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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 12 of 12. This is the beginning of the thread.
Posted by Simcha on August 6, 2001, at 8:23:15
OK, I'm not happy. :-(
Sex is better on this mix than it was on Effexor. I am able to get it up but I can't always acheive orgasm.
I'm on 20mg of Celexa in the am. I take 150mg WellbutrinSR at noon. Perhaps I need to go up to 300mg of WellbutrinSR? I see my pdoc tomorrow.
Are there any suggestions from you guys?
Posted by Bill L on August 6, 2001, at 9:10:58
In reply to Sexual Problems on Celexa WellbutrinSR? :-(, posted by Simcha on August 6, 2001, at 8:23:15
I would recommend that you try adding Ginkgo. A medical trial showed success with SSRI induced sexual dysfunction with 240 mg per day of Ginkgo(120 twice a day). I take Celexa and the Ginkgo has helped me a lot. I only take 120 mg per day. Give it about 2 weeks to start working and 4 weeks for a full effect. Ginkgo can act as an anticoagulant just like aspirin. So if you currently have bleeding problems, check with your doctor first.
> OK, I'm not happy. :-(
>
> Sex is better on this mix than it was on Effexor. I am able to get it up but I can't always acheive orgasm.
>
> I'm on 20mg of Celexa in the am. I take 150mg WellbutrinSR at noon. Perhaps I need to go up to 300mg of WellbutrinSR? I see my pdoc tomorrow.
>
> Are there any suggestions from you guys?
Posted by Ted on August 6, 2001, at 16:52:52
In reply to Re: Sexual Problems on Celexa WellbutrinSR? :-(, posted by Bill L on August 6, 2001, at 9:10:58
I did the Ginkgo Biloba thing (240 mg/day in divided doses) for 8 weeks with absolutely no affects. No benefits, no side affects, nothing. I take 200 mg zoloft & 300 mg wellbutrin. I think it is a placebo (though I DID want it to work!).
Ted
> I would recommend that you try adding Ginkgo. A medical trial showed success with SSRI induced sexual dysfunction with 240 mg per day of Ginkgo(120 twice a day). I take Celexa and the Ginkgo has helped me a lot. I only take 120 mg per day. Give it about 2 weeks to start working and 4 weeks for a full effect. Ginkgo can act as an anticoagulant just like aspirin. So if you currently have bleeding problems, check with your doctor first.
>
> > OK, I'm not happy. :-(
> >
> > Sex is better on this mix than it was on Effexor. I am able to get it up but I can't always acheive orgasm.
> >
> > I'm on 20mg of Celexa in the am. I take 150mg WellbutrinSR at noon. Perhaps I need to go up to 300mg of WellbutrinSR? I see my pdoc tomorrow.
> >
> > Are there any suggestions from you guys?
Posted by SalArmy4me on August 6, 2001, at 22:27:56
In reply to Sexual Problems on Celexa WellbutrinSR? :-(, posted by Simcha on August 6, 2001, at 8:23:15
http://www.dr-bob.org/tips/split/Mirtazapine-for-SSRI-ADRs.html
Posted by Simcha on August 7, 2001, at 7:44:14
In reply to Re: Sexual Problems on Celexa WellbutrinSR? :-( » Simcha, posted by SalArmy4me on August 6, 2001, at 22:27:56
Thanks Sal.. Remeron.. Hmmm. I'll ask my pdoc today when I see him... I'll let you know...
> http://www.dr-bob.org/tips/split/Mirtazapine-for-SSRI-ADRs.html
Posted by Ted on August 7, 2001, at 11:27:30
In reply to Re: Sexual Problems on Celexa WellbutrinSR? :-( » Simcha, posted by SalArmy4me on August 6, 2001, at 22:27:56
> http://www.dr-bob.org/tips/split/Mirtazapine-for-SSRI-ADRs.html
I mentioned this to my pdoc a few months ago. He said he would not deny my trying it and offered to write a prescription. However, he also said that *EVERY* patient of his without exception gained significant weight when taking Remeron. He offered me the choice. I turned it down (for now).
Ted
Posted by Simcha on August 7, 2001, at 14:37:59
In reply to Re: Sexual Problems on Celexa WellbutrinSR? :-(, posted by Ted on August 7, 2001, at 11:27:30
I just got back from the pdoc. He suggested that we wait and see. I've been on Celexa for only 2 weeks and I've been on the Wellbutrin for only 4 weeks. He says that it may take 4 more weeks to determine where I will stabilize. So he thinks that I should give the treatment a chance before changing meds. I think that that is sound advice.
