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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 theo on August 27, 2005, at 11:19:17
Okay, I'm confused. I thought Wellbutrin was supposed to not cause sexual side effects and that people even take it to offset SSRI sexual side effects.
I've been on Wellbutrin XL 150mg for 8 days now, by itself, no other meds. Before I started it, my girlfriend could touch me and I would have an erection. Last night I couldn't get an erection after being on it for 8 days!!! This is worse for me because the desire is there, but I can't get an erection. At least with SSRI's, there was simply no drive, so if I couldn't get an erection, I really didn't care.
Looking back to my recreational days, this situation almost reminds me of using cocaine and wanting to have sex, but having complete shrinkage.
Any input about sexual problems with Wellbutrin XL would be appreciated.
Posted by lakesguy78 on August 27, 2005, at 13:11:07
In reply to I Having Sexual Side Effects on Wellbutrin XL!!!!!, posted by theo on August 27, 2005, at 11:19:17
My doc recently put me on 150mg and said that this will help with sexual side effects. Even the manufacture's website, as well as other "real ones" say it as well.
However, I have the same problem currently but am on one other that I think is causing the problem.
So that is all I have to say
Posted by SLS on August 27, 2005, at 14:15:57
In reply to I Having Sexual Side Effects on Wellbutrin XL!!!!!, posted by theo on August 27, 2005, at 11:19:17
> I've been on Wellbutrin XL 150mg for 8 days now, by itself, no other meds. Before I started it, my girlfriend could touch me and I would have an erection. Last night I couldn't get an erection after being on it for 8 days!!! This is worse for me because the desire is there, but I can't get an erection. At least with SSRI's, there was simply no drive, so if I couldn't get an erection, I really didn't care.
We both know that 8 days is extremely early in treatment with such a potent drug to evaluate its long-term effects. This side effect may be transient, but might take a few weeks to dissipate.
I would be inclined to be patient and not jump to any conclusions.
- Scott
Posted by Maximus on August 27, 2005, at 14:30:22
In reply to I Having Sexual Side Effects on Wellbutrin XL!!!!!, posted by theo on August 27, 2005, at 11:19:17
Allo Theo,
It happened with me too on Wellbutrin SR. XL formula isn't available in Canada. I would add that recent studies suggest that Wellbutrin is no more effective than placebo to offset SSRI sexual side effects. I tend to believe it.
I was wondering which meds were "clean" in the sex department. But they are none. Certains are better and certains are worse. Hell, even clonazepam blunts the physical sensation.
Good Luck!
Posted by theo on August 27, 2005, at 14:41:32
In reply to Re: I Having Sexual Side Effects on Wellbutrin XL!!!!!, posted by lakesguy78 on August 27, 2005, at 13:11:07
> My doc recently put me on 150mg and said that this will help with sexual side effects. Even the manufacture's website, as well as other "real ones" say it as well.
>
> However, I have the same problem currently but am on one other that I think is causing the problem.
I think you will be surprised if you read the full prescribing info on the manufactuers web site http://us.gsk.com/products/assets/us_wellbutrinXL.pdf page 19 below the chart. I reads "AT LEAST 1% of males experienced flatulance!! I've never noticed this but it's right there on their prescribing information. It doesn't cause any libido problems, which is great for females, but flatulance for men is worse than low libido, at least on SSRI's I can get an erection!
Posted by theo on August 27, 2005, at 15:05:26
In reply to Re: I Having Sexual Side Effects on Wellbutrin XL!!!!!, posted by SLS on August 27, 2005, at 14:15:57
> We both know that 8 days is extremely early in treatment with such a potent drug to evaluate its long-term effects. This side effect may be transient, but might take a few weeks to dissipate.
>
> I would be inclined to be patient and not jump to any conclusions.
>
>
> - ScottI fully agree 8 days isn't a fair evalution and hopefully it will dissapate, but I was shocked because libido is fine but I am experiencing complete flatulence, which has never happened in my life expcept back in my college days with cocaine. I would want to have sex but couldn't! This also happens with other stims like diet pills, but NOT with Concerta, which actually helps. How can some stims cause flatulence and some not? On page 19 of the PI under the last chart, in fine print says "AT LEAST 1% males experience flatulence."
Also, you mentioned Wellbutrin being "potent." Isn't it considered a weak inhibitor? I was also surprised to see in the PI that it works on norepinephrine, SEROTONIN and dopamine. I didn't think Wellbutrin effected serotonin at all? What is a fair evaluation period for Wellbutrin XL? Aren't you supposed to know fairly quick with this med versus SSRI's?
Confused,
Ted
Posted by SLS on August 27, 2005, at 15:47:50
In reply to Re: I Having Sexual Side Effects on Wellbutrin XL!!!!! » SLS, posted by theo on August 27, 2005, at 15:05:26
They still don't know how Wellbutrin works. However, it is a potent antidepressant that demonstrates efficacy equivalent to the others. I used the word "potent" not to characterize its ability to alter synaptic monoamine concentrations, but rather to reinforce the concept that whatever these drugs do in the CNS, their pharmacological effects are powerful.
