![[dr. bob]](/dr-bob-sm.gif)
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 12 of 12. This is the beginning of the thread.
Posted by Racer on July 22, 1999, at 0:24:47
I've been hoping that I'd find something, and have sought diligently, but found no hard answer to my question. You, who are the fount from which all knowledge springs, must be able to shed light on this subject.
Is there a drug which helps counteract the anorgasmia which results from ADs? In the support group I go to, there's them as says switching to Wellbutrin for 24 hours before sex helps, then there's them as says Buspar helps. Then, there are others who say never having sex again helps, or that nothing helps.
I figure you can tell us the real truth, the straight dope, the latest and greatest. Please?
Thanks again, for all and more.
Posted by Roo on July 22, 1999, at 6:50:57
In reply to Dr Bob, HELP!! Sexual side effects? Any help?, posted by Racer on July 22, 1999, at 0:24:47
> I hope you do answer this one, Doc, b/c it's
one I know all of us are longing to figure out--how
to have our mental health and our sexuality too.
I've read the pharm and tricks--whatever that thing
is where all the docs discuss what works for their
patients. They all differ so much though.
What has worked best for your patients?
SHOULD we give up? I'm like Racer, and I've been
dilligently searching...but I haven't tried any
of the fine tuning of meds, tweaking, adding other stuff
to the meds to counteract that side effect, maybe
that's the answer.
I'm on prozac now, 20 mg's a day. I have some
leftover wellbutrin from back when I tried it...
would it hurt to take Racer's suggestion..take
it 24 hours before sex? Any risk for seratonin
syndrome? ai ai ai...
I'm also curious about the buspar addition--has
anyone added this to their meds to counteract sexual
side effects and had any luck?
Posted by Dr. Bob on July 24, 1999, at 2:16:46
In reply to Re: Yes, Dr. Bob, Please Do answer!, posted by Roo on July 22, 1999, at 6:50:57
> I've read the pharm and tricks--whatever that thing
> is where all the docs discuss what works for their
> patients.I guess you mean:
http://www.dr-bob.org/tips/split/SSRI-sexual-dysfunction.html
> They all differ so much though.
> What has worked best for your patients?There are lots of different approaches because no one works very consistently. Unfortunately. It's a lot of trial and error sometimes.
> SHOULD we give up? I'm like Racer, and I've been
> dilligently searching...but I haven't tried any
> of the fine tuning of meds, tweaking, adding other stuff
> to the meds to counteract that side effect, maybe
> that's the answer.If it's important to you, don't give up, especially if you haven't even tried anything yet.
Bob
Posted by Roo on July 26, 1999, at 7:35:27
In reply to Re: Sexual side effects? Maybe some help, posted by Dr. Bob on July 24, 1999, at 2:16:46
Well it's not exactly correct to say I've never
even tried anything--I've been trying different
things for the past 10 months...I've been trying
different AD's, but I haven't tried a lot of
_tweaking_ with the AD's. And even that's not
entirely true--I've tried cyphrodetamine (I know
I'm not spelling that right, but it's the drug
that supposed to have the antihistamine effect).
I've also tried L-arginine, and inadvertently tried
augmenting prozac with wellbutrin while weaning
off prozac to switch to wellbutrin. Tried Ginko.
I guess I was just wondering if you'd seen any
trend in your practice. It seems from my layman's
research
(reading posts on this issue a couple of hours a
day) that there's a group of people that do great
on wellbutrin and serzone type drugs, and then
another group who do awful on those drugs, and
much better on the SSRI's (I'm in that camp unfortunately)
and I was just wondering if maybe pharmacologists
or psychiatrists have noticed that certain sexual
antidotes tend to be more successful with the
people who do well on SSRI's. Like maybe we have
similar brain chemistry or something, so maybe
the cure for the sexual dysfunction would be
similar too. Obviously, I'm not at all medically or
clinically knowledgeable, heck I don't know.
Sounds like all I can do is just randomly try
different stuff and hope something will eventually
work.
And try not to go nuts in the meantime.I hope I'm not annoying everybody with harping on
this subject.
Posted by Elizabeth on July 26, 1999, at 8:47:08
In reply to Re: Sexual side effects? Maybe some help, posted by Roo on July 26, 1999, at 7:35:27
>I've tried cyphrodetamine (I know
>I'm not spelling that right, but it's the drug
>that supposed to have the antihistamine effect).Cyproheptadine, or "Periactin (TM)" for short! :-) That's pretty sedating, isn't it? I've never heard of anyone who was able to stay awake to appreciate the effects!
>I've also tried L-arginine
This is one I keep hearing about...does anyone know why it's supposed to work?
>and inadvertently tried
>augmenting prozac with wellbutrin while weaning
>off prozac to switch to wellbutrin.Wow, that's one I've heard has really worked for people (I even have evidence, though admittedly for a very small n (2) :-). It didn't help at all?
>Tried Ginko.
Haven't heard of anyone having much luck with this one.
