Posted by Rick on November 5, 2001, at 22:01:18
In reply to Re: Celexa and Pindolol for sexual problems, posted by Mark H. on November 5, 2001, at 20:13:44
I suppose low blood pressure or excessively low heart rate could cause tremor, but Beta Blockers are in fact one of the primary *treatments* for tremor. (Pindolol isn't usually the BB chosen for this purpose, although it helped me some.)
I've heard that BB's can cause sexual dysfunction, but I didn't have that problem when I was taking Klonopin+pindolol; it only surfaced when I aded Celexa to the mix. I think you need fairly large doses of BB's to cause sexual dysfunction, and the specific adverse effect is usually erectile dysfunction in men, so of course it wouldn't be a factor for Teri. (I think I may have heard some reports of decreased libido from the doses of B's given for hypertension, but that's a less common occurence.)
Since Klonopin is especially good for treating tremor (the primary physical manifestation of my social phobia), I highly doubt that's the culprit.
My money's on the Celexa, and ben could be right about the pindolol potentiating the Celexa and thus causing more Celexa-induced tremor. Teri, if you recently increased your Celexa dose, maybe you just need some time for the tremor to go away (I'd have a 1-2 week increase in tremor with every Celexa dose increase), or alternatively a Celexa dose reduction but with a careful eye on maintaining adquate antidepressant effect.
For some people, Celexa sexual dysfunction can go away, although it can take well over a month. I sure wouldn't *think* that added pindolol would acomplish this, although you really never know. Alternatively, there are many augmentation and timing strategies such as those Mark mentioned, plus low-dose Wellbutrin, ginkgo, BuSpar or many other meds which might help restore sexual function. BTW, I *have* seen posts here attesting to Viagra offseting sexual dysfunction in women.
Rick
> Pindolol is a beta-blocker, as you probably know, and it both lowers your blood pressure and limits your heart rate. This can make you quite faint-feeling while exercising, for instance, as your heart will not speed up to levels you are used to. Also, even if you had normal blood pressure before starting on Pindolol, you'll want to taper off of it very carefully if you and your doctor decide to discontinue it, as the rebound effect of high blood pressure can be both painful (headaches) and dangerous.
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> In men, augmentation of anti-depressants with Pindolol tends to increase unwanted sexual side effects, since it cuts blood pressure and limits stamina. Nevertheless, it can be a very effective adjunctive medication in fighting depression.
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> For those whose relationships permit them to plan for sex, timing one's medication so that the next dose can be taken afterwards seems to help. For instance, if you normally take your meds in the morning, but you and your partner would like to spend intimate time together on a weekend morning, you could postpone your dose that day until lunchtime. Since you're at the end of your daily medication cycle, the amount of meds in your system is lowest at that point.
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> Viagra, for all the jokes made about it, truly is a miracle drug for men of any age who are on anti-depressant meds and adjunctives that cause sexual dysfunction. However, it does not affect the desire for sex, just the ability to perform it. Some women have experimented with it, but I have not read any anecdotal reports here about whether they found it helpful as an offset to anti-depressants.
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> Can any readers of this thread comment from experience?
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> Mark H.
poster:Rick
thread:83264
URL: http://www.dr-bob.org/babble/20011104/msgs/83302.html