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Re: Synchronised Transcranial Magnetic Stimulation » Lamdage22

Posted by SLS on June 26, 2015, at 22:32:31

In reply to Re: Synchronised Transcranial Magnetic Stimulation, posted by Lamdage22 on June 26, 2015, at 16:55:03

> There is no tweaking my meds. There is nothing i can do.
>
> Accepting the fact can be helpful.
>
> LO is against suicidal thoughts. For this purpose very little of whatever lithium can be helpful.
>
> Effexor: I have taken it in higher dosages but i have not been better than at 37.5... More and i get anorgasmia.
>
> So theres no tweaking, no trying.
>
> I am sick of this.


Depression is a dark beast.

Please don't get too mad at me:

* For the sake of factual accuracy:

1. How much time did you give Effexor 300 mg/day to work?
2. Do any of the SSRIs you've tried produce anorgasmia?

I can't blame you for wanting to stop taking full therapeutic dosages of Effexor. In the past, I have had a difficult time staying on drugs long enough to allow them to work when side effects appeared - especially while I continued to feel terrible. How many times am I expected to put myself through that?

For long-standing cases of severe depression, it can take several months for a drug to really kick in. So, how long are you supposed to suffer anorgasmia before 300 mg/day has had enough time to work - especially when there are no guarantees that it will? If you experience a partial response to Effexor at 37.5 mg/day, I would feel somewhat hopeful that full therapeutic dosages could make you feel much, much better. Are you willing to give up the capacity to have orgasms for a stable full remission? I already made this decision for myself, but I would not presume to suggest what is best for anyone else. It is a terrible compromise.


Options:

1. Increase the dosage of Effexor gradually to at least 300 mg/day to first determine your responsivity to it. If it works, you could then see if the anorgasmia lessens over time. I doubt it will, though.

2. Increase the dosage of Effexor and look for remedial treatments for the anorgasmia. Ritalin, Buspar, Wellbutrin, and Periactin come to mind. I'm wondering if Viibryd would help.

3. Switch to Pristiq. This metabolite of Effexor has been reported to be less likely to produce anorgasmia. Perhaps this is because therapeutic dosages are much lower (50 - 100 mg/day).

4. Switch to Cymbalta.

5. Switch to nortriptyline.

6. Switch to Parnate or Marplan. Nardil is known to produce anorgasmia.

7. Abandon antidepressants.
a) Switch to lithium carbonate.
b) Add Lamictal 200 - 300 mg/day

8. Evaluate Seroquel 800 mg/day as a contributor to anorgasmia.
a) Reduce the dosage to 400 mg/day
a) Switch to Saphris 20 mg/day
b) Add Trileptal

* #8 would be tricky and perhaps ill-advised if you are apt to become manic / psychotic.

* I'm a layman - not a doctor.

* You might be frustrated and resistant to everything I wrote here. You may have tried many, if not all of these things. You might get really pissed off at me. I would understand this. Just don't question my motives, though.

* Don't give up yet.


- Scott


Some see things as they are and ask why.
I dream of things that never were and ask why not.

- George Bernard Shaw

 

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