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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 John Michael on April 14, 2011, at 21:55:41
Hi, I'm a 27 year old man that has been suffering from anorgasmia, or the inability to feel orgasm, for the last several years. This is due to taking SSRIs I believe, and I took the drugs to help with depression, but mostly anxiety, specifically BDD.
Let me first state that I started drinking in college on the weekends, mostly the weekend, pretty heavy. I started smoking weed when I was about 21, and smoked pretty regularly up until the last few months, with a few 3-6 month breaks here and there. I now intend to stop smoking weed forever if that's what it takes for me to get better.
I took paxil when I was 21 for about a year, and during that time my orgasm was severely diminished if not gone. The first day I took the paxil, my penis felt numb. Once I weened off (after about a year of use), my orgasm and feel came back gradually to normal levels.
Took some time off, tried some Effexor around age 23, took paxil again when I was 24, tried throwing in some Wellbutrin to counteract the sexual sides and it didn't seem to work. The last time I was on something everyday was Zolof, last fall, about 6 months ago.
So the most recent thing I've taken is Seroquel 50mg to help sleep, and Xanax for certain social situations, 1-1.5mg, 1-2x/week. I saw my pdoc yesterday and she said to stop the seroquel for at least 2 weeks before we try some meds, and to see my primary care doctor and a urologist. So I'm going to stop the Seroquel and Xanax for as long as needed.
My sexual problem is really starting to affect me. It is horrible not being able to feel an orgasm at all, there is very, very little sensation on my penis during intercourse or oral sex, and if a condom is used, it's like why even bother. So after finally getting the courage to meet some women, and have sex with them, I found it's not worth it with the problem I have.
I've always ate halfway decent and exercised, but now I'm going to do more cardio, and eat even better, and try to get more sleep, which may be hard without a sleep aid.
Just wondering what I can do, what kind of drugs might help for orgasm/libido. I'm trying to get my doctor to prescribe Ritalin because I also believe I have ADD, and I've read that Ritalin can help with orgasm, so maybe kill two birds with one stone.
Thanks for anyone who can help.
Good day.
Posted by SLS on April 15, 2011, at 8:24:47
In reply to Anorgasmia, posted by John Michael on April 14, 2011, at 21:55:41
You might want to look into cyproheptadine (Periactin). It is used on an as-needed basis (PRN) to restore orgasmic function in SSRI anorgasmia. This works for both males and females. I'll be curious to see what you come up with. I believe it is the antagonism of serotonin 5-HT2c receptors that is responsible for this restorative effect. People often take cyprohaptadine 30-60 minutes before sex. It is sedating, so you will have to experiment to find the optimum timing. If that doesn't work, perhaps yohimbine would. It works via a different mechanism involving norepinephrine NE alpha-2 receptor antagonism in the spinal chord.
- Scott
Posted by Agomelatinehope on April 15, 2011, at 9:14:12
In reply to Anorgasmia, posted by John Michael on April 14, 2011, at 21:55:41
Every serotonine antidepressant causes that side effect.
You should try dopamine antidepressants. They don't have this side effect.
Posted by SLS on April 15, 2011, at 9:38:55
In reply to Re: Anorgasmia, posted by Agomelatinehope on April 15, 2011, at 9:14:12
> Every serotonine antidepressant causes that side effect.
>
> You should try dopamine antidepressants. They don't have this side effect.Which ones?
- Scott
Posted by John Michael on April 15, 2011, at 19:07:18
In reply to Re: Anorgasmia » John Michael, posted by SLS on April 15, 2011, at 8:24:47
I will mention it to the doctor. Right now I'm making a huge list of drugs and collecting tons of data to show my doc.
So cyproheptadine is okay to take even if I'm not on any anti-depressants/SSRIs? I've been off all anti-depressants for about 6 months, and don't plan on taking any SSRIs ever again.
> You might want to look into cyproheptadine (Periactin). It is used on an as-needed basis (PRN) to restore orgasmic function in SSRI anorgasmia. This works for both males and females. I'll be curious to see what you come up with. I believe it is the antagonism of serotonin 5-HT2c receptors that is responsible for this restorative effect. People often take cyprohaptadine 30-60 minutes before sex. It is sedating, so you will have to experiment to find the optimum timing. If that doesn't work, perhaps yohimbine would. It works via a different mechanism involving norepinephrine NE alpha-2 receptor antagonism in the spinal chord.
>
>
> - Scott
Posted by John Michael on April 15, 2011, at 19:08:50
In reply to Re: Anorgasmia, posted by Agomelatinehope on April 15, 2011, at 9:14:12
I don't want to get on an anti-depressant if I don't have to. I know I might have to take what the doctor gives me, but I don't want to take a pill everyday, I'd really prefer something that acts right away if possible.
> Every serotonine antidepressant causes that side effect.
>
> You should try dopamine antidepressants. They don't have this side effect.
>
Posted by desolationrower on April 19, 2011, at 0:11:14
In reply to Re: Anorgasmia, posted by John Michael on April 15, 2011, at 19:08:50
you can take cyproheptadine if you are on an AD, but it is specifically effective at blocking hte negative effects of an SSRI.
You coudl try bupropion, which could improve the sexual disfunction and ADD.
I think yohimbine would help, but it tends to make people anxious (although to me it just feels like 'fun')
Mirtazapine might be ok, but tends to cause weight gain, which might be bad for someone with body dysmorphic disorder.
-d/r
This is the end of the thread.
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