SSRI's and libido/ solutions?

Back in the early 70's i had an embroidered pullover with that slogan on the back! Some things never change!

jb

quote:

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I'll try it and let you guys know what happened.

Please keep us posted. I hope adding that agent (or another one suggested by your doc) helps.

I have used Cyproheptadine (Periactin) as an appitite stimulant. It worked well but left me feeling so depressed the next day that I still have 2 boxes in the cupboard.

It makes sense that it could counter the effect of SSRI's.

I would be interested to know but I am doing OK on my 20mg Prozac and am not going to risk feeling like that again.

Would Pizotifen have similar actions? I dont get the same bad reaction from that. But I also dont get as much appitite increase so I assume it does not effect serotonin to the same degree?

Posted by: Nandi12

Please keep us posted. I hope adding that agent (or another one suggested by your doc) helps.

lord, it was like pulling teeth just to get a sample package of the Remeron, sigh.

Anyway, I have a new ssri to try, Lexapro, and some remeron for the grand experiment.

I probably won't even start the Lexapro until after the weekend, LOL.

I'll keep you guys posted...

Sonic

update, please?

No new data, as yet - I like the Lexapro because it seems to be the most effective at low dosages and doesn't seem to be causing sleepiness or weight gain. However, it does have the same delayed orgasm side effect as the other SSRIs.

I have not yet tried the Remeron as a short-term counteracting agent, but I'll report as soon as I do. Since I'm only delayed instead of unable, there has been less urgency to the experiment. Oh, and I discovered if I skip 2 days of the Lexapro, I go back to normal functioning too.

As soon as I do the Remeron experiment, I'll let you know.

Sonic

http://www.fpnotebook.com/PSY167.htm

See Also
Erectile Dysfunction Causes

Causes
See Medication Induced Sexual Dysfunction
Tricyclic Antidepressants
MAO inhibitors
Selective Serotonin Reuptake Inhibitor (SSRI)
Fluoxetine (54% Incidence sexual dysfunction)
Sertraline (56% Incidence sexual dysfunction)
Paroxetine (65% Incidence sexual dysfunction)

Management: Approach
Observe for 4 to 6 weeks for adverse effects to subside
Adjust current Antidepressant dosing
Decrease Antidepressant dosage
Alter timing of daily dose
Consider 2 day drug holiday
Sertraline (Zoloft)
Paroxetine (Paxil)
Not effective for Fluoxetine (Prozac)
Consider adjunctive therapy (see below)
Substitute another Antidepressant
Minimal to no sexual dysfunction
Nefazodone (Serzone)
Bupropion (Wellbutrin)
Mirtazapine (Remeron)
Low risk of sexual dysfunction (10-15%)
Fluvoxamine (Luvox)
Citolopram (Celexa)
Venlafexine (Effexor)

Management: Adjunctive therapy to improve sexual function
Approach to specific sexual dysfunction problems
Orgasm: all of the agents below
Libido: Amantadine, Buspar, Periactin, Yohimbine
Erection: Amantadine, Buspar, Periactin, Yohimbine
As Needed dosing
Amantadine 100 to 400 mg PO prn 2 days before coitus
Bupropion 75-150 mg PO prn 1 to 2 hours before coitus
Buspar 15-60 mg PO prn 1 to 2 hours before coitus
Periactin 4-12 mg PO prn 1 to 2 hours before coitus
Dexadrine 5-20 mg PO prn 1 to 2 hours before coitus
Yohimbine 5.4-10.8 mg prn 1 to 2 hours before coitus
Daily Dosing
Amantadine 75-100 mg PO bid to tid
Bupropion 75 mg PO bid to tid
Buspar 5-15 mg PO bid
Dexadrine 2.5 to 5 mg bid to tid
Pemoline 18.75 mg PO qd
Yohimbine 5.4 mg PO tid

References
Montejo-Gonzalez (1997) J Sex Marital Ther 23:176
Moore (Jan 1999) Hospital Practice, p. 89-96
Labbate (1998) J Sex Marital Ther 24:3

Hey Sonic, what were the results of the experiment with remeron? Hope you're doin well otherwize.

Posted by: headdoc

Hey Sonic, what were the results of the experiment with remeron? Hope you're doin well otherwize.

oh, sorry, I thought I had posted a followup, but I see I didn't.

Well, the Remeron experiment was a total bust, it made me so sleepy that all I wanted to do was nap, not have sex! LOL

Since then, I have been on Lexapro, which I have found to be a fairly decent medication with few side effects. It helps with the anxiety/depression, doesn't make me sleepy, and it flushes out of my system reasonably quickly if I want to take a brief drug holiday.

In fact, on lower dosages of it (10 mg/day), I can occasionally have a decent orgasm. My doc had mentioned that sometimes the side effect of anorgasmia will disappear with time, and I have hopes that this will be the case for me with Lexapro. I'm considering trying a half Viagra tab just to see what effect that might have, per my doctor's suggestion.

Also, my personal life has gotten less chaotic, which also helps greatly. I'm back in the gym lifting again, and I found a great dojo so I started doing martial arts again, very satisfying.

Thanks for asking.

Sonic

I feel I should thank you. This is a signficant problem that just doesn't get enough attention. The solutions are not universal.

I'm just guessing here, but I think I might be lucky in having a strong sex drive and an... um... willing husband who knows what he's doing I suspect many women aren't as interested in sex, or maybe don't get much out of it.

So I'm really giving up something important being on an SSRI, which makes me highly motivated to keep working on finding a solution.

After my wife has her hysterectomy, there were some serious concerns about sex. With the addition of dhea and certain increased , ah, atention from me ( i try to bring her to orgasm prior to penetration) our sex life has gotten nothing but better.

jb

Posted by: sonic

I'm just guessing here, but I think I might be lucky in having a strong sex drive and an... um... willing husband who knows what he's doing I suspect many women aren't as interested in sex, or maybe don't get much out of it.

So I'm really giving up something important being on an SSRI, which makes me highly motivated to keep working on finding a solution.

yup, that's always a good thing <grin> Makes it happier for everybody

is it also true that herbal meds take a heavy effect on libido's? Like ginseng for example, i haven't tried it yet because it's not prescribed by doctor's any idea about it?

is hysterectomy applicable for women that has not yet bear a child?