Psycho-Babble Medication Thread 866

Shown: posts 1 to 5 of 5. This is the beginning of the thread.

 

another one for toby

Posted by sue on October 13, 1998, at 12:46:47

Okay, here is the story.
I was started on SSRIs 3 years ago w/ no real diagnosis.
I am by nature a very high achiever and began having
problems w/ depressed mood in high school. I can't
really say that I ever hit a real major "depression", i have
always functioned fine, but basically struggle w/ a
chronic, negative, annoying voice in my head, the repetitive
tape of negativity. Also seem to have some social
anxiety issues, feeling acutely self-conscious in
groups etc.
Three yrs ago was placed on zoloft by my family doc.
It seemed to help fairly well, i dc'd it about six
months later b/c for me the sexual side effects were
severe-complete anorgasmia. I noticed that I gradually
slipped back into my more negative, down on myself,
nervous about very minor things mode. Nine months off
of zoloft i was quite tearful, still doing everything
I had to do in daily life, sleeping fine, eating fine,
seeing friends and exercising, but just feeling BAD inside
and, having felt better on zoloft, not wanting to put
up w/ it. (plus i was single again). Started on prozac
20 mg and really had quite a dramatic response. Subtle
but dramatic at the same time. Went off of it due to
relationship and same sexual stuff, relapsed again,
went on it again w/ the same noticeable improvement,
off it again, every time due to the severe sex stuff.

Off of it now, i am back to my baseline, which is getting
by but limping along. I know my dysthmia/depression/mood
whatever you want to call it interferes w/ my relationship
with my boyfriend and i know that i feel so much better
on the prozac but the price to pay is so high.
I am seeing a psychiatrist now who put me on wellbutrin
SR 150/day and have been on that for 4 weeks and
basically really notice no effect. Although it is
exceptionally painful to discuss the sex stuff (easier
on email) he knows about the problems in the past. He
now wants to up it to 300/day and then up to 450/day.

In the past, i had a very rapid (w/in a week) response
to prozac and i just felt better. I HATE taking
meds in general and feel nervous about maxxing out
on a dosage of a drug that doesn't really seem to work
for me.

The sad thing is that I know that I can 'get by' indefinitely
without medication, but I just feel way up and down,
irritable, negative, self-conscious, nervous and a whole
host of other grim things.
What would you recommend? Is my choice really no sex
or putting up w/ this chronic stuff? It is like having
to choose between two unbearable options.
Thank you.

 

Re: sexual side effects

Posted by Toby on October 13, 1998, at 13:32:37

In reply to another one for toby, posted by sue on October 13, 1998, at 12:46:47

If Wellbutrin does nothing for your depession, I would say you need to go back to whichever medication was most helpful (Prozac or Zoloft) and then treat the sexual side effect if it happens again.

How to treat? Several options are available, especially if the problem is mainly loss of orgasm but the libido is fine. 1) Some folks do well with a drug holiday: stop the medication on Friday and resume on Monday, planning the desired interlude on Saturday or Sunday. You just have to be sure and not forget to start back on the medication on Monday so that the depression won't recur. 2) There are also medications that do not cause this side effect (the reason loss of orgasm occurs with SSRI's is that one of the serotonin receptor subtypes is responsible for allowing an orgasm to occur and most SSRI's block this receptor to some degree): Wellbutrin, Serzone, Remeron do not block that particular serotonin receptor and so sexual function remains intact. 3) There are medications that can reverse this side effects, either through unblocking that receptor or overriding it by antihistamine effects. These include adding Buspar 15 - 60 mg per day; adding Wellbutrin SR 150 - 300 mg per day; adding Periactin (a powerful antihistamine, so a side effect may be drowsiness, but if it works like it should, you may be drowsy that evening anyway) 4 - 8 mg, 1 to 2 hours before intercourse (costs about $35 for 60 tabs); adding an over the counter amino acid called L-arginine 500 mg, 4 tablets on an empty stomach 1 to 2 hours before intercourse (cheapest: GNC stores currently have a sale on for 60 tabs for $9.99 with the second bottle for $5.00). The results vary with individual people, although I am beginning to hear very consistent, good results about the L-arginine, and since it is OTC you don't need a prescription or a doctor's visit every time you run out. Also, the Periactin and L-arginine do not have to be taken every day, just when you need it.

