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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 15 of 15. This is the beginning of the thread.
Posted by jb on March 28, 2001, at 15:41:39
Has anyone had anything close to 100% effectiveness (I realize that's just a goal)for treatment of their social phobia. I seem to read more and more about various "cocktails," which are augmentation or combinations.
I'd really, really like to stay away from Klonopin, because of its cognitive and memory effects. Also, I've had little effectiveness from most other AD's, including the SSRI's and their cousins. Nardil was effective, but had intolerable side effects.
I've seen a few postings about people touting Wellbutrin as an almost 100% cure or Adrafinil as a 100% cure. Anyone with any experience?
Thanks.
JB
Posted by SalArmy4me on March 29, 2001, at 4:24:46
In reply to Treatment for Social Phobia w/o MAOI ,benzo, SSRI?, posted by jb on March 28, 2001, at 15:41:39
I was thinking of desipramine as an alternative to SSRIs with the least side-effects. But what's wrong with venlafaxine or mirtazapine?
> Has anyone had anything close to 100% effectiveness (I realize that's just a goal)for treatment of their social phobia. I seem to read more and more about various "cocktails," which are augmentation or combinations.
>
> I'd really, really like to stay away from Klonopin, because of its cognitive and memory effects. Also, I've had little effectiveness from most other AD's, including the SSRI's and their cousins. Nardil was effective, but had intolerable side effects.
>
> I've seen a few postings about people touting Wellbutrin as an almost 100% cure or Adrafinil as a 100% cure. Anyone with any experience?
>
> Thanks.
>
> JB
Posted by jb on March 29, 2001, at 10:26:02
In reply to Re: Treatment for Social Phobia w/o MAOI ,benzo, SSRI?, posted by SalArmy4me on March 29, 2001, at 4:24:46
Hi, Sal. Thanks for your thoughtful response. I think I should take another look at Mirtazapine, at a minimum. Regarding Venlafaxine, I'm wary of its high level of sexual dysfunction (see PubMed article, below). With Nardil, I already have sexual dysfunction, but I also get a high level of relief from SP. Desipramine, although an agent with predominant nor-adrenergic activity, I understand to be less efficacious than Fluvoxamine, which is less efficacious than Nardil.
So, I guess I'm trying to get around the sexual dysfunction of drugs with prominent 5HT2a activity (mostly SSRI's, venlafaxine), and the prominent cognitive/memory impairment of benzo's. Sometimes, I feel like a dog chasing its tail.
I did see a post where someone was claiming Adrafinil as a 100% solution for Social Phobia, but I guess I'd like to see others making similar claims. Separately, I know more people are trying various "cocktails" of augmenting and combining agents to address social phobia, such as using Modafinil to offset the decreased alertness of Klonopin. However, research on PubMed has shown Modafinil does not reverse the short-term amnestic effect of Klonopin. The conclusion is the amnestic effect is not related to the decrease in vigilance or psychomotor impairment of benzo's.
Oh, well, guess I'll continue to chase my tail.
Thanks.
JB
____________________
Incidence of sexual dysfunction associated with antidepressant agents: a prospective multicenter study of 1022 outpatients. Spanish Working Group for the Study of Psychotropic-Related Sexual Dysfunction.Montejo AL, Llorca G, Izquierdo JA, Rico-Villademoros F
University Hospital of Salamanca, Psychiatric Teaching Area, University of Salamanca, School of Medicine, Spain. angelluis.montejo@globalmed.es
BACKGROUND: Antidepressants, especially selective serotonin reuptake inhibitors (SSRIs), venlafaxine, and clomipramine, are frequently associated with sexual dysfunction. Other antidepressants (nefazodone, mirtazapine, bupropion, amineptine, and moclobemide) with different mechanisms of action seem to have fewer sexual side effects. The incidence of sexual dysfunction is underestimated, and the use of a specific questionnaire is needed. METHOD: The authors analyzed the incidence of antidepressant-related sexual dysfunction in a multicenter, prospective, open-label study carried out by the Spanish Working Group for the Study of Psychotropic-Related Sexual Dysfunction. The group collected data from April 1995 to February 2000 on patients with previously normal sexual function who were being treated with antidepressants alone or antidepressants plus benzodiazepines. One thousand twenty-two outpatients (610 women, 412 men; mean age = 39.8 +/- 11.3 years) were interviewed using the Psychotropic-Related Sexual Dysfunction Questionnaire, which includes questions about libido, orgasm, ejaculation, erectile function, and general sexual satisfaction. RESULTS: The overall incidence of sexual dysfunction was 59.1% (604/1022) when all antidepressants were considered as a whole. There were relevant differences when the incidence of any type of sexual dysfunction was compared among different drugs: fluoxetine, 57.7% (161/279); sertraline, 62.9% (100/159); fluvoxamine, 62.3% (48/77); paroxetine, 70.7% (147/208); citalopram, 72.7% (48/66); venlafaxine, 67.3% (37/55); mirtazapine, 24.4% (12/49); nefazodone, 8% (4/50); amineptine, 6.9% (2/29); and moclobemide, 3.9% (1/26). Men had a higher frequency of sexual dysfunction (62.4%) than women (56.9%), although women had higher severity. About 40% of patients showed low tolerance of their sexual dysfunction. CONCLUSION: The incidence of sexual dysfunction with SSRIs and venlafaxine is high, ranging from 58% to 73%, as compared with serotonin-2 (5-HT2) blockers (nefazodone and mirtazapine), moclobemide, and amineptine.
