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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 16 of 16. This is the beginning of the thread.
Posted by jms600 on November 7, 2004, at 16:05:11
Hi,
This is probably a question that has been asked countless times on Psycho Babble, but which of the SSRIs has the least sexual side effects?
Im on 40mg of Prozac and found my sex drive has dropped (although not as bad as when I was taking Paxil). Im in a relationship at the moment so I could do with switching to an anti-depressant with no sexual side-effects.
Any ideas?
Thanks for your help!
Posted by linkadge on November 7, 2004, at 16:19:48
In reply to SSRIs and sex drive, posted by jms600 on November 7, 2004, at 16:05:11
You could try lowering the prozac, and *adding* wellbutrin (which can counteract the sexual side effects of most SSRI's.) or you could try swiching over completely to wellbutrin, which would pose no problems in terms of sexual function.
Linkadge
Posted by King Vultan on November 7, 2004, at 22:23:40
In reply to SSRIs and sex drive, posted by jms600 on November 7, 2004, at 16:05:11
> Hi,
>
> This is probably a question that has been asked countless times on Psycho Babble, but which of the SSRIs has the least sexual side effects?
>
> Im on 40mg of Prozac and found my sex drive has dropped (although not as bad as when I was taking Paxil). Im in a relationship at the moment so I could do with switching to an anti-depressant with no sexual side-effects.
>
> Any ideas?
>
> Thanks for your help!
They all seem to be bad, but Paxil is generally considered to be the worst. I do not believe you are likely to find any of the other SSRIs to be much less of a problem than Prozac. The tricyclic nortriptyline is not known for causing sexual side effects as do the SSRIs; although, it is more likely to cause side effects such as dry mouth and constipation. It's really not too bad for a tricyclic, though. Of course, Wellbutrin is also known for its lack of sexual side effects, but its antidepressant and anti-anxiety efficacy does not generally seem to be as good as that of the SSRIs.Todd
Posted by Ted Brosnan on November 8, 2004, at 7:48:17
In reply to Re: SSRIs and sex drive, posted by King Vultan on November 7, 2004, at 22:23:40
ALL SSRIs KILL THE SEX DRIVE! It's just because the mechanism they work. They block the re-uptage of serotonin. The serotonin would hit then all +15 receptors of it. One of which the 5HT-2. When the 5HT-2 gets activated (all day long) it inhibits orgasm and reduces the drive.
Wellbutrin, that TCA (I am on it now), Remeron don't cause such terrible side effects.
Posted by Bill LL on November 8, 2004, at 9:22:11
In reply to Re: SSRIs and sex drive, posted by King Vultan on November 7, 2004, at 22:23:40
As Todd said, Nortriptyline often causes dry mouth and constipation. In studies, it has generally proven to be more effective than Prozac for depression. I know that sometimes doctors prescribe both drugs at the same time.
I guess you could ask your doc about lowering the Prozac dose and augmenting with Nortriptyline or Wellbutrin or Remeron.
Are you male or female? If you are male, a good option might be Viagra, Levitra or Cialis.
> > Hi,
> >
> > This is probably a question that has been asked countless times on Psycho Babble, but which of the SSRIs has the least sexual side effects?
> >
> > Im on 40mg of Prozac and found my sex drive has dropped (although not as bad as when I was taking Paxil). Im in a relationship at the moment so I could do with switching to an anti-depressant with no sexual side-effects.
> >
> > Any ideas?
> >
> > Thanks for your help!
>
>
> They all seem to be bad, but Paxil is generally considered to be the worst. I do not believe you are likely to find any of the other SSRIs to be much less of a problem than Prozac. The tricyclic nortriptyline is not known for causing sexual side effects as do the SSRIs; although, it is more likely to cause side effects such as dry mouth and constipation. It's really not too bad for a tricyclic, though. Of course, Wellbutrin is also known for its lack of sexual side effects, but its antidepressant and anti-anxiety efficacy does not generally seem to be as good as that of the SSRIs.
>
> Todd
Posted by ants on November 8, 2004, at 10:08:57
In reply to SSRIs and sex drive, posted by jms600 on November 7, 2004, at 16:05:11
how long have you been on Prozac? I have been on Effexor (its an SNRI, I think. Not an SSRI) for about 7 weeks. The first 5 weeks it killed my sex drive, now it is returning, thank goodness.
Maybe give it a little more time, if you can.
