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Re: Need help w/ SSRI + antipsychotic sexual SEs

Posted by Dave954 on June 1, 2006, at 6:14:03

In reply to Re: Need help w/ SSRI + antipsychotic sexual SEs Dave954, posted by yxibow on June 1, 2006, at 3:02:08

> Its not only the antagonism of dopamine, but also prolactin levels that cause sexual side effects with antipsychotics, though Seroquel I believe has a lower amount of that issue. Sheer sedation from the above medications is another reason why you could be experiencing sexual side effects. I would place the SSRI ahead of the Seroquel, which is a fairly low dose of that neuroleptic.
> I don't remember whether Cymbalta is sexually stimulating, neutral, or inhibiting, but have you tried that medication or looked into it?
> I also take Seroquel and I think the sheer groggy factor and the fact that it lowers blood pressure (you can do the math with where blood pressure is important....) may be a greater factor.
> I don't have any great solutions as you said you cannot tolerate Wellbutrin... I assume you used XR or SR, because Wellbutrin by itself can cause greater heart factors as it is immediate release. The only other thing would be to go out on a total limb and say take a small amount of Wellbutrin SR with a beta blocker like atenolol -- of course, beta blockers will also mess with your blood pressure.
> Just my 2c
> -- Jay
I am aware that Seroquel elevates prolactin levels the least amount compared to the other APs (except maybe Abilify, which is not good for insomnia) - however it still impairs my libido way more than Lexapro (I have been on each medication by itself - even 25 mg of Seroquel by itself causes worse sexual dysfunction for me than 10 mg of Lexapro by itself - go figure). I have read that Cymbalta's sexual side effects are very similar to Effexor's - hence why I wasn't interested in it (besides, my main issue at this point is the sexual dysfunction from the Seroquel). I considered asking my psychiatrist if he could try me on 150 mg of Wellbutrin XL with a beta blocker, but am not sure if this is a good idea? I question if this approach would even work as I've tried Wellbutrin with a combination of Effexor and Risperdal in the past and I had a lot of anxiety with no increase in sexual desire - though Wellbutrin by itself increased sexual desire big time. I wonder if Lexapro and Seroquel combined with Wellbutrin would have a more favorable effect ...




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