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Dr. Bob is Robert Hsiung, MD,
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Posted by michael on January 14, 2000, at 19:32:13
Seems to be a fairly knowledgeable crowd, so here's another one...
My main question has to do with delayed orgasm or difficulty/inability to reach orgasm while taking antidepressants, specifically effexor. (I'm a 33 year old male)
My specifics:
I'm taking effexor XR 75 mg/once daily, and 150mg of wellbutrin SR twice daily, for dysthymia. Since I have been taking the effexor, I have had difficulty reaching orgasm, or at times, been unable to reach orgasm. The effexor seems to help me to focus & think a bit more clearly, and I am somewhat more outgoing again (don't avoid conversations, actually start them, etc.), and I am somewhat less sleepy & run-down. But it has not eliminated the tired/run-down/sleepy/non-motivated/lack-of-energy feelings.
The effexor seems to have a sedtive effect on me, so I find taking the effexor when I go to bed is best for me. I'm taking the wellbutrin to assist in trying to quit smoking.
The combination with wellbutrin hasn't helped any as far as the orgasm issue goes. Nor has it as far as the other issues are concerned, but it does help with the smoking. (I initially had tried wellbutrin alone, switched to effexor, and now have added wellbutrin to the effexor - over roughly 2 year period)I'm on a relatively low dose of the effexor already, so reducing the dose doesn't seem to be a very practical option? (especially since I haven't completely shaken the dysthymia yet) I have also tried ginko biloba (40mg three times daily), which helps slightly.
The Questions...?
1) I have read about "holidays/vacations" for a couple of days from antidepressant medications , in order to avoid some of the unwanted side effects. However, I thoughtI had typically seen these "holidays" with respect to SSRI's. Is that an effective & safe option with effexor? (I have missed a couple of days of effexor in the past, and not had any problems with withdrawl - however, don't know at this time if it solves my problem, or if it has any impact on the theraputic effects of the effexor)
2) I've also seen adding another medication as another possible solution for the orgasm issue: amantadine (which I believe I have read may also address some of the fatigue?), bromocriptine or granisetron (both of which I gather are very expensive), buspirone, cyproheptadine, and yohimbine. Once again (with the exception of bromocriptine, which I saw specifically mentioned with effexor) I believe it has been predominantly in conjunction with SSRI's that I have seen these.
So...?
I'm just looking for any feedback, comments, opinions, experience, preferenes, etc. anyone might have to offer with respect to this issue, and any (all?) of the myriad of anecdotal remedies I mentioned above... Or any additional info, remedies, etc. that may be of use. (I'll be discussing this w/my psych doctor next appointment, but it's not for a while)
Thanks for taking the time to read all of this (hope it's somewhat coherent), and thanks for any advice/feedback/info you may have to provide.michael
Posted by Cindy W on January 14, 2000, at 21:36:32
In reply to effexor & orgasm (or lack thereof), posted by michael on January 14, 2000, at 19:32:13
> Seems to be a fairly knowledgeable crowd, so here's another one...
>
> My main question has to do with delayed orgasm or difficulty/inability to reach orgasm while taking antidepressants, specifically effexor. (I'm a 33 year old male)
>
> My specifics:
>
> I'm taking effexor XR 75 mg/once daily, and 150mg of wellbutrin SR twice daily, for dysthymia. Since I have been taking the effexor, I have had difficulty reaching orgasm, or at times, been unable to reach orgasm. The effexor seems to help me to focus & think a bit more clearly, and I am somewhat more outgoing again (don't avoid conversations, actually start them, etc.), and I am somewhat less sleepy & run-down. But it has not eliminated the tired/run-down/sleepy/non-motivated/lack-of-energy feelings.
>
> The effexor seems to have a sedtive effect on me, so I find taking the effexor when I go to bed is best for me. I'm taking the wellbutrin to assist in trying to quit smoking.
>
> The combination with wellbutrin hasn't helped any as far as the orgasm issue goes. Nor has it as far as the other issues are concerned, but it does help with the smoking. (I initially had tried wellbutrin alone, switched to effexor, and now have added wellbutrin to the effexor - over roughly 2 year period)
>
> I'm on a relatively low dose of the effexor already, so reducing the dose doesn't seem to be a very practical option? (especially since I haven't completely shaken the dysthymia yet) I have also tried ginko biloba (40mg three times daily), which helps slightly.