Publication Types:
Clinical trial
Multicenter studyPMID: 11229449
Posted by SLS on March 29, 2001, at 11:28:18
In reply to Re: Treatment for Social Phobia w/o MAOI ,benzo, SSRI?, posted by SalArmy4me on March 29, 2001, at 4:24:46
> I was thinking of desipramine as an alternative to SSRIs with the least side-effects. But what's wrong with venlafaxine or mirtazapine?
You may want to try Neurontin in the meantime. It might work very quickly to reduce your anxiety a bit while you try some of the drugs already mentioned.
You may need to investigate Parnate, another MAO-inhibitor. It tends to have less side effects than Nardil and is sometimes just as effective.
- Scott
Posted by jb on March 29, 2001, at 17:47:40
In reply to Re: Treatment for Social Phobia w/o MAOI ,benzo, SSRI?, posted by SLS on March 29, 2001, at 11:28:18
Hi, Scott. Thanks for your suggestions. Unfortunately, I've tried both Parnate and Neurontin, with little effect from either. Neurontin, I tried at the higher suggested dosage, which I believe I was up to 3600 mg/day. Perceived little benefit after continued 12 weeks of treatment. A new drug. which you may have heard of, Pregabalin, is very similar to Neurontin, but, I understand, much stronger. It's also been developed by Pfizer,who has seemingly abandoned its quest to have Neurontin approved for SP, and, instead, is hoping Pregabalin will do the trick. Pfizer has been taking Pregabalin through very large placebo-controlled trials. I don't know if the research has been completed, and I have heard nothing about efficacy over Neurontin. My psychdoc told me Neurontin clears the body too fast to provide a significant therapeutic effect for social phobia, given its low potency. This is why, I believe, there were not follow-up studies to the Neurontin "social phobia" trials conducted about two years ago. So, Pfizer developed pregabalin as essentially a stronger version.
Parnate, an irreversible non-hydrazine non-selective MAOI, had very little effect, for me. There is one study on PubMed showing Parnate's efficacy for social phobia, but I've seen no other controlled research to corroborate this. As a non-hydrazine, Parnate does not increase whole brain GABA levels. Phenelzine, a hydrazine MAOI, does increase whole brain GABA levels, and this is thought to be at least partially responsible for its very high level of efficacy. Also, as far as Parnate, I had significant dry mouth (always had to carry a diet coke or glass of water wherever I went), and, worse, a noticeable slowing of my speaking pattern. Because of its relatively low efficacy, I had to increase my intake of Klonopin to combat social phobia. But Klonopin, perhaps even more than other high-potency benzo's causes substantial cognitive impairment, decreased psychomotor performance and, importantly, impaired short-term memory. Dopaminergic acting drugs (e.g., Deprenyl and Bupropion)and stimulants (amphetamine based or not), can counteract the lowered vigilance induced by benzo's, but do not conteract the impaired short-term memory. The hypothesis that short-term memory loss is related to sedation or diminished vigilance has been shown to be incorrect, according to many PubMed research articles. By the way, I've taken Parnate for periods of over two years at a time, and these side effects stay with me, unabated, until I drop it and it washes out.
