Posted by Dave954 on July 8, 2006, at 15:06:37
I am a 25 year old male who is going through a difficult struggle. I have come to terms with the fact that I must be on some kind of antipsychotic along with a serotonergic antidepressant (lexapro in my case). The only problem is that *all* antipsychotics seem to cause complete loss of libido (I can get erections just fine but I don't feel my orgasms). I have tried adding wellbutrin xl 150 mg, and while it increases my desire slightly, the orgasms are still non-existant until I stop taking the antipsychotic completely (in this case seroquel, and yes, I have tried even the smallest of doses). I am putting forth a desperate plea for advice from patients, chemists or otherwise as to good alternative adjuncts to add to the lexapro for treating irritible/psychotic depression (i.e. medication classes other than antipsychotics such as mood stabilizers and so forth). My current medication regimen is 10 mg of lexapro and wellbutrin xl 150 mg in the am and 900 mg of neurontin and 20 mg of valium in the pm. The valium and neurontin are for my insomnia but the valium does nothing to take away my irritable/psychotic depression (in fact it makes me more irritable and depressed at times - my initial impression was that benzos were at least mild mood stabilizers). The neurontin is a fairly decent mood stabilizer at night but if I take more than 900 mg I become extremely depressed and am unable to take it during the day for that reason. I was curious about abilify in terms of if it causes less sexual dysfunction than seroquel, but according to some newsgroup postings it seems that they are both about the same in that department (contrary to what their website advertising will try to tell you about them causing lower or non-existant prolactin level increases compared to other APs). There seems to be more to loss of libido than just prolactin levels – just the fact that antipsychotics antagonize dopamine is reason enough to understand why they impair libido. What about lamictal or topomax? The whole reason I went on the valium to begin with was to replace the seroquel for insomnia at night and mood/irritability during the day and because it didn't cause the sexual side effects that the seroquel did. The wellbutrin obviously is making my irritibility worse but I only started that just recently. Because I am in recovery, the valium is a moral issue for me and I need some way to figure out how to balance my mood and insomnia without loosing my sex drive (I have tried trazodone, serzone and remeron and while they are sedating, they do nothing to stabilize my mood and tend to make me more irritable). My doctor says that dopamine agonists in combination with antipsychotics don’t help libido that much, so there goes that idea. Any helpful/constructive advice or opinions for what to bring up during my next doctor's visit would be most appreciated. Thank you.
poster:Dave954
thread:665153
URL: http://www.dr-bob.org/babble/20060701/msgs/665153.html