Posted by Caleb462 on April 17, 2003, at 0:40:12
In reply to my boyfriend has dysthymia -- what meds to try?, posted by fairnymph on April 17, 2003, at 0:09:26
> My bf has dysthymia...his main symptoms are:
>
> -almost no libido
> -lacks interest in life in general
> -he has had past issues with drug use ('self-medication')
> -doesn't get excited about things; no enthusiasm; feel somewhat numb and dissociated
> -constanly tired and lackluster/lacking in energy
>
> These have been problems his entire life, pretty much. He doesn't appear to have major depression or anxiety issues. Just dysthymia.
>
> One particular reason we would like him to be treated is because his lack of libido is causing major problems in our relationship. I get senstive about being rejected and not feeling sexually desired.
>
> I don't know much about dysthymia. I read some really good stuff about amisulpride but we are in the US and I don't know how we'd get some. Would a US dr be able to obtain amisulpride?
>
> How about reboxetine? I found it increased libido for me...and generally had a positive effect on my mood.
>
> Other options? Of course, whatever meds are recommended CANNOT have libido effects...and preferably should have minimal non-libido sexual side effects.
>
> Thanks!
>
> fnWell... I can't say I know too much about how dysthimia is generally treated.. but I would assume that the symptoms you listed would be best treated with an activating stimulant type med. Reboxetine is one, yeah... straterra is another. These act primarily on norepinephrine however, and what your boyfriend likely needs is dopaminergic stimulation. Wellbutrin is the obvious choice, particularly if there is a concern that he might abuse his meds as Wellbutrin has very little, if any, abuse potential. Other options are stimulants like Ritalin, Adderall and Dexedrine, plus Parkinson's drugs such as Mirapex.
Fish Oil is another option if he doesn't want to go the pharmaceutical route. There's also SAM-e and St. John's Wort - both can have positive effects on dopamine activity.
Wellbutrin seems like the first-line option to me though.
And of course, he may have deep-seeded issues that needed to be worked out, and that no medication is going to change. So therapy is always an option.
poster:Caleb462
thread:219956
URL: http://www.dr-bob.org/babble/20030411/msgs/219964.html