![[dr. bob]](/dr-bob-sm.gif)
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 7 of 7. This is the beginning of the thread.
Posted by Teri on November 5, 2001, at 12:07:32
Hi. I've been on Celexa (30mg) for a couple of months. It's helped my depression and along with Klonopin, my anxiety. The sexual dysfunction has been a problem and my doctor prescribed pindolol to offset the sex problem. Has anyone had success with this? He said that SSRI's target the s2 receptor where sexual response is located and that Pindolol blocks that effect without changing what the Celexa does for depression and anxiety. Has anyone had any luck with this combo for sexual problems while on SSRI's?
I've been really shaky the last week or so also and not sure if the Pindolol is causing that or if the Klonopin and occassional Xanax aren't working as well anymore. He gave me Klonopin to help me sleep and help with my anxiety.
Thanks! Teri
Posted by ben on November 5, 2001, at 13:45:33
In reply to Celexa and Pindolol for sexual problems, posted by Teri on November 5, 2001, at 12:07:32
> Hi. I've been on Celexa (30mg) for a couple of months. It's helped my depression and along with Klonopin, my anxiety. The sexual dysfunction has been a problem and my doctor prescribed pindolol to offset the sex problem. Has anyone had success with this? He said that SSRI's target the s2 receptor where sexual response is located and that Pindolol blocks that effect without changing what the Celexa does for depression and anxiety. Has anyone had any luck with this combo for sexual problems while on SSRI's?
>
> I've been really shaky the last week or so also and not sure if the Pindolol is causing that or if the Klonopin and occassional Xanax aren't working as well anymore. He gave me Klonopin to help me sleep and help with my anxiety.
>
> Thanks! Teri
Hi TeriI guess the pindolol makes you shaky, because it potentiates the SSRI. If sexual
probs doesnt fade away you should change the AD. SSRI are often very nasty concerning sexual probs, but everyone reacts in another way. I didnt have sexual probs with Celexa but it didnt worked enough, so I changed to Paxil. Paxil worked better against depression but caused sexual problems. So I have too try something other again. Good luck.
Posted by Mark H. on November 5, 2001, at 20:13:44
In reply to Celexa and Pindolol for sexual problems, posted by Teri on November 5, 2001, at 12:07:32
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.
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.
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.
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.
Can any readers of this thread comment from experience?
Mark H.
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.
>
> 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.
>
> 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.
>
> 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.
>
> Can any readers of this thread comment from experience?
>
> Mark H.
Posted by bonnie_ann on November 6, 2001, at 21:10:56
In reply to Celexa and Pindolol for sexual problems, posted by Teri on November 5, 2001, at 12:07:32
> Hi. I've been on Celexa (30mg) for a couple of months. It's helped my depression and along with Klonopin, my anxiety. The sexual dysfunction has been a problem and my doctor prescribed pindolol to offset the sex problem. Has anyone had success with this? He said that SSRI's target the s2 receptor where sexual response is located and that Pindolol blocks that effect without changing what the Celexa does for depression and anxiety. Has anyone had any luck with this combo for sexual problems while on SSRI's?
>
> I've been really shaky the last week or so also and not sure if the Pindolol is causing that or if the Klonopin and occassional Xanax aren't working as well anymore. He gave me Klonopin to help me sleep and help with my anxiety.
>
> Thanks! TeriTeri,
I don't know about Pindolol - I added 300mg Wellbutrin IR to my Celexa 10mg- and this is working fine for me, In fact I've noticed an increase in libido. The weaning on process was a little tough -as I have anxiety, the addition of Wellbutrin increased that- but it passes quickly enough -maybe a week or so for each increase.
Bonnie
Posted by Teri on November 9, 2001, at 9:37:23
In reply to Re: Celexa and Pindolol for sexual problems, posted by Rick on November 5, 2001, at 22:01:18
Hi Thanks for everyone's input. I did increase the Celexa from 20mg to 30mg about two weeks ago. I didn't have this tremor problem as bad on the 20 but maybe the increase caused it. I'm taking Klonopin,too and also occassional Xanax. I'm wondering if I'm building up a tolerance to those drugs. I'm taking them to help me sleep. I want my doctor to let me try Ambien for sleep (it worked with other drugs I was on before) but he said it won't help my anxiety. I would like to take it for a full night's sleep and the take the benzos if needed during the day for anxiety. I keep waking up in the middle of the night and have to take either another Klonopin or a Xanax. I don't like pumping that many benzos in me every night like that.
I called his office again about the Pindolol and they said that unlike other beta blockers, it's one that blocks the sexual side effects of SSRI's and they use it mainly for that purpose. I'm only on 5mg and am scared to take more than that since I read that it causes serotonin to hang around longer than the SSRI's do which helps the depression but I've had serotonin syndrome in the past and don't want to go there again. Maybe this wouldn't cause it. Hope not. Still not sure if just one pill of Pindolol is working on the sex issue. Haven't tried it! Teri
Posted by Rick on November 9, 2001, at 15:20:31
In reply to Re: Celexa and Pindolol for sexual problems, posted by Teri on November 9, 2001, at 9:37:23
Teri -
I think your idea could make a lot of sense. I quickly learned that Klonopin works much better against my anxiety -- *and still fights insomnia* --when I take it only during the day.
In fact, I used to have insomnia about half the time (but from anxiety,not depression), but I was pleasntly surpised to find that regular *daytime* dosing of Klonopin apparently leaves enough of the benzo in my system at bedtime to ward off insomnia. So if you do go to daytime-only dosing, don't be too quick to seek Ambien or another sleep aid. Instead, try to give the Klonopin a chance to reach steady-state first, and *then* assess whether you still need to take anything at bedtime.
As for pindolol, the idea of using it to reverse sexual dysfunction still really throws me for a loop. I’ve never heard of anything like that, and I’ve read loads of studies on that med and monitored posts about experiences with it on this board and others. While it caused me no sexual problems in the small dose I was taking (2.5-5.0 mg/day), the following two abstracts suggest that it’s actually one of the stronger potential INHIBITORS of sexual function among BB’s. The caveat is that these studies were in males humans and rodents who were presumably taking it without an AD.
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=2900627&dopt=Abstract
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=1977175&dopt=Abstract
Rick
> Hi Thanks for everyone's input. I did increase the Celexa from 20mg to 30mg about two weeks ago. I didn't have this tremor problem as bad on the 20 but maybe the increase caused it. I'm taking Klonopin,too and also occassional Xanax. I'm wondering if I'm building up a tolerance to those drugs. I'm taking them to help me sleep. I want my doctor to let me try Ambien for sleep (it worked with other drugs I was on before) but he said it won't help my anxiety. I would like to take it for a full night's sleep and the take the benzos if needed during the day for anxiety. I keep waking up in the middle of the night and have to take either another Klonopin or a Xanax. I don't like pumping that many benzos in me every night like that.
>
> I called his office again about the Pindolol and they said that unlike other beta blockers, it's one that blocks the sexual side effects of SSRI's and they use it mainly for that purpose. I'm only on 5mg and am scared to take more than that since I read that it causes serotonin to hang around longer than the SSRI's do which helps the depression but I've had serotonin syndrome in the past and don't want to go there again. Maybe this wouldn't cause it. Hope not. Still not sure if just one pill of Pindolol is working on the sex issue. Haven't tried it! Teri
This is the end of the thread.
Psycho-Babble Medication | Extras | FAQ
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.org
Script revised: February 4, 2008
URL: http://www.dr-bob.org/cgi-bin/pb/mget.pl
Copyright 2006-17 Robert Hsiung.
Owned and operated by Dr. Bob LLC and not the University of Chicago.