Posted by mattsit on November 8, 2004, at 14:02:46
In reply to Re: SSRIs and sex drive, posted by ants on November 8, 2004, at 10:08:57
I am on 10 mg Lexapro and my sex drive is lower, and My in-ability to orgasm is hurting my relationship with my wife...She knows it is the medicine, but feels like she cant fulfill me...which obviously is crazy!
Posted by Dan Perkins on November 9, 2004, at 21:34:59
In reply to Re: SSRIs and sex drive, posted by King Vultan on November 7, 2004, at 22:23:40
I don't seem to have much of a sex drive on ssri's (or any other AD) or off of them. What was great about being on Prozac was being able to sustain an erection for HOURS during intercourse. I guess that's called looking at the bright side of things.
Posted by gromit on November 10, 2004, at 18:59:46
In reply to Re: SSRIs and sex drive, posted by Dan Perkins on November 9, 2004, at 21:34:59
> I don't seem to have much of a sex drive on ssri's (or any other AD) or off of them. What was great about being on Prozac was being able to sustain an erection for HOURS during intercourse. I guess that's called looking at the bright side of things.
Yeah but at some point it's just beating a dead horse.
mattsit, I am in the same situation with my wife. I don't have any advice, women are difficult to understand sometimes.
Rick
Posted by lalaland7 on November 10, 2004, at 21:22:36
In reply to Re: SSRIs and sex drive, posted by ants on November 8, 2004, at 10:08:57
> how long have you been on Prozac? I have been on Effexor (its an SNRI, I think. Not an SSRI) for about 7 weeks. The first 5 weeks it killed my sex drive, now it is returning, thank goodness.
>
> Maybe give it a little more time, if you can.Question for ANTS.....I am considering switching from Prozac to effexor. I am always tired and we added wellbutrin...I'm still tired so I was wondering about effexor...were you on a SSRI before effexor? and how have the side effects(other than sexual) been?thanks :-)
Posted by mattsit on November 11, 2004, at 8:18:26
In reply to Re: SSRIs and sex drive, posted by gromit on November 10, 2004, at 18:59:46
Yeah, isn't it tough? She knows for a fact that when Im on the medicine the result in the bedroom is often a letdown...so why would she think for a second I dont love her/aren't attracted to her? I guess somtimes emotion outweighs logic, which is exactly the reason I am taking the medicine to begin with.
Posted by ants on November 11, 2004, at 8:33:29
In reply to Re: SSRIs and sex drive » ants, posted by lalaland7 on November 10, 2004, at 21:22:36
> Question for ANTS.....I am considering switching from Prozac to effexor. I am always tired and we added wellbutrin...I'm still tired so I was wondering about effexor...were you on a SSRI before effexor? and how have the side effects(other than sexual) been?thanks :-)
Effexor is my first AD ever, so I don't have a very good basis for comparison, but I have had a really good experience on it, especially now that the sexual stuff is working itself out. I started at 37.5mg (the XR version) for about 10 days, then up to 75mg, where I still am. The first week I felt very "up", which was fun, but a little wierd. At 75mg, I had a few days of feeling a little drugged-not bad, just some headaches and a little "out of it". I did, however, get pretty sad about the sexual side effects-there were tears and arguing with my boyfriend one night. It was like I was just numb. Awfully frustrating. I think i also posted somewhere on this site that I was losing all my motivation at work, but I think that was all in my head-I had read a post about apathy from effexor, and it scared me. I never had any fatigue from it. If anything it has been energizing. I went for a physical and my GP suggested I switch to Wellbutrin because of the sexual issues. This was after about 3 weeks on Effexor. I didn't want to go through the switch without giving Effexor a good chance, so I stuck with it and it did, in fact, improve on its own.
If you try Effexor, I would give it at least 2 months for the sexual side effects to dissipate, if you are otherwise tolerating it well.