He increased my Celexa to 40mg because he says that it sounds like I need it for my depression. He was a bit reluctant to increase my dose because of the sexual difficulties that I have experienced.
I told him that I'd rather not be depressed and that I would rather increase the Celexa to 40mg and not be depressed. He also said that the sexual side effects are cut by the Wellbutrin and that I could take my Wellbutrin at 3pm to be able to have better sex at night. He even said that if I have trouble with the 40mg dose of Celexa that I could cut it back to 20mg on the days where I anticipate that I will be sexual.
Basically he gave me choices. I chose to follow his advise... After all I'm not the doctor... I'll let all of you know how this experiment turns out....
> > http://www.dr-bob.org/tips/split/Mirtazapine-for-SSRI-ADRs.html
>
> I mentioned this to my pdoc a few months ago. He said he would not deny my trying it and offered to write a prescription. However, he also said that *EVERY* patient of his without exception gained significant weight when taking Remeron. He offered me the choice. I turned it down (for now).
>
> Ted
Posted by paxvox on August 8, 2001, at 11:37:26
In reply to Re: Sexual Problems on Celexa WellbutrinSR? :-( » Ted, posted by Simcha on August 7, 2001, at 14:37:59
>
> >
> I told him that I'd rather not be depressed and that I would rather increase the Celexa to 40mg and not be depressed. He also said that the sexual side effects are cut by the Wellbutrin and that I could take my Wellbutrin at 3pm to be able to have better sex at night. He even said that if I have trouble with the 40mg dose of Celexa that I could cut it back to 20mg on the days where I anticipate that I will be sexual.
exception gained significant weight when taking Remeron. He offered me the choice. I turned it down (for now).
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.
Posted by jojo on August 8, 2001, at 12:11:42
In reply to Re: Sexual Problems on Celexa WellbutrinSR? :-(, posted by paxvox on August 8, 2001, at 11:37:26
> >
> > >
> > I told him that I'd rather not be depressed and that I would rather increase the Celexa to 40mg and not be depressed. He also said that the sexual side effects are cut by the Wellbutrin and that I could take my Wellbutrin at 3pm to be able to have better sex at night. He even said that if I have trouble with the 40mg dose of Celexa that I could cut it back to 20mg on the days where I anticipate that I will be sexual.
> exception gained significant weight when taking Remeron. He offered me the choice. I turned it down (for now).
>
>
> 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."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."I can't disagree with the above, and I had no untoward effects from Wellbutrin at 400 mg. per day. Taken alone, however, Wellbutrin was completely ineffective as an AD for me, and taken with Celexa (either 20 or 40 mg. per day) did not improve my sexual ability in any way.
jojo
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.
Posted by paxvox on August 8, 2001, at 16:30:57
In reply to Re: Sexual Problems on Celexa WellbutrinSR? :-( » paxvox, posted by Simcha on August 8, 2001, at 12:33:54
.
>>
> 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. as he has prescribed.... I don't feel that I'm getting whacky advise... I'll keep you posted.OK Simcha,
Like I said, and you concur, we all react differently to meds. Like my guy has me as an OCD on paper, but has never considered Paxil or Luvmox(?) the only "approved" ADs for OCD. But I also have panic problems (not regularly) and general anxiety (which worrying about makes much better!!!). But seriously, him saying the Wellbutrin will counteract some of the effects of Celexa...that's the part I have trouble understanding. I know that Celexa also has been used successfully for OCD. I like Wellbutrin as a mood lifer. I really don't think you should take it that late in the day, noon-1P.M. maybe. It speeds me up too much that if negatively affects my sleep. I do know that Wellbutrin clearly can help your cravings for something (I quit drinking cold turkey...which is not the best idea due to the seizure risk) that's why they give it as Zyban to smokers. Good luck, but I suspect you will feel better if you take the WB earlier than 3 P.M.
Posted by Simcha on August 8, 2001, at 23:02:36
In reply to Re: Sexual Problems on Celexa WellbutrinSR? :-( » Simcha, posted by paxvox on August 8, 2001, at 16:30:57
Good luck, but I suspect you will feel better if you take the WB earlier than 3 P.M.
Hello, I took my Wellbutrin at 3pm and I fell asleep at 7pm.... Like we have both said different meds affect different people differently.
;-)
This is the end of the thread.
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