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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 4 of 4. This is the beginning of the thread.
Posted by PhoenixGirl on September 8, 2004, at 16:50:29
I don't know exactly which board this post belongs on, because it's kind of a blend of medical and social.
It's like, I want to want sex, but I don't really. I'm only 26, but I've had depression since I was 12. I had a strong libido until about half-way through college. I had taken libido-killing antidepressants, and struggled to get off them. Now I'm taking Wellbutrin and a small dose of Klonopin. I thought going off the other antidepressants would help, but my libido is still low.
Maybe it's the depression itself. But even in times when I feel sort-of okay, and I'm not acutely suffering, my libido is still missing. I want to have a sex life. Sex is an important part of your identity. Especially at my age.
My days are fraught with worry and sadness and frustration. I have brief times of actually feeling good, but most of the time I feel pain or flatness. I've often felt that I'm an elderly woman in a 26-year-old body, after all the hell I've been through. I can't say I feel excited or fired-up about much of anything.
I just feel a deep sense of loss and incompleteness because of my lack of libido.
Posted by alesta on September 8, 2004, at 19:11:39
In reply to Why don't I have an interest in sex??, posted by PhoenixGirl on September 8, 2004, at 16:50:29
hi, there,:)
it could very well be a hormonal problem...perhaps you should get your hormone levels checked.
amy:)
> I don't know exactly which board this post belongs on, because it's kind of a blend of medical and social.
> It's like, I want to want sex, but I don't really. I'm only 26, but I've had depression since I was 12. I had a strong libido until about half-way through college. I had taken libido-killing antidepressants, and struggled to get off them. Now I'm taking Wellbutrin and a small dose of Klonopin. I thought going off the other antidepressants would help, but my libido is still low.
> Maybe it's the depression itself. But even in times when I feel sort-of okay, and I'm not acutely suffering, my libido is still missing. I want to have a sex life. Sex is an important part of your identity. Especially at my age.
> My days are fraught with worry and sadness and frustration. I have brief times of actually feeling good, but most of the time I feel pain or flatness. I've often felt that I'm an elderly woman in a 26-year-old body, after all the hell I've been through. I can't say I feel excited or fired-up about much of anything.
> I just feel a deep sense of loss and incompleteness because of my lack of libido.
Posted by King Vultan on September 8, 2004, at 19:28:16
In reply to Why don't I have an interest in sex??, posted by PhoenixGirl on September 8, 2004, at 16:50:29
I have had similar issues in the past and to some extent in the present. Wellbutrin is known for not causing sexual side effects, but it is not necessarily a super powerful sexual aid, either. I think its efficacy as an antidepressant is probably also only okay. What dosage are you taking? If you aren't taking at least 300 mg/day, I would certainly try increasing it to that level first, as my own experience with the med was that dosages below that just didn't seem to do very much.
The problem with this stuff is that it has a relatively narrow therapeutic range--probably 200 mg is the bare minimum for antidepressant effects, but the maximum dosage is only 450 mg/day. This is in contrast to an SSRI like Zoloft, where the maximum dosage (200 mg/day) is 4x greater than the generally accepted bottom of the range (50 mg/day). I've personally even experienced noticeable AD effects on Zoloft at only 25 mg/day, not that I am trying to recommend it for your particular situation.
If you're interested in something much more powerful--but also with some significant drawbacks--you might consider the MAOI Parnate, which has some stimulant properties on top of the strong antidepressant effects associated with being an MAO inhibitor. Like Wellbutrin, it is also relatively dopaminergic, which tends to minimize sexual side effects while possibly having pro-sexual effects for some people. The big drawback to Parnate is the dietary restrictions, which are overstated on many of the lists, but there are certain items that do have to be absolutely avoided.
Another drug that might be worth trying is Provigil, which is an expensive but relatively innocuous stimulant that is also dopaminergic, and you might also want to consider one of the drugs in the dopamine agonist class, such as bromocriptine or Mirapex. Some of these have shown some efficacy in treating female hypoactive sexual desire. The problem with these is that they tend to have bad nausea and sleepiness side effects, but they do seem to be more tolerable at lower dosages.
Todd
Posted by PhoenixGirl on September 8, 2004, at 21:12:03
In reply to Re: Why don't I have an interest in sex??, posted by King Vultan on September 8, 2004, at 19:28:16
Hi Todd. Thanks for your post. I've tried Parnate and Provigil, but not bromocriptine or Mirapex. Parnate messed up my sleep/wake cycle too much and then I had to stop it so I could get surgery with anesthesia, about a week ago. I have some Provigil left over, and may try it after the Wellbutrin is settled into my system. I just increased the Wellbutrin to 300mg, the dose I've taken for several years. (I stopped Wellbutrin for a little while to try Parnate). I don't know about the bromocriptine and Mirapex, it may be hard to get scripts for them. I may ask my pdoc after the Wellbutrin is settled in.
Actually having a sexual partner would probably help too :/> I have had similar issues in the past and to some extent in the present. Wellbutrin is known for not causing sexual side effects, but it is not necessarily a super powerful sexual aid, either. I think its efficacy as an antidepressant is probably also only okay. What dosage are you taking? If you aren't taking at least 300 mg/day, I would certainly try increasing it to that level first, as my own experience with the med was that dosages below that just didn't seem to do very much.
>
> The problem with this stuff is that it has a relatively narrow therapeutic range--probably 200 mg is the bare minimum for antidepressant effects, but the maximum dosage is only 450 mg/day. This is in contrast to an SSRI like Zoloft, where the maximum dosage (200 mg/day) is 4x greater than the generally accepted bottom of the range (50 mg/day). I've personally even experienced noticeable AD effects on Zoloft at only 25 mg/day, not that I am trying to recommend it for your particular situation.
>
> If you're interested in something much more powerful--but also with some significant drawbacks--you might consider the MAOI Parnate, which has some stimulant properties on top of the strong antidepressant effects associated with being an MAO inhibitor. Like Wellbutrin, it is also relatively dopaminergic, which tends to minimize sexual side effects while possibly having pro-sexual effects for some people. The big drawback to Parnate is the dietary restrictions, which are overstated on many of the lists, but there are certain items that do have to be absolutely avoided.
>
> Another drug that might be worth trying is Provigil, which is an expensive but relatively innocuous stimulant that is also dopaminergic, and you might also want to consider one of the drugs in the dopamine agonist class, such as bromocriptine or Mirapex. Some of these have shown some efficacy in treating female hypoactive sexual desire. The problem with these is that they tend to have bad nausea and sleepiness side effects, but they do seem to be more tolerable at lower dosages.
>
> Todd
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