I've also tried selegiline (deprenyl) at 60 mg/day, at which it non-selectively inhibits both MAO-A and MAO-B. Yet, no efficacy even approaching Nardil, though it was great for sexual functioning. Again, I think the GABA elevating properties of Nardil contribute to Phenelzine's efficacy. By the way, there is some thought that SSRIs and other serotonin acting agents show some efficacy for social phobia(generally in the 40-50% range for CGI scores of 1 [very much improved] or 2 [much improved], versus about 20% for placebo), not directly due to serotonin increase or agonism, but, indirectly, by raising GABA levels, through allopregnanolone. It's the GABAergic propertis of Pregabalin which seem to make it appear promising.
Oh, well, sometime,I should probably post a short novel about my social phobia (generalized) experiences, and the various meds and med combinations I've tried. Outside of Pregabalin (perhaps still a year or two away), my hope is directed primarily at combination (two or more of same class of drugs) and augmentation (separate classes of drugs added together) treatment. However, I'm most concerned about staying away from the benzo's, due to their cognitive effect. Yet, I need them if I can't achieve a level of efficacy greater than Nardil.
So, when I came across a post indicating Adrafinil as a 100% solution, my interest was immeasurably peaked, to say the least!!! Unfortunatley, I haven't seen anything from any other posts or anything on PubMed or just on the Internet to corroborate this. Argh!
Maybe a combinatin of Serzone and Wellbutrin? I'm sure this is contraindicated, but some pharmacologists feel they can manage some of these drug interactions. Maybe with these drugs, the 5HT1a agonist Buspar might then become effective?
The interactions among various neurotransmitters is so immensely complex, it's easy to despair in not getting to what pharmacologists refer to as "high end state functioning." With social phobia, a 60-70% solution still seems fairly unacceptable.
Sorry to run on. I guess I'm really just continuing to try to think things through in my head, as well as dream of what life would be like with a 90-100% solution.
Best regards, and thanks again for taking the time to share your thoughts.
John
> You may need to investigate Parnate, another MAO-inhibitor. It tends to have less side effects than Nardil and is sometimes just as effective.
>
>
> - Scott
Posted by Elizabeth on March 30, 2001, at 4:06:49
In reply to Treatment for Social Phobia w/o MAOI ,benzo, SSRI?, posted by jb on March 28, 2001, at 15:41:39
> Has anyone had anything close to 100% effectiveness (I realize that's just a goal)for treatment of their social phobia. I seem to read more and more about various "cocktails," which are augmentation or combinations.
Hi, John. Have you ever tried buprenorphine or another mu opioid agonist? My experience has been that they pretty much eradicate the crippling social and "performance" anxiety that I've suffered since childhood.
Posted by Elizabeth on March 30, 2001, at 4:08:53
In reply to Treatment for Social Phobia w/o MAOI ,benzo, SSRI?, posted by jb on March 28, 2001, at 15:41:39
BTW, tricyclics are not a good choice for social phobia, with the possible exception of clomipramine (which has all the standard TCA side effects). Desipramine would be a particularly poor choice because of its near-selectivity for the NE transporter.
Posted by Dubya on March 30, 2001, at 16:13:32
In reply to Re: Treatment for Social Phobia w/o MAOI ,benzo, SSRI?, posted by Elizabeth on March 30, 2001, at 4:08:53
Clomipramine for social anxiety? please tell me it is so?
> BTW, tricyclics are not a good choice for social phobia, with the possible exception of clomipramine (which has all the standard TCA side effects). Desipramine would be a particularly poor choice because of its near-selectivity for the NE transporter.
Posted by JahL on March 30, 2001, at 18:15:57
In reply to Social Phobia treatments -- something different?, posted by Elizabeth on March 30, 2001, at 4:06:49
> > Has anyone had anything close to 100% effectiveness (I realize that's just a goal)for treatment of their social phobia. I seem to read more and more about various "cocktails," which are augmentation or combinations.
>
> Hi, John. Have you ever tried buprenorphine or another mu opioid agonist? My experience has been that they pretty much eradicate the crippling social and "performance" anxiety that I've suffered since childhood.Hi Elizabeth.
I've read a few posts on this board stating success with opioid agonists for depression & s. phobia. I have both (v. TR), but also have intense concentration difficulties (not unlike ADD) & was wondering if in yr experience, opioids benefit cognition? Do they 'clear' yr head?
Thanks,
J.