Good luck!
ants
Posted by lalaland7 on November 11, 2004, at 8:52:41
In reply to Re: SSRIs and sex drive » lalaland7, posted by ants on November 11, 2004, at 8:33:29
> > Question for ANTS.....I am considering switching from Prozac to effexor. I am always tired and we added wellbutrin...I'm still tired so I was wondering about effexor...were you on a SSRI before effexor? and how have the side effects(other than sexual) been?thanks :-)
>
> Effexor is my first AD ever, so I don't have a very good basis for comparison, but I have had a really good experience on it, especially now that the sexual stuff is working itself out. I started at 37.5mg (the XR version) for about 10 days, then up to 75mg, where I still am. The first week I felt very "up", which was fun, but a little wierd. At 75mg, I had a few days of feeling a little drugged-not bad, just some headaches and a little "out of it". I did, however, get pretty sad about the sexual side effects-there were tears and arguing with my boyfriend one night. It was like I was just numb. Awfully frustrating. I think i also posted somewhere on this site that I was losing all my motivation at work, but I think that was all in my head-I had read a post about apathy from effexor, and it scared me. I never had any fatigue from it. If anything it has been energizing. I went for a physical and my GP suggested I switch to Wellbutrin because of the sexual issues. This was after about 3 weeks on Effexor. I didn't want to go through the switch without giving Effexor a good chance, so I stuck with it and it did, in fact, improve on its own.
>
> If you try Effexor, I would give it at least 2 months for the sexual side effects to dissipate, if you are otherwise tolerating it well.
>
> Good luck!
>
> antsHi ANTS thanks for your response! WHen I added wellbutrin for energy/sexual side effects it did help! but after a few years on wellbutrin and prozac I am fairly numb sexually again :-( I have tried a supplement which my Dr said was ok with the meds...its called Arginmax(formula for women)You can get it at GNC. It really helps especially with oragasm. It helped so much that my boyfriend go the male version and he loved it. You need to give it at least 2-3 weeks to work. However you have to take 3 big horsepills of it 2x's a day which got to be a bit much when I was taking so many other pills. But it may help you so ask your Dr if you can use it...you can go to link and get the ingredients list to show your Dr.
http://www.arginmax.com/html/wmn-ingredients.htmHope it helps.....Oh did you gain any weight on effexor??take care!!!
Posted by ants on November 11, 2004, at 10:12:38
In reply to Re: SSRIs and sex drive » ants, posted by lalaland7 on November 11, 2004, at 8:52:41
Lalaland-I haven't gained weight so far (knock on wood). In the few months before I started effexor, I lost about 10 lbs (which I attribute to my anxiety and depression, but who knows). On Effexor, I haven't lost any more weight, but i haven't gained more than a pound or so back.
to the others in this thread-
I had similar issues to those you are discussing, with my boyfriend feeling inadequate, etc. It was so frustrating, and made me feel all this pressure to "perform" to appease him, which of course just exacerbated the problem!I think I finally got him to understand that it was the medication, not him, that was the problem (this required a lot of crying and yelling on my part...) Maybe having your partner read some of these posts would help.
the thing that made it all click is the fact that when i am on Effexor, I am a much nicer person and our relationship is way more fun.
Posted by Iansf on November 11, 2004, at 19:41:04
In reply to Re: SSRIs and sex drive » ants, posted by lalaland7 on November 11, 2004, at 8:52:41
> Hi ANTS thanks for your response! WHen I added wellbutrin for energy/sexual side effects it did help! but after a few years on wellbutrin and prozac I am fairly numb sexually again :-( I have tried a supplement which my Dr said was ok with the meds...its called Arginmax(formula for women)You can get it at GNC. It really helps especially with oragasm. It helped so much that my boyfriend go the male version and he loved it. You need to give it at least 2-3 weeks to work. However you have to take 3 big horsepills of it 2x's a day which got to be a bit much when I was taking so many other pills. But it may help you so ask your Dr if you can use it...you can go to link and get the ingredients list to show your Dr.
> http://www.arginmax.com/html/wmn-ingredients.htmJust a word of caution for your boyfriend. Arginmax contains iron, and men should not take iron supplements unless they know for certain their iron levels are low. It can be very bad for the heart. It is particularly dangerous if they already taking a multivitamin with iron. It is of less concern for women, especially pre-menopausal women because of monthly blood loss, but even women would be wise to get their iron checked before taking supplementation. There are also some studies suggesting that excess iron can contribute to depression.
Furthermore, if by chance you have one or both genes for hemochromatosis - and about 10% of the population does - you are really putting yourself at risk by taking extra iron.
Posted by lalaland7 on November 11, 2004, at 20:18:42
In reply to Re: SSRIs and sex drive » lalaland7, posted by Iansf on November 11, 2004, at 19:41:04
Hi, I am no longer with that boyfiend LOL! But regardless there is only iron in the womens formula...not in the mens formula. I do agree with you that you have to be careful even with OTC supplements though! :-)
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