
Thank you for your support and your concern. No, I have not gotten my specific diagnosis from my pdoc as far as the dsm code. Maybe it's time to do that. What I've read in the dsm about depression and OCD is right on for me... The treatment for both is as he has prescribed.... I don't feel that I'm getting whacky advise... I'll keep you posted.
poster:Simcha
thread:73747
URL: http://www.dr-bob.org/babble/20010804/msgs/74160.html