Posted by crabwalk on June 7, 2006, at 13:43:05
In reply to Re: Effexor Sexual Side Effects After Discontinuat, posted by TommyIsland on June 7, 2006, at 3:50:52
Tommy,
My story is long and marked by disappointment after disappointment, but I'm just one person out of several hundred (probably more) who are trying to beat this. I lost all sexual feeling (libido, tactile pleasure, orgasm pleasure, romantic feelings) while I took paxil for 2 months 2 years ago. I was switched directly to prozac, and for about 3 weeks as the paxil left my system all my sexual feelings returned, I thought I was ok. Then I literally woke up one morning and everything had gone numb again, physically and emotionally. Foolishly I stayed on prozac for another 5 months. I developed severe restless leg syndrome that was so maddening I had no choice but to quit, which I was actually happy about since I thought I'd lose the side effects. The restless leg went away, but the sexual side effects never did, not one bit. I waited three months and then decided to try to do something about it. I started taking buspar, then added ginkgo, and eventually yohimbe; several months later I was still nowhere close to normal. I quit those and immediately had problems with erections, became very depressed for a couple months, then decided to go back on buspar. For some reason this time I had a very bad reaction (akathisia) and had to stop. A few months later I tried tianeptine, and had a terrible reaction to it. Quit that, now I am on emsam and have been for about 6 weeks with no substantial changes sexually, which means I am still very unhappy.
There might be a chance that things will come back for you naturally, it's really up to you to decide how long you want to wait (before trying to treat it) because the only prognosis is 'indefinite'. In the meantime you should see a doctor and get your hormones tested, especially testosterone and prolactin, although hormone imbalance seems to have little if anything to do with this, but just to be sure. If you have a competent doctor, he/she should do a complete blood workup after you tell them the problem (make sure you ask for total testosterone and bioavailable or 'free' and you'll probably have to ask for prolactin) but they are likely to be skeptical. There are a few articles you can print out from the ssri side effects group to show your doctor, also several individual testimonials; if they see these they'll be less likely to dismiss the problem and tell you to 'just keep waiting' or of course blame it on depression. Unfortunately, even if they at least acknowledge the possibility of persistent side effects, they probably won't have much to offer as ideas for treatment as it will almost surely be the first time they've heard of it happening.
The closest we have to a theory is that the problem is primarily due to a compromise of dopaminergic responses in sexual/emotional/pleasurable reward areas of the brain. Serotonin generally inhibits the release of dopamine (this is likely what causes restless leg) and its likely that chronically raising synaptic levels of serotonin causes long-term inhibition or rearrangement of dopaminergic receptors or pathways; this probably occurs due to an alteration of gene expression. That's just a theory though, no one really knows anything beyond an educated guess. Why it persists in some people but reverses quickly in most is the biggest mystery. Based on the dopamine hypothesis, a number of people have tried dopaminergic drugs, but nothing has proven consistently helpful. One of the hardest parts about this for me is that I have had no professional guidance. I've suggested all my treatments based on my research or word of mouth, so everything's been an experiment.
Hope this helps. You could still be able to get better without treatment. I hope this is the case for you.
-C
poster:crabwalk
thread:652190
URL: http://www.dr-bob.org/babble/20060604/msgs/654064.html