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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 15 to 39 of 39. Go back in thread:
Posted by diane on October 12, 1999, at 22:33:24
In reply to it never ends..., posted by jp on October 12, 1999, at 2:28:18
> I am currently trying Serzone at nights, but am not too impressed by it's effects.
serzone took about 4-5 weeks to fully kick in for me in terms of antidepressant effects...
Posted by Um, not really Bob at all ... on October 13, 1999, at 12:31:08
In reply to Re: Still not a man, but..., posted by Annie on October 12, 1999, at 22:28:52
> I'm glad I could be partners with you! I suspect you are trying to get rid of me though!
> Am I right? LOLOL
>
> Annie
> aka AnnieDonia@aol.comI **TOLD** you not to ... er, um, well, I guess I *did* open my mouth first ... ;^)
Posted by Sean on October 13, 1999, at 12:40:30
In reply to Re:SSRI dysfunction : Zo is a No-go, posted by Cindy on October 12, 1999, at 21:34:09
> > > Hello,
> > >
> > > Which of the SSRI's (Prozac, Zoloft, Luvox, Paxil, or Effexor) cause the least sexual dysfunction in men? According to medscape.com Prozac shows up the most favourable. Experienced people please comment.
> > > Thanks
> >
> > Had bad luck with Zoloft on this front. I did,
> > however, find that over time, I actaully "re-trained" my
> > nerves somehow by, uh, er, practicing...
>
> Sean, you're lucky! I practiced and practiced, but never got anywhere even after 4 hours!!!Well, me too, but it took over a *month* if you
can believe it! And even then things were a bit
capricious and took forever. But taking "forever"
is not necessarily a bad thing for a guy...
I think it may be a bit tougher for females. Such
weird side effect, numb genitalia. I wonder what
Freud would say?Sean.
Posted by jp on October 13, 1999, at 14:57:16
In reply to Re: Which SSRI causes least sexual dysfunction in men?, posted by Cindy on October 12, 1999, at 9:08:04
When I tried Prozac i felt very good already after a couple of days... felt great, confident, and sexually confident too.
I too am on day 9 of Serzone. It seems to work a little on things like bad dreams etc (I am on onetime dose at night, managed to gradually go up to 500mg as recommended).
Anyone else been on both? Please let me know how they compared for you.
jp
Posted by Cindy on October 13, 1999, at 21:16:37
In reply to Serzone vs Prozac, posted by jp on October 13, 1999, at 14:57:16
> When I tried Prozac i felt very good already after a couple of days... felt great, confident, and sexually confident too.
>
> I too am on day 9 of Serzone. It seems to work a little on things like bad dreams etc (I am on onetime dose at night, managed to gradually go up to 500mg as recommended).
>
> Anyone else been on both? Please let me know how they compared for you.
>
> jpJP, I've been on both Prozac (60 mg/day) and Serzone (450 mg/day). Stopped the Prozac due to inability to climax. Otherwise, it worked OK for a while but then seemed to lose its antidepressant and anti-OCD effect (took it for l0 years!). Have taken Serzone x2, first for three weeks by itself then with Luvox for three weeks; the Luvox was also a bummer in terms of sexual side effects. Tried Zoloft next, with the same inability to climax. Now am back on Serzone 450 mg/day and noticed an antidepressant effect within the first week (I think it takes a high dose to counteract the depression...unfortunately, I don't know if it will have any beneficial effect on the OCD).
Posted by david on October 16, 1999, at 19:16:02
In reply to Which SSRI causes least sexual dysfunction in men?, posted by jp on October 11, 1999, at 15:46:54
> Hello,
>
> Which of the SSRI's (Prozac, Zoloft, Luvox, Paxil, or Effexor) cause the least sexual dysfunction in men? According to medscape.com Prozac shows up the most favourable. Experienced people please comment.
> ThanksFlouvoxamine causes the least sexual dysfunction
Posted by Brandon on October 16, 1999, at 23:41:24
In reply to Re: Which SSRI causes least sexual dysfunction in men?, posted by david on October 16, 1999, at 19:16:02
> Flouvoxamine causes the least sexual dysfunctionIs this personal opinion or do you have studies which support this?...I have heard many coin the phrase "chemical castration" when referring to Luvox.
Posted by saint james on October 17, 1999, at 1:08:00
In reply to Re: Which SSRI causes least sexual dysfunction in men?, posted by Brandon on October 16, 1999, at 23:41:24
>
> > Flouvoxamine causes the least sexual dysfunction
>
> Is this personal opinion or do you have studies which support this?...I have heard many coin the phrase "chemical castration" when referring to Luvox.James here...
