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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 yellowbird01 on August 17, 2012, at 21:09:05
I'm currently taking 45mg Nardil (split into 3 doses) and 5mg Ritalin twice per day. I started the Nardil in early June and the Ritalin in apx mid July. I'm quite petite and tend to respond to low levels of medications, and these seem to be good doses for me. Amazingly, this combo seems to be working quite well for me after years of medication failures. I feel happier than I have in a long time, but I dont believe I've crossed into manic in any way. I have found ritalin to affect me much more strongly when added to Nardil than it did at 3x the dose on its own.
On to the concern/question....
I've noticed in the past 4-6 weeks+, and increased further in the past 1-2 weeks, I have been experiencing some hypersexuality and behaviors that are very abnormal for me. I find myself feeling aroused VERY frequently and making decisions in regards to my sexual interactions I'd normally never make. Engaging in risky behaviors without real regard for possible harm/consequences (safety with strangers, etc). I recently slept with a person I'd never met, then with another person who has made it quite clear its a "sex only" relationship (which never ever would have been acceptable to me before). In recent days, I've found myself actively seeking out sexual encounters on internet dating sites. All of these behaviors are VERY unusual and out of character for me. I've never had any real interest in "casual sex" before, and never even considered seeking it out. Yikes.
Any chance this hypersexuality/change in sex drive could be related to either of these medications or the combination of the two? I just cant explain it. I took Lamical in the winter/spring and did notice it to increase my sex drive, but not close to this extent. Any thoughts? Or am I just losing it?
Posted by Phil on August 18, 2012, at 8:37:55
In reply to hypersexuality, posted by yellowbird01 on August 17, 2012, at 21:09:05
I think you should stop Ritalin now and see what happens and call your doc. It may not be mania but it's dangerous behavior.
Looking for hook ups on line? Yup, call your doc ASAP. There is no end to the misery this can create in your life.
Posted by Novelagent on August 18, 2012, at 11:51:03
In reply to hypersexuality, posted by yellowbird01 on August 17, 2012, at 21:09:05
Ritalin and Adderall are known to cause hypersexuality, but it's surprising you're experiencing it at such a low dose. Maybe try splitting the 5mg in half, or try switching to Provigil, which should give you the same mood benefit.
> I'm currently taking 45mg Nardil (split into 3 doses) and 5mg Ritalin twice per day. I started the Nardil in early June and the Ritalin in apx mid July. I'm quite petite and tend to respond to low levels of medications, and these seem to be good doses for me. Amazingly, this combo seems to be working quite well for me after years of medication failures. I feel happier than I have in a long time, but I dont believe I've crossed into manic in any way. I have found ritalin to affect me much more strongly when added to Nardil than it did at 3x the dose on its own.
>
> On to the concern/question....
>
> I've noticed in the past 4-6 weeks+, and increased further in the past 1-2 weeks, I have been experiencing some hypersexuality and behaviors that are very abnormal for me. I find myself feeling aroused VERY frequently and making decisions in regards to my sexual interactions I'd normally never make. Engaging in risky behaviors without real regard for possible harm/consequences (safety with strangers, etc). I recently slept with a person I'd never met, then with another person who has made it quite clear its a "sex only" relationship (which never ever would have been acceptable to me before). In recent days, I've found myself actively seeking out sexual encounters on internet dating sites. All of these behaviors are VERY unusual and out of character for me. I've never had any real interest in "casual sex" before, and never even considered seeking it out. Yikes.
>
> Any chance this hypersexuality/change in sex drive could be related to either of these medications or the combination of the two? I just cant explain it. I took Lamical in the winter/spring and did notice it to increase my sex drive, but not close to this extent. Any thoughts? Or am I just losing it?
>
Posted by yellowbird01 on August 18, 2012, at 23:25:16
In reply to Re: hypersexuality, posted by Novelagent on August 18, 2012, at 11:51:03
Thank you both for your responses.
I think I will call my doctor on Monday. I've been debating doing so.. keep thinking it'll disappear on its own, but it hasnt. I'm intellectually aware of the significant danger I'm putting myself in, in a variety of ways, but for some reason I just cant make myself care. The drive is strong enough to outweigh such logic. SO unusual for me... in fact, my sex drive is usually on the lower end of normal when in relationships etc. This is really quite scary for me. I guess I've been embarrassed to call my doctor about this.. myself a 29 year old woman, my doctor a ~50 year old man.. but he's a wonderful doctor and very professional. I'm hesitant to give up my stimulant entirely.. but I will talk to him about changing to something else. I've taken adderall and concerta in the past, both without nardil (for months at a time) and each briefly since beginning nardil.. and not had any reaction of this sort to either. Part of the reason this makes so little sense.
Thanks again.
Posted by phidippus on August 19, 2012, at 0:59:04
In reply to hypersexuality, posted by yellowbird01 on August 17, 2012, at 21:09:05
Ritalin can cause sexual arousal on its own.
Are you bipolar? IF you are, you may be experiencing some hypomania. I don't think the Ritalin is pushing you into this state, but I do find the Nardil somewhat suspect.
I don't think you're losing it, but I do think one of your medications is pushing you to the edge or the Ritalin may be effecting your sex drive.
