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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 17 of 17. This is the beginning of the thread.
Posted by GuyinGHo on April 19, 2010, at 17:30:28
I've been taking Prozac for a year now and it has really helped decrease my depression. I am dxed with double depression (that's MDD and Dysthymia) since about 18 years ago and have had intermittent responses from Paxil, Effexor, MAOIs and Wellbutrin. In the interval I was diagnosed with HIV (gratefully healthy on meds) and started abusing stimulants which I have also stopped.
I'm doing well but recently started dating again and find that I have very low libido. Is this typical on Wellbutrin and Prozac -- does anyone have any antidotes or suggestions.
Posted by bulldog2 on April 19, 2010, at 18:23:14
In reply to Sexual Side Effects, posted by GuyinGHo on April 19, 2010, at 17:30:28
> I've been taking Prozac for a year now and it has really helped decrease my depression. I am dxed with double depression (that's MDD and Dysthymia) since about 18 years ago and have had intermittent responses from Paxil, Effexor, MAOIs and Wellbutrin. In the interval I was diagnosed with HIV (gratefully healthy on meds) and started abusing stimulants which I have also stopped.
> I'm doing well but recently started dating again and find that I have very low libido. Is this typical on Wellbutrin and Prozac -- does anyone have any antidotes or suggestions.There's a lot to google in our archives but here's a start...buspar, ginko biloba, stimulants such as ritalin,,dopamine agonists etc..
Posted by Deneb on April 20, 2010, at 1:00:17
In reply to Sexual Side Effects, posted by GuyinGHo on April 19, 2010, at 17:30:28
Hello GuyinGHo!
Welcome to Psycho-Babble! Yes, sexual side effects are very common when taking SSRI's like Prozac. Wellbutrin however, is actually used to counter sexual side effects. It is often added to an SSRI or replaces an SSRI to help regain sexual drive and function.
I have not heard of Wellbutrin causing sexual side effects.
Are you currently on both Prozac and Wellbutrin? If so, maybe you can ask your doctor if you could drop the Prozac and just increase the Wellbutrin.
Sorry about the HIV diagnosis. I'm glad you're still healthy.
Deneb
Posted by ed_uk2010 on April 20, 2010, at 13:18:18
In reply to Sexual Side Effects, posted by GuyinGHo on April 19, 2010, at 17:30:28
>I've been taking Prozac for a year now and it has really helped decrease my depression.........I have very low libido.
Reduced sexual function is common on SSRIs such as Prozac. You may benefit from a lower dose with fewer side effects.
Posted by Donoz on April 21, 2010, at 10:47:10
In reply to Re: Sexual Side Effects, posted by bulldog2 on April 19, 2010, at 18:23:14
> > I've been taking Prozac for a year now and it has really helped decrease my depression. I am dxed with double depression (that's MDD and Dysthymia) since about 18 years ago and have had intermittent responses from Paxil, Effexor, MAOIs and Wellbutrin. In the interval I was diagnosed with HIV (gratefully healthy on meds) and started abusing stimulants which I have also stopped.
> > I'm doing well but recently started dating again and find that I have very low libido. Is this typical on Wellbutrin and Prozac -- does anyone have any antidotes or suggestions.
>
> There's a lot to google in our archives but here's a start...buspar, ginko biloba, stimulants such as ritalin,,dopamine agonists etc..I have had sexual side effects with Effexor XR and am now slowly trying to reduce my dosage. My Dr. is trying Buspar as a substitute because he claims that it has less sexual side effects. I have cut my Effexor from 300mg to 150mg and am now down to 75mg and am taking 40mg of Buspar. It seems like I have less sexual side effects on this new dosage but have had increased anxiety and depression.
Posted by GuyinGHo on April 21, 2010, at 11:07:09
In reply to Re: Sexual Side Effects, posted by Donoz on April 21, 2010, at 10:47:10
> I have had sexual side effects with Effexor XR and am now slowly trying to reduce my dosage. My Dr. is trying Buspar as a substitute because he claims that it has less sexual side effects. I have cut my Effexor from 300mg to 150mg and am now down to 75mg and am taking 40mg of Buspar. It seems like I have less sexual side effects on this new dosage but have had increased anxiety and depression.