Posted by jb on March 30, 2001, at 21:14:14
In reply to Social Phobia treatments -- something different?, posted by Elizabeth on March 30, 2001, at 4:06:49
>
> Hi, John. Have you ever tried buprenorphine or another mu opioid agonist? My experience has been that they pretty much eradicate the crippling social and "performance" anxiety that I've suffered since childhood.Hi, Elizabeth. I've never have even heard of buprenorphine or mu opioid agonists. This is very, very interesting. I'll look into to it and see if I can give it a try.
Thank you!
John
Posted by jb on March 30, 2001, at 21:35:49
In reply to Re: Social Phobia treatments Elizabeth?, posted by jb on March 30, 2001, at 21:14:14
Hi, again, Elizabeth. On second thought, after perusing a few articles, opioid agonists are a little outside of my comfort range. I relized they helped you, and I'm glad you feel so much better on them. However, I've probably trained my mind to focus on those meds targeting serotonin, gaba, dopamine, or norepinephrine. Fortunately, I've been able to remove benzodiazepines from my meds consideration set,give what is, for me (not saying anthing about efficacy and value to others), is a significantly stupefying effect.
Thanks. Johnb
Posted by AndrewB on March 31, 2001, at 13:06:23
In reply to Treatment for Social Phobia w/o MAOI ,benzo, SSRI?, posted by jb on March 28, 2001, at 15:41:39
There seems to be different 'flavors' of social anxiety and these different flavors in general may respond to different groups of meds or med combos. Yes some respond to SSRIs, some to Benzes, some to alpha andrenergic agonists. Some people have exotic subtypes that respond yet other med.s (i.e. tianeptine, adrafinil, buprenophine, methadone). Many people respond to MAO-Is like Nardil, but it is my belief that there are substitutes for a drug like Nardil, and Nardil is to be avoided if possible due to the side effects.
I have completely treated my flavor of social anxiety (without any side effects) and others using variations on this med combo I use also have been able to free themselves of social anxiety.
My social anxiety is centered on low self esteem and the idea that the world is full of eyes that if they discovered who I really am would be disgusted and come down hard on me. My head is filled with self critical thoughts. Often I just hide out in my apartment or wherever and avoid all contact. I envision this type of social anxiety equivalent to being on the bottom of the social pecking order. If you observed a group of baboons, you might see the one at the bottom in order of dominance exhibiting similar behavior.
As I said, I have found complete relief. The med.s I have used are dopamine centered. Indeed research indicates that people with social anxiety and detachment have hypofunction at certain D2 dopamine sites.
My drug combination is low dose amisulpride, low dose selegiline, adderall, and memantine.
When amisulpride works it makes people feel more socially open, less threatened. It is like the world seems friendlier. It also takes away that self critical internal talk. I have an inf. piece on amisulpride that I can email to you (andrewb@seanet.com). Sulpiride, a cousin of amisulpride, has much the same effect. Some studies have been showing sulpiride’s effectiveness for social anxiety. I suspect that Mirapex might help some in a similar way with social anxiety.
For me and others though, they find that amisulpride by itself may not be enough. You feel good but you may still lack motivation and confidence----you lack that feeling that the world and the future is yours to ‘take and make’ and you want to ‘take that tiger by its tail’.
Selegiline taken at 5mgs/day can improve motivation. One study showed it to have a modest effectiveness for social anxiety. I believe, however, as an adjunct it can be very useful. It took 30 days for it to take effect on me. For some its effects are almost immediate, for others it may take 45 days.
I also take adderall, an amphetamine. It gives me confidence and motivation and extra sociableness. Some may find dexedrine or adrafinil will provide motivation. There are options, in other words.
Adderall pooped out in me after about 3 days use and I would have to take a vacation of about 2 days off it to regain its effects. My impression is that many people are like me and find that the confidence and motivation of adderall wears off after a few days.
Enter memantine- it is a NMDA antagonist that I have taken for over a month. It prevents this adderall poop out. The benefit I get from adderall is constant and steady. Eventually I will write a post on memantine, since this is a little known med, and this is a novel use for it.
Anyway, your probably thinking, this is too complicated. But I would like to emphasize that it is worth the effort to pursue one’s ideal med regimen. The effects can be dramatic. My life of dread has been replaced by one that I cherish. As Bob Dylan once said, “the change in weather can be extreme”.