You could always try Serzone or Remeron, but these are usually used in very anxious depressed people and may make you too sedated if anxiety is not a part of your depression.

 

sexual side effects

Posted by janey on October 30, 1998, at 19:51:21

In reply to another one for toby, posted by sue on October 13, 1998, at 12:46:47

sue and Toby,

While I did my "time" on Prozac and then Zoloft, I didn't realize I had no sex drive or was essentially anorgasmic. I put it down to staying completely away from anything that resembled a hint of a relationship since my first and last foray involved in a short one where I learned first-hand about domestic violence.

First Prozac ran out of steam for me, and then Zoloft. My doctor switched me to Effexor. Whoa! Within two weeks my sex drive was back with a vengeance! It wasn't until then I realized that my lack of one wasn't due to fear alone, but side effects from medication. Effexor is a little different from the SSRIs in that it is an SNRI and works norepinephrine, too. I don't know if the norepinephrine link had anything to do about it, but what a wonderful change for me.

And thank you, Toby, for the info on L-something-or-other (I'll go back get it right in a sec.)

janey

 

Re: sexual side effects

Posted by Victor D. Escobar on October 31, 1998, at 16:05:44

In reply to sexual side effects, posted by janey on October 30, 1998, at 19:51:21

I have been on Effexor for a little over 3 months.
The saxual dysfunction turned out be a blessing in
disguise, My wife and I have married 32 years and
she says that this is the best so far, because it
takes me so much longer to achieve an orgasm, she
experiences many most of the time. I take the XR
flavor; and I can not express the change in my life.
If I had been born blind and suddenly could see,
I would not be more amazed. This is the very first
time in my life that I have taken this kind of
medication, and my doctor must have gotten me pegged
right the first time. Side effcts are there, but
they are either going away or I am learning to
adjust. The worst was the nightmares that came
when i ran out of medicine because i was stranded
on a business trip during hurricane Georges.
BAD withdrwal symptoms. I am new at this posting
or reply thing. But I wish all peace.

Victor

> sue and Toby,
> While I did my "time" on Prozac and then Zoloft, I didn't realize I had no sex drive or was essentially anorgasmic. I put it down to staying completely away from anything that resembled a hint of a relationship since my first and last foray involved in a short one where I learned first-hand about domestic violence.
> First Prozac ran out of steam for me, and then Zoloft. My doctor switched me to Effexor. Whoa! Within two weeks my sex drive was back with a vengeance! It wasn't until then I realized that my lack of one wasn't due to fear alone, but side effects from medication. Effexor is a little different from the SSRIs in that it is an SNRI and works norepinephrine, too. I don't know if the norepinephrine link had anything to do about it, but what a wonderful change for me.
> And thank you, Toby, for the info on L-something-or-other (I'll go back get it right in a sec.)
> janey

 

Re: sexual side effects

Posted by walter on November 21, 1998, at 0:58:20

In reply to sexual side effects, posted by janey on October 30, 1998, at 19:51:21

> Here's one I think almost no one has heard of. My wife has been on Paxil, which caused anorgasmia. Adding Wellbutrin helped but it was still like climbing Mt. Everest. She started perimenopause and a friend suggested she take Remifemin. It is a
well standardized dose of an herb called Black Cohosh. It has been used for a long time by many to relieve menopause related symptoms. We were happy to find that it also relieved the anorgasmia far better than the Wellbutrin. She takes it once per day
and does not have to worry about its timing in relationship to intercourse. It relieved about 75-80% of the sexual dysfunction. Orgasm is routine, the climb to it is still significantly longer than pre-Paxil days, but on most occasions, quite doable.


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