Hi Donoz,
I'm sorry to hear about your increased depression and anxiety. That is what I'm concerned about -- it has been years since I've felt this well and probably would rather give up some libido in order to not slog through my days. Like anything, it's a delicate balance: how much anxiety are you willing to tolerate in order to achieve intimacy with a partner (would you even have the partner if you were too depressed?). Sometimes life confronts us with unpleasant choices.
Does anyone have any experience with behavioral or non-chemical treatment of sexual side-effects, like sensate focus or sex therapy?
Posted by Donoz on April 21, 2010, at 11:14:47
In reply to Re: Sexual Side Effects » Donoz, posted by GuyinGHo on April 21, 2010, at 11:07:09
Thank you for your feedback. I am still trying to figure out if the increased anxiety (mostly) and depression is environmental or related to the medication. I do agree with you that there is some trade off but at this point the reduction in sexual-side effects is more important to me.
I would be interested in hearing if anyone has had success with buspar in reducing anxiety while not having the same sexual side-effects as Effexor or other similar medication.
Posted by bulldog2 on April 21, 2010, at 15:45:41
In reply to Re: Sexual Side Effects » Donoz, posted by GuyinGHo on April 21, 2010, at 11:07:09
> > I have had sexual side effects with Effexor XR and am now slowly trying to reduce my dosage. My Dr. is trying Buspar as a substitute because he claims that it has less sexual side effects. I have cut my Effexor from 300mg to 150mg and am now down to 75mg and am taking 40mg of Buspar. It seems like I have less sexual side effects on this new dosage but have had increased anxiety and depression.
>
> Hi Donoz,
>
> I'm sorry to hear about your increased depression and anxiety. That is what I'm concerned about -- it has been years since I've felt this well and probably would rather give up some libido in order to not slog through my days. Like anything, it's a delicate balance: how much anxiety are you willing to tolerate in order to achieve intimacy with a partner (would you even have the partner if you were too depressed?). Sometimes life confronts us with unpleasant choices.
>
> Does anyone have any experience with behavioral or non-chemical treatment of sexual side-effects, like sensate focus or sex therapy?This will require hormonal or chemical intervention. Certain hormonal balances are required inorder to function. I'm guessing that increased prolactin could be a major player with your sexual problems. One person here used dostinex successfully for that. It's a dopamine agonist that lowers prolactin. You could combine that with a drug like viagra that pushes some blood down there.
Posted by Deneb on April 21, 2010, at 16:17:51
In reply to Re: Sexual Side Effects, posted by Donoz on April 21, 2010, at 10:47:10
Hello Donoz!
Welcome to Psycho-Babble! It's too bad your anxiety and depression are worse. I hope you find a solution.
Deneb
Posted by kimbersaur on April 21, 2010, at 17:19:04
In reply to Re: Sexual Side Effects » Donoz, posted by GuyinGHo on April 21, 2010, at 11:07:09
> > I have had sexual side effects with Effexor XR and am now slowly trying to reduce my dosage. My Dr. is trying Buspar as a substitute because he claims that it has less sexual side effects. I have cut my Effexor from 300mg to 150mg and am now down to 75mg and am taking 40mg of Buspar. It seems like I have less sexual side effects on this new dosage but have had increased anxiety and depression.
>
> Hi Donoz,
>
> I'm sorry to hear about your increased depression and anxiety. That is what I'm concerned about -- it has been years since I've felt this well and probably would rather give up some libido in order to not slog through my days. Like anything, it's a delicate balance: how much anxiety are you willing to tolerate in order to achieve intimacy with a partner (would you even have the partner if you were too depressed?). Sometimes life confronts us with unpleasant choices.
>
> Does anyone have any experience with behavioral or non-chemical treatment of sexual side-effects, like sensate focus or sex therapy?I don't think a non-chemical solution is the answer, since the sexual side effects are a chemical problem. Viagra and Levitra helped me.