>It seems from my layman's research
>(reading posts on this issue a couple of hours a
>day) that there's a group of people that do great
>on wellbutrin and serzone type drugs, and then
>another group who do awful on those drugs, and
>much better on the SSRI's (I'm in that camp unfortunately)That's interesting, I hadn't noticed that trend. I think Serzone and Wellbutrin are very much "hit or miss" types of things, though.
>and I was just wondering if maybe pharmacologists
>or psychiatrists have noticed that certain sexual
>antidotes tend to be more successful with the
>people who do well on SSRI's. Like maybe we have
>similar brain chemistry or something, so maybe
>the cure for the sexual dysfunction would be
>similar too.No, I think it's just a side effect, not so much a function of individual brain chemistry. It seems like almost everybody who takes an SSRI gets it to some extent. :-(
>Obviously, I'm not at all medically or
>clinically knowledgeable, heck I don't know.Eh, it's not your job to be; you've got other things to worry about I'm sure!
>Sounds like all I can do is just randomly try
>different stuff and hope something will
>eventually work.Yup. Sound familiar?
> And try not to go nuts in the meantime.
Oh yeah, that too. :-)
> I hope I'm not annoying everybody with harping on
> this subject.I think it's of interest to many people!
I did ask my pdoc about this, and he brought in a list of things, which I don't have because we both forgot to xerox it as we'd planned.
Posted by Roo on July 26, 1999, at 9:56:34
In reply to Re: Sexual side effects? Maybe some help, posted by Elizabeth on July 26, 1999, at 8:47:08
ct).
>
> Cyproheptadine, or "Periactin (TM)" for short! :-) That's pretty sedating, isn't it? I've never heard of anyone who was able to stay awake to appreciate the effects!It's the one that's worked best--but still not much of a solution,
b/c spontaneity is pretty key for me. Also I'm much
more of a morning/afternoon person, sex-wise. Nightime is my
least favorite time. These might seem like petty or
picky complaints, but I want to find something that seems to go
well with my overall nature, spontaneous morning person.
> This is one I keep hearing about...does anyone know why it's supposed to work?I really don't know...it seemed to worsen the problem for me.
> Wow, that's one I've heard has really worked for people (I even have evidence, though admittedly for a very small n (2) :-). It didn't help at all?Well, maybe I just didn't do it right. The purpose at the time was to try Wellbutrin as a new AD. I was on prozac, so I was tapering on prozac while adding the wellbutrin, then just wellbutrin. I still got the sexual side effects from the prozac
after a month and a half off of it. In other words, I didn't lose the effect until it was totally and completely out of my system, regardless of the wellbutrin.
> Haven't heard of anyone having much luck with this one.Yeah, which is confusing b/c you see all these studies where it supposedly completely
reversed sexual side effects for people on SSRI's in 80% of the cases...
It took a month though 120 mg's 2 times a day. I probably have never
experimented with it consistently enough to have given it a fair trial.>
> That's interesting, I hadn't noticed that trend. I think Serzone and Wellbutrin are very much "hit or miss" types of things, though.I swear wellbutrin and serzone made my depression worse.
I felt really anxious and irritable on them both.
Again, maybe I should have given them more time, but I was
just completely miserable on them and couldn't stand much
more than a month.
>
>
> Eh, it's not your job to be; you've got other things to worry about I'm sure!Yeah, it seems to be all I'm worrying about, which
I'm sure is just making my little problem worse :-)
I've kind of had to make it my job b/c it seems like
i know more than the general practicioners I've been
seeing. I see a pharmacologist next monday, and I'm
really looking forward to dealing with a specialist in
these issues. I feel hopeful, overall.
> Yup. Sound familiar?Has anything worked for you?
>
>
> I think it's of interest to many people!Good, good :-) I just feel like such a whiner...
>
> I did ask my pdoc about this, and he brought in a list of things, which I don't have because we both forgot to xerox it as we'd planned.Well if you ever get a chance, share the knowledge :-)
Thanks for your response :-)
Ruth
Posted by Czx on July 26, 1999, at 14:18:50
In reply to Re: Sexual side effects? Maybe some help, posted by Roo on July 26, 1999, at 9:56:34
Re l-arginine: I've heard it's a precursor to NO, which leads to erections in men; maybe more genital blood flow for women, too. Anybody else?
Posted by Elizabeth on July 26, 1999, at 16:24:52
In reply to Re: Sexual side effects? Maybe some help, posted by Roo on July 26, 1999, at 9:56:34
> > Cyproheptadine, or "Periactin (TM)" for short! :-) That's pretty sedating, isn't it? I've never heard of anyone who was able to stay awake to appreciate the effects!
>
> It's the one that's worked best--but still not much of a solution,
> b/c spontaneity is pretty key for me. Also I'm much
> more of a morning/afternoon person, sex-wise. Nightime is my
> least favorite time. These might seem like petty or
> picky complaints, but I want to find something that seems to go
> well with my overall nature, spontaneous morning person.I understand - if you're trying to make sex better, you don't want to have side effects (wrong time of day for you, lack of spontaneity) that will make it worse!