Best wishes,
AndrewB
Posted by Adam on April 2, 2001, at 1:16:57
In reply to Treatment for Social Phobia w/o MAOI ,benzo, SSRI?, posted by jb on March 28, 2001, at 15:41:39
Hi, jb,
You know your stuff, and perhaps you've already tried it...I'm not anti-drug at all, and I know sometimes this route doesn't work, but I have an axiety disorder (OCD-spectrum), and cognative-behavioral therapy helped a great deal.
I have no doubt that these disorders have a biological component. But CBT is especially good for anxiety disorders and phobias, such as social phobia (efficacy is on par with meds in all the studies I've seen, though there are always individual variations, of course), and if you haven't tried it, I highly recommend it as an augmentation to your search for a good drug therapy. It's very hard work, and it can take a very long time, but there is the opportunity in adopting such a regimen to learn a great deal about yourself and other people that you just can't get from medicines. Even if you fail to achieve the desired result, I think you will find what you (should you try it) learned during therapy is extremely useful in making the transition to a state of greater health. The sad thing about these illnesses is they have effects that are more subtle than their extant symptoms. Those with pathological anxiety (like I have had, and sometimes still have) can suffer a penalty in the loss, through avoidance, of some of the experiences that facilitate social adaptation. The only way to gain such experiences is to seek them out, ready or not. Social discomforts and embarassments (which I have had in abundance) can be painful, humiliating, demoralizing, and, yes, even depressing. But it gets better, after a while, and, as a result, so do you, if everything works as planned.
Again, don't mean to give you advice you may not need, but I saw no mention of therapy, and, if you are suffering from an anxiety disorder, it's very much worth trying.
> Has anyone had anything close to 100% effectiveness (I realize that's just a goal)for treatment of their social phobia. I seem to read more and more about various "cocktails," which are augmentation or combinations.
>
> I'd really, really like to stay away from Klonopin, because of its cognitive and memory effects. Also, I've had little effectiveness from most other AD's, including the SSRI's and their cousins. Nardil was effective, but had intolerable side effects.
>
> I've seen a few postings about people touting Wellbutrin as an almost 100% cure or Adrafinil as a 100% cure. Anyone with any experience?
>
> Thanks.
>
> JB
Posted by Elizabeth on April 5, 2001, at 7:23:02
In reply to Re: Social Phobia treatments -- something differen » Elizabeth, posted by JahL on March 30, 2001, at 18:15:57
> I've read a few posts on this board stating success with opioid agonists for depression & s. phobia. I have both (v. TR), but also have intense concentration difficulties (not unlike ADD) & was wondering if in yr experience, opioids benefit cognition? Do they 'clear' yr head?
I have trouble concentrating also, and buprenorphine definitely helps with that. However, it is activating for me (at least, at the dose I use), whereas most people find it sedating, so I don't know if you can expect the same effect.
I don't know where you live, but it's difficult to get buprenorphine in the U.S. It's only available in a solution intended for IM or IV injection, so doctors don't like to prescribe it -- they'd rather prescribe a pill. (The solution can also be used intranasally or sublingually, the former being much more reliable and requiring a lower dose.) Also, at least in my part of the country, a lot of pharmacies seem to be unable to get it lately because their wholesalers don't have it. I've had this problem with other meds that need to be special-ordered as well and wonder whether drug manufacturers might not be cutting back because of what's happened to the economy.
Posted by rick_number1001@yahoo.com on August 17, 2001, at 2:10:11
In reply to Re: Treatment for Social Phobia w/o MAOI ,benzo, SSRI?, posted by jb on March 29, 2001, at 10:26:02
Hi, I'm a 34 year old male.
Untreated I'm diagnosed very severe SP.I have found many treatments very helpful since
starting med treatment age 26. Currently I take
60 Nardil + 2.5-2.75 Klonopin + 75-100 Provilgil
(modafinil).I recently heeded the suggestion of a friend and
put up a website, it is at www.socialfear.com.I'd welcome any comments, input.
I think most people can achieve relief of most
symtoms with medication. Habits may not change
as easy, but many will just with meds. Age
makes a difference I think.My generally most recommended meds include:
Nardil
Klonopin
Provigil
ZoloftHowever, there are so many meds that can be used
in comination to produce similar effect.