Posted by bleauberry on April 21, 2010, at 18:15:03
In reply to Sexual Side Effects, posted by GuyinGHo on April 19, 2010, at 17:30:28
Viagra can help, but you will also need to put focus on romance. Viagra can get things started because, well, you notice things gettin a little bigger, and well, you start thinking...hmmmm.
Candles, take your time, foreplay...you will probably need to take some time in getting to the actual act.
The reuptake inhibitor antidepressants are notorious for causing low libido. That isn't going away, and other than a few select herbs I am not aware of any reliable antidote to restore normal libido throughout a day.
But you can do things to boost libido in the hours leading up to the act. Ritalin can help. Certain herbs. Foreplay, fondling, fantasizing. Romance.
Viagra. Chew 50mg into chunks (doesn't taste bad) and part it under the tongue for about 5 minutes. Swallow with a little water. Don't eat anything for at least 2 hours prior to that. You'll be ready for action in about an hour, plus or minus.
With the drug induced lack of libido, sex becomes a planned romantic adventure rather than a spontaneous thing that you do whenever you feel like it.
Posted by X-ray on April 22, 2010, at 10:07:19
In reply to Sexual Side Effects, posted by GuyinGHo on April 19, 2010, at 17:30:28
Quit Prozac, try Wellbutrin and Remeron.
I'm pleased with this combo myself.X-ray
Posted by GuyinGHo on April 22, 2010, at 10:17:45
In reply to Re: Sexual Side Effects, posted by X-ray on April 22, 2010, at 10:07:19
> Quit Prozac, try Wellbutrin and Remeron.
> I'm pleased with this combo myself.
>
Doesn't Remeron cause weight gain? I'm Diabetes prone as it is from other meds. Another choice -- lets see . . . sex or chocolate? I think chocolate may be more reliable, lol. Have we all lost faith in the ability to work on sexual intimacy with a partner?
Posted by ed_uk2010 on April 23, 2010, at 13:47:04
In reply to Re: Sexual Side Effects, posted by GuyinGHo on April 22, 2010, at 10:17:45
>Have we all lost faith in the ability to work on sexual intimacy with a partner?
Low libido is common with many antidepressants, but so long as you still have some libido you should be able to have a good time..... assuming that you're with the right person.
In my opinion, most men have too much libido. This can lead them into difficult situations and bad decisions can be made, which may have unpleasant consequences.
Posted by Iansf on April 23, 2010, at 16:23:52
In reply to Re: Sexual Side Effects, posted by X-ray on April 22, 2010, at 10:07:19
> Quit Prozac, try Wellbutrin and Remeron.
> I'm pleased with this combo myself.
>
> X-rayYou haven't had problems with sleepiness or weight gain from the Remeron?
Posted by evenintherain on April 23, 2010, at 19:36:02
In reply to Re: Sexual Side Effects, posted by Iansf on April 23, 2010, at 16:23:52
i know this is not an option for some people, but i find smoking a little bit of marijuana helps me enjoy sex more (whether i'm on medication w/sexual side effects or not). i find it a lot easier to achieve a satisfying climax. i'm not sure exactly why, but i think part of the reason is that it is easier to focus on what feels good and block everything else out. it also reduces a bit of the anxiety (for me. i know that it can cause anxiety in some people, so i wouldn't recommend it if that is the case for you).
as a side note, i think i am the only person i've ever heard of who had sexual side effects w/bupropion (wellbutrin). my doctor hypothesized that perhaps it was withdrawal from the buproprion that was causing it though, not the actual drug, as i generally engaged in sex at night and took my pill in the morning. i'm not sure, but am probably going to try bupropion again so we'll see what happens this time. the effect was i couldn't enjoy sex at all, it just dulled everything.
Posted by GuyinGHo on April 24, 2010, at 10:14:45
In reply to Re: Sexual Side Effects, posted by evenintherain on April 23, 2010, at 19:36:02
Thanks for your message Evenin-I too used to get quite a rise out of marijuana, but it soon became a gateway drug for me. I'm told that my town has just decriminalized possession so I may talk to my shrink about some judicious experimenting.
This is the end of the thread.
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