What are your brain cooties?
Eric
Posted by phidippus on August 19, 2012, at 1:52:31
In reply to Re: hypersexuality, posted by yellowbird01 on August 18, 2012, at 23:25:16
Try Vyvanse-the way its metabolized makes it one of the mellowist stimulants. Maybe it won't rev you up like what you're currently on.
Eric
Posted by yellowbird01 on August 19, 2012, at 23:01:46
In reply to Re: hypersexuality » yellowbird01, posted by phidippus on August 19, 2012, at 0:59:04
Brain cooties... I like that.
I'm not bipolar, no. I believe my current dx is something real descriptive like "depressive disorder nos".. but recurrent major depression (currently mostly in remission) is my real concern. There have been times when I've mixed stimulants with other meds (concerta and lamictal, for instance) where I've felt hypomanic, but my dr and therapist have disagreed. They didnt see it as any degree of mania.. just energy etc I'm not used to. Not sure. I dont feel even hypomanic now though.. nothing beyond the hypersexuality. I do feel happier than I have in a long time.. credited to finally finding an anti-depressant (nardil) that actually works for me. I'm sure some increase in my sex drive is a result of just feeling better, more energy, etc.. but certainly not this degree.
I forgot to mention that apx 2 weeks ago, I started taking 2000mg Vitamin D (over the counter) at the advice of my podiatrist of all people. He recommended it for a variety of reasons, none of which her mental health related in any way. I googled Vit D today and it looks like there may be some relationship between this and increased sex drive? Very interesting.. I'd never have considered this. Do you (or anyone) know anything about this?
Posted by phidippus on August 19, 2012, at 23:38:54
In reply to Re: hypersexuality » phidippus, posted by yellowbird01 on August 19, 2012, at 23:01:46
Since you're not bipolar, we can not ascribe your current hypersexuality to your illness. It is more likely being triggered by the use of the stimulants.
Here's a link on Vitamin D:
http://www.livestrong.com/article/271479-what-are-vitamins-to-help-women-with-low-sex-drive/
The other possibility is that what you're experiencing is purely psychological. You just may be in a place where you need intimacy or may be exploring your sexuality. Are you frightened by this sudden onset of needs?
Eric
Posted by yellowbird01 on August 21, 2012, at 17:22:08
In reply to Re: hypersexuality » yellowbird01, posted by phidippus on August 19, 2012, at 23:38:54
Thanks.. good information.
I stopped the Vitamin D the other day and I think it has improved some. Not completely, but I'm less tempted to follow through with unsafe ideas (ie finding people online) and such. I do think it makes sense my sex drive would be increased to some degree, given that I'm feeling happier and more energized than I have in some time... that fact doesnt scare me at all. I rather like it! What does scare me is when I find myself making unsafe and ridiculous decisions and behaviors.. intellectually I realize the dangers associated with this (physical danger from strangers, negatively impacting friendships, STDs, pregnancy, etc).. but I just havent been able to stop myself. That scares me. Luckily that does seem to have decreased some in the past 2 days... hopefully for good.
Thanks again for your information and comments!
Posted by phidippus on August 22, 2012, at 8:09:41
In reply to Re: hypersexuality » phidippus, posted by yellowbird01 on August 21, 2012, at 17:22:08
>I'm less tempted to follow through with unsafe >ideas (ie finding people online)
I date through Craigslist.org and find it safe as long as you use common sense.
My worry for you is that you may be doing this compulsively. It's thrill-seeking behavior, which begs the question, 'am I feeling empty inside?'. Is something missing?
Eric
Posted by brynb on August 22, 2012, at 12:51:15
In reply to hypersexuality, posted by yellowbird01 on August 17, 2012, at 21:09:05
You might look into a bipolar diagnosis. I had hypersexuality when a medication made me manic (Neurontin). I too am a woman, and it was very out of character for me. When I stopped the med, it disappeared.
Good luck...
-b
Posted by yellowbird01 on August 22, 2012, at 22:35:08
In reply to Re: hypersexuality » yellowbird01, posted by brynb on August 22, 2012, at 12:51:15
Thank you both..
Really interesting. I stopped the Vitamin D the other day and it has gone away 75%. Maybe I'm riding in placebo land, but whatever works. I do see evidence online (as someone else here linked) that vit D is sometimes used to help those with low sex drive, so I wonder if that combined with the other meds (ritalin, nardil) was just too much. I never would think it could have that much effect, but interactions are weird... maybe it's possible?
I actually had a man over this evening who I have an ongoing sexual relationship with. We did engage in sexual activity and honestly, I was bored! I had a very difficult time with arousal. That is also unusual for me (in the opposite direction), but not surprising with psych meds of course. I'm thinking back to an arrangement I've set up with another potential partner and I'm actually a big turned off by it! That's a good sign. I wish it hadnt swung quite so far this opposite direction, but it doesnt surprise me...
I did talk with my therapist today at length about this issue. After much dancing around, I think we got to the bottom of what part of me the behavior is feeding/what need it has been meeting. That helps also.
I do still plan to talk to my psychiatrist about this at our next meeting, or if it becomes a major issue again before then.
This is the end of the thread.
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