I think Klonopin is probably the single most
effective purely for symtoms, but it may increase
depression and cause cognitive difficulties in
long run. High dose Nardil may (much like Paxil
and celexa and Zoloft) cause sexual side effects
which need to be treated with another med
to elimate or reduce. Ultimately for moderate
and severe SP I believe polypharmacy often provides
the best results. I don't like taking meds
for it's own sake, but for good effect. I like
CBT which I started about 6 months ago in group
form and now individual.Thanks for all the good info in previous posts!
great site!
> Hi, Sal. Thanks for your thoughtful response. I think I should take another look at Mirtazapine, at a minimum. Regarding Venlafaxine, I'm wary of its high level of sexual dysfunction (see PubMed article, below). With Nardil, I already have sexual dysfunction, but I also get a high level of relief from SP. Desipramine, although an agent with predominant nor-adrenergic activity, I understand to be less efficacious than Fluvoxamine, which is less efficacious than Nardil.
>
> So, I guess I'm trying to get around the sexual dysfunction of drugs with prominent 5HT2a activity (mostly SSRI's, venlafaxine), and the prominent cognitive/memory impairment of benzo's. Sometimes, I feel like a dog chasing its tail.
>
> I did see a post where someone was claiming Adrafinil as a 100% solution for Social Phobia, but I guess I'd like to see others making similar claims. Separately, I know more people are trying various "cocktails" of augmenting and combining agents to address social phobia, such as using Modafinil to offset the decreased alertness of Klonopin. However, research on PubMed has shown Modafinil does not reverse the short-term amnestic effect of Klonopin. The conclusion is the amnestic effect is not related to the decrease in vigilance or psychomotor impairment of benzo's.
>
> Oh, well, guess I'll continue to chase my tail.
>
> Thanks.
>
> JB
>
>
>
>
>
> ____________________
> Incidence of sexual dysfunction associated with antidepressant agents: a prospective multicenter study of 1022 outpatients. Spanish Working Group for the Study of Psychotropic-Related Sexual Dysfunction.
>
> Montejo AL, Llorca G, Izquierdo JA, Rico-Villademoros F
>
> University Hospital of Salamanca, Psychiatric Teaching Area, University of Salamanca, School of Medicine, Spain. angelluis.montejo@globalmed.es
>
> BACKGROUND: Antidepressants, especially selective serotonin reuptake inhibitors (SSRIs), venlafaxine, and clomipramine, are frequently associated with sexual dysfunction. Other antidepressants (nefazodone, mirtazapine, bupropion, amineptine, and moclobemide) with different mechanisms of action seem to have fewer sexual side effects. The incidence of sexual dysfunction is underestimated, and the use of a specific questionnaire is needed. METHOD: The authors analyzed the incidence of antidepressant-related sexual dysfunction in a multicenter, prospective, open-label study carried out by the Spanish Working Group for the Study of Psychotropic-Related Sexual Dysfunction. The group collected data from April 1995 to February 2000 on patients with previously normal sexual function who were being treated with antidepressants alone or antidepressants plus benzodiazepines. One thousand twenty-two outpatients (610 women, 412 men; mean age = 39.8 +/- 11.3 years) were interviewed using the Psychotropic-Related Sexual Dysfunction Questionnaire, which includes questions about libido, orgasm, ejaculation, erectile function, and general sexual satisfaction. RESULTS: The overall incidence of sexual dysfunction was 59.1% (604/1022) when all antidepressants were considered as a whole. There were relevant differences when the incidence of any type of sexual dysfunction was compared among different drugs: fluoxetine, 57.7% (161/279); sertraline, 62.9% (100/159); fluvoxamine, 62.3% (48/77); paroxetine, 70.7% (147/208); citalopram, 72.7% (48/66); venlafaxine, 67.3% (37/55); mirtazapine, 24.4% (12/49); nefazodone, 8% (4/50); amineptine, 6.9% (2/29); and moclobemide, 3.9% (1/26). Men had a higher frequency of sexual dysfunction (62.4%) than women (56.9%), although women had higher severity. About 40% of patients showed low tolerance of their sexual dysfunction. CONCLUSION: The incidence of sexual dysfunction with SSRIs and venlafaxine is high, ranging from 58% to 73%, as compared with serotonin-2 (5-HT2) blockers (nefazodone and mirtazapine), moclobemide, and amineptine.
>
> Publication Types:
> Clinical trial
> Multicenter study
>
> PMID: 11229449
This is the end of the thread.
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