> Well, maybe I just didn't do it right. The purpose at the time was to try Wellbutrin as a new AD. I was on prozac, so I was tapering on prozac while adding the wellbutrin, then just wellbutrin. I still got the sexual side effects from the prozac
> after a month and a half off of it. In other words, I didn't lose the effect until it was totally and completely out of my system, regardless of the wellbutrin.I guess it just wasn't the right solution for you. Maybe you metabolize it differently than most people do? (Always my favorite rationalization whenever anything odd and unexplained happens!)
> > Haven't heard of anyone having much luck with this one.
>
> Yeah, which is confusing b/c you see all these studies where it supposedly completely
> reversed sexual side effects for people on SSRI's in 80% of the cases...
> It took a month though 120 mg's 2 times a day. I probably have never
> experimented with it consistently enough to have given it a fair trial.Yeah, it'd be nice to have something you could just take when you needed it.
> I swear wellbutrin and serzone made my depression worse.
> I felt really anxious and irritable on them both.
> Again, maybe I should have given them more time, but I was
> just completely miserable on them and couldn't stand much
> more than a month.Well, I tried them both, and while Serzone didn't give me this problem (feeling even worse than I already did), Wellbutrin did. I gave it a long enough trial to know that the side effects weren't going to go away.
> I've kind of had to make it my job b/c it seems like
> i know more than the general practicioners I've been
> seeing. I see a pharmacologist next monday, and I'm
> really looking forward to dealing with a specialist in
> these issues. I feel hopeful, overall.Let us know if you learn anything interesting!
> > Yup. Sound familiar?
>
> Has anything worked for you?I meant that the "try things randomly until you find what works" thing should sound familiar because that's how you find the antidepressant that's right for you in the first place.
> > I think it's of interest to many people!
>
> Good, good :-) I just feel like such a whiner...It's a subject that could make anyone whine!
> > I did ask my pdoc about this, and he brought in a list of things, which I don't have because we both forgot to xerox it as we'd planned.
>
> Well if you ever get a chance, share the knowledge :-)I will.
Posted by Roo on July 27, 1999, at 7:46:36
In reply to Re: Sexual side effects? Maybe some help, posted by Elizabeth on July 26, 1999, at 16:24:52
Thanks again, Elizabeth, for writing :-)
It helps just to talk about it!
Posted by Elizabeth on July 29, 1999, at 23:23:27
In reply to Re: Thanks Elizabeth, posted by Roo on July 27, 1999, at 7:46:36
Okay, this is a list of herbs and spices or whatever that some people think might help with this problem (which I believe sooner or later will affect at least one member of every couple in the country), and what little I know about them:
(NO = nitric oxide)
ginkgo: incrases blood flow. several studies on impotence, 1 on reversing SRI-related sexual dysfunction specifically. does not help with libido. dose: 120mg bid. not as effective as Viagra. may take a couple weeks to work.
panax ginseng: traditional use, 1 report of hypersexual behavior, 1 controlled study for impotence. stimulant, found to release NO, increase testosterone in animals.
(caution with MAOIs)yohimbine: studies support use for impotence. 40% improvement. side effects: nausea, headache, high BP, tachycardia, anxiety. start at 1/4 of a (4mg, I believe) pill.
(do not use with MAOIs)deer antler: anecdotal only.
marapuama or muira puama: traditionally used as aphrodisiac. 1 controlled study; improves libido and "potency." dosage: 1500mg/day. brand name "Olympia." may take a couple weeks to work.
maca: another traditional aphrodisiac. in rats, seems to cause increased testosterone among other things. don't use if you have: fibroids, endometriosis, prostate cancer.
saw palmetto/pygeum: increases sexual behavior, improves prostatic hypertrophy (for whatever that's worth).
l-arginine: increases NO synthesis (like Viagra).
(not an herb, but I thought I'd mention it anyway).(My shrink graciously provided me with a copy of a list of this stuff, complete with illegible notes he had scrawled.)
Posted by Roo on July 30, 1999, at 6:53:53
In reply to "herbal remedies" that allegedly help, posted by Elizabeth on July 29, 1999, at 23:23:27
Elizabeth,
I've been using Ginko this past week, and am going
to try and give it a fair trial (try and be
disciplined about remembering to take it, and give
it a month at least)...it's a cool herb anyway,
and I really notice it helps my concentration.
But my question is--I'm using the liquid extract
rather than the capsules...so it's hard to know
my dosage (it dosen't say what the equivalent is
in mg's)...does anyone out there have a guess
on what the liquid extract equivalent is in mg's?
I take about 2 full droppers a day...I'm also going to try taking prozac 3 times a week
(rather than 20 mg's every day)
and see if that helps...I had a dream last night that zoloft was the answer.
Maybe my subconscious has the answer!Woo-hoo! It's friday and I'm so glad :-)
Have a good weekend, everybody :-)
Posted by saintjames on July 30, 1999, at 8:47:44
In reply to "herbal remedies" that allegedly help, posted by Elizabeth on July 29, 1999, at 23:23:27
> Okay, this is a list of herbs and spices or whatever that some people think might help with this problem (which I believe sooner or later will affect at least one member of every couple in the country), and what little I know about them:
>
James here...Try my site: Medical info on Herbs
http://www.la-tierra.com/stjames/411onherbs.htmA meta study of herb info.
james
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.