I would not want to characterize Wellbutrin as a "fast-acting" antidepressant. It still takes a minimium of two weeks for the therapeutic biological responses to its pharmacology to *begin* to appear. You might not feel perceptably better for a month or so. You might not reach remission for 4-6 months. Prozac takes a little longer to begin to work simply because it takes so long for the drug to build up in the body and reach steady state.
- Scott
Posted by lakesguy78 on August 27, 2005, at 18:12:08
In reply to Re: I Having Sexual Side Effects on Wellbutrin XL!!!!! » lakesguy78, posted by theo on August 27, 2005, at 14:41:32
What are you talking about?
Here is the definition of FLATULENCE
The presence of excessive gas in the digestive tract.I dont understand why you cited this referring to gas when the discussion is libido, unless I am missing something???
Please advise,
Posted by gromit on August 27, 2005, at 19:19:35
In reply to Re: I Having Sexual Side Effects on Wellbutrin XL!!!!! » lakesguy78, posted by theo on August 27, 2005, at 14:41:32
> I think you will be surprised if you read the full prescribing info on the manufactuers web site http://us.gsk.com/products/assets/us_wellbutrinXL.pdf page 19 below the chart. I reads "AT LEAST 1% of males experienced flatulance!! I've never noticed this but it's right there on their prescribing information. It doesn't cause any libido problems, which is great for females, but flatulance for men is worse than low libido, at least on SSRI's I can get an erection!
I'm confused, isn't flatulence gas? Even though it's more embarassing I think it's easier to treat impotence. I can say for sure that levitra worked well for me, it only lasts a few hours so you have to plan ahead. "The weekender" cialis supposedly works for several days so you get more bang for your buck but I've never tried it.
Nothing I tried helped with the anorgasmia from SSRI's.
Rick
Posted by yxibow on August 28, 2005, at 2:12:59
In reply to Re: I Having Sexual Side Effects on Wellbutrin XL!, posted by gromit on August 27, 2005, at 19:19:35
To me this is a curious paradoxical side effect reaction since Wellbutrin SR gave me a ridiculous sex drive not too distant in the future after I started it and I've heard numerous reports of this. However understandably everyone is different and you could be too. I would try it beyond 8 days though if it is indicated and good for your depression.
I believe I was on definately 300mg and I think 400. Insomnia was the worst problem since I already am an insomniac. Eventually it wasnt the right drug for someone with already obsessive thoughts (at bedtime, etc). I think I was only on Klonopin also at the same time, I forget.
Posted by theo on August 28, 2005, at 11:37:30
In reply to Re: I Having Sexual Side Effects on Wellbutrin XL!!!!!, posted by lakesguy78 on August 27, 2005, at 18:12:08
Posted by Chairman_MAO on August 30, 2005, at 13:57:51
In reply to I Having Sexual Side Effects on Wellbutrin XL!!!!!, posted by theo on August 27, 2005, at 11:19:17
I have this problem on any adrenergic drug. I feel that it is under-reported in the literature, given that NE uptake inhibition--which bupropion and/or one of its metabolites does--stimulates alpha-adrenoreceptors in the male genitalia causing the shrinkage. To rememdy this you need a PDE5 inhibitor (I recommend tadalafil) or a drug which antagonizes the alpha-adrenoreceptors. You can try yohimbine, but that is probably too stimulating for someone already on Wellbutrin. A great drug to try is tamsulosin (Flomax), which is selective for the receptors in the genitals.
You could also add trazodone or nefazodone, both of which have an alpha-1 blocking effect and get a better AD response at the same time.
Best of luck! Any questions, babblemail me, as I have done extensive research in this area because it affected me.
Posted by Chairman_MAO on August 30, 2005, at 13:58:34
In reply to Re: I Having Sexual Side Effects on Wellbutrin XL!!!!!, posted by SLS on August 27, 2005, at 14:15:57
Scott--
I feel this is an underreported problem with NE uptake inhibitors in general. See my post.
--cm
Posted by theo on August 30, 2005, at 22:54:44
In reply to Re: I Having Sexual Side Effects on Wellbutrin XL! » theo, posted by Chairman_MAO on August 30, 2005, at 13:57:51
> I have this problem on any adrenergic drug. I feel that it is under-reported in the literature, given that NE uptake inhibition--which bupropion and/or one of its metabolites does--stimulates alpha-adrenoreceptors in the male genitalia causing the shrinkage.
What's weird is I tried Concerta before and just knew it was going to cause shrinkage, but it DID NOT. Why is this that some stims do and some stims don't cause shrinkage? I tried Provigil for a short time and it caused major shrinkage.
Posted by SLS on August 31, 2005, at 7:04:28
In reply to Re: I Having Sexual Side Effects on Wellbutrin XL! » SLS, posted by Chairman_MAO on August 30, 2005, at 13:58:34
Hi CM.
> I feel this is an underreported problem with NE uptake inhibitors in general. See my post.
Hmm.
I'll try to be more aware of this in the future.
Thanks.
I wonder what percentage of people taking Wellbutrin or TCAs are affected this way? I don't recall ever having this problem with these drugs. Interestingly, I did have a "shrinkage" problem with Parnate, but this resolved on its own within the first two weeks.
- Scott
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