>
> The Questions...?
>
> 1) I have read about "holidays/vacations" for a couple of days from antidepressant medications , in order to avoid some of the unwanted side effects. However, I thoughtI had typically seen these "holidays" with respect to SSRI's. Is that an effective & safe option with effexor? (I have missed a couple of days of effexor in the past, and not had any problems with withdrawl - however, don't know at this time if it solves my problem, or if it has any impact on the theraputic effects of the effexor)
>
> 2) I've also seen adding another medication as another possible solution for the orgasm issue: amantadine (which I believe I have read may also address some of the fatigue?), bromocriptine or granisetron (both of which I gather are very expensive), buspirone, cyproheptadine, and yohimbine. Once again (with the exception of bromocriptine, which I saw specifically mentioned with effexor) I believe it has been predominantly in conjunction with SSRI's that I have seen these.
>
> So...?
>
> I'm just looking for any feedback, comments, opinions, experience, preferenes, etc. anyone might have to offer with respect to this issue, and any (all?) of the myriad of anecdotal remedies I mentioned above... Or any additional info, remedies, etc. that may be of use. (I'll be discussing this w/my psych doctor next appointment, but it's not for a while)
>
> Thanks for taking the time to read all of this (hope it's somewhat coherent), and thanks for any advice/feedback/info you may have to provide.
>
> michaelMichael, sorry to hear the Effexor isn't working out for you. I'm taking Effexor 225 mg/day, and hope my psychdoc will increase it next visit. It makes me feel more energetic and less depressed, and decreases my obsessions and compulsions a bit, and doesn't interfere with orgasm. I tried SSRI's (Prozac, Luvox, Zoloft) and they interfered with desire, arousal and orgasm (I tried once for four hours without getting anywhere!). Serzone didn't interfere with orgasm and made me less depressed and less socially anxious, but didn't decrease my obsessions and compulsions. Check out the article by Dr. Jenike on sexual side effects of SSRI's at the OC Foundation (Obsessive-Compulsive Foundation) online; he has an excellent discussion of remedies available for counteracting sexual side effects of antidepressants, including Viagra, periactin, ginkgo biloba, yohimbe. I tried ginkgo biloga and yohimbe but they didn't help. Lately I have read that mianserin can be helpful for women. Good luck and please let us know if you find something that works (I'm on Effexor-XR too!)--Cindy W
Posted by JohnL on January 15, 2000, at 7:05:41
In reply to effexor & orgasm (or lack thereof), posted by michael on January 14, 2000, at 19:32:13
1. If you can get your doc to cooperate, 5mg to 10mg of ritalin an hour or two before anticipated sex will do the trick.
2. Drug holidays didn't help at all for me. Effexor does have a short halflife though, so it would be easy to try.
3. All the drugs you mention are used, but their success is spotty I think. The most popular remedy is the one you already have...wellbutrin.
4. There is an herb at WalMart called ExSativa that has helped me a lot. I also take 240mg gingko a day. The two have really helped my sex life a lot, with benefits becoming obvious after about 2 or 3 weeks. I've tried yohimbe, but it has some uncomfortable side effects (irritibility, total insomnia, racing heart).jamie
Posted by Noa on January 15, 2000, at 10:10:56
In reply to Re: effexor & orgasm (or lack thereof), posted by JohnL on January 15, 2000, at 7:05:41
I wouldn't recommend taking medication vacations from effexor. Missing doses has made me feel kind of sick.
Posted by petite on June 12, 2006, at 23:15:42
In reply to Re: effexor & orgasm (or lack thereof), posted by Cindy W on January 14, 2000, at 21:36:32
I was on 150 mg of effexor and was more often than not unable to have an orgasm. The very few times it happened, there was so much effort involved, it was more work than my husband or I wanted. It was not fun! I also quit taking the med. without slowly decreasing my dosage and I have not felt well since. (It's been 3 weeks). I have been extremely dizzy and feeling unable to cope with just normal every day stress in life. My PTSD symptoms are worse. I do NOT recommond anyone stopping this med without your doctors instructions. I only wish I could be on a medication that helped me cope, but not interfere with the intimacy in my marriage. Glad to be back to normal, but questioning if I'm selfish to quit taking the meds only because of the sexual side effects.
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