I don't think anyone can answer this question ( using all men as the group) All AD's cause sexual problems in some people, there are not any that don't have this effect in everybody. It is more a question of finding one that does not cause this effect in you. Trial and error is the process that works the best%
Posted by jennyann on October 17, 1999, at 11:00:53
In reply to Re: Which SSRI causes least sexual dysfunction in men?, posted by saint james on October 17, 1999, at 1:08:00
what I find disturbing is that most clinical trials are done using the male population; the percentages and statistics regarding side effects are based primarily on information gathered from a male population. Atlest I know this is true for SSRI and sexual dysfunction...most info is regarding premature ejaculation or inability to achieve erection. My AP said that if we were to consider to female population along with the male population regarding this side effect, the stats would sky rocket. I know I have experienced this side effect on paxil, zoloft and now celexa.....oooh the mysogyny of the pharmeceutical/medical world is frustrating....just thought I would vent.....
JennyAnn
Posted by Rick on October 17, 1999, at 15:57:07
In reply to Which SSRI causes least sexual dysfunction in men?, posted by jp on October 11, 1999, at 15:46:54
Sorry, I couldn't resist...but I've read that if the user, ummm, sticks it out 3-6 months (!), anorgamsmia and sexual desire fully return in about half of male users who suffered SSRI sexual dysfunction. Did anyone, "hang on" that long before dropping the offending med? And still no relief?
Interestingly, I understand that those with social phobia (and perhaps some other comorbid conditions) are the most likely to suffer strong side effects (sexual and otherwise) from AD's.
BTW, MAOI Nardil had a weird effect on me sexually. It INCREASED desire and INCREASED sexual pleasure sensations, but orgasm was imposiible. What a weird juxaposition. You'd think increased sensation would ENCOURAGE the ejaculation mechanism, rather
than inhibit it.Other MAOI's have less sexual dysfunction, but except for Manerix (unavailable in the U.S.), they all require food restrictions at theraputic doses.
While it's not marketed for GAD, I understand that BuSpar at 90mg+ (and a good four weeks) can be a great AD, and actually ENHANCES sexual desire and function.
Rick
> Hello,
>
> Which of the SSRI's (Prozac, Zoloft, Luvox, Paxil, or Effexor) cause the least sexual dysfunction in men? According to medscape.com Prozac shows up the most favourable. Experienced people please comment.
> Thanks
Posted by Rick on October 17, 1999, at 16:01:53
In reply to But did anybody try sticking it out?, posted by Rick on October 17, 1999, at 15:57:07
My apologies for the obvious typos in my post above (e.g., should say BuSpar IS marketed for GAD)
----
> Sorry, I couldn't resist...but I've read that if the user, ummm, sticks it out 3-6 months (!), anorgamsmia and sexual desire fully return in about half of male users who suffered SSRI sexual dysfunction. Did anyone, "hang on" that long before dropping the offending med? And still no relief?
>
> Interestingly, I understand that those with social phobia (and perhaps some other comorbid conditions) are the most likely to suffer strong side effects (sexual and otherwise) from AD's.
>
> BTW, MAOI Nardil had a weird effect on me sexually. It INCREASED desire and INCREASED sexual pleasure sensations, but orgasm was imposiible. What a weird juxaposition. You'd think increased sensation would ENCOURAGE the ejaculation mechanism, rather
> than inhibit it.
>
> Other MAOI's have less sexual dysfunction, but except for Manerix (unavailable in the U.S.), they all require food restrictions at theraputic doses.
>
> While it's not marketed for GAD, I understand that BuSpar at 90mg+ (and a good four weeks) can be a great AD, and actually ENHANCES sexual desire and function.
>
> Rick
> > Hello,
> >
> > Which of the SSRI's (Prozac, Zoloft, Luvox, Paxil, or Effexor) cause the least sexual dysfunction in men? According to medscape.com Prozac shows up the most favourable. Experienced people please comment.
> > Thanks
Posted by JohnL on October 17, 1999, at 17:05:19
In reply to But did anybody try sticking it out?, posted by Rick on October 17, 1999, at 15:57:07
> Sorry, I couldn't resist...but I've read that if the user, ummm, sticks it out 3-6 months (!), anorgamsmia and sexual desire fully return in about half of male users who suffered SSRI sexual dysfunction. Did anyone, "hang on" that long before dropping the offending med? And still no relief?
I was on paxil for over a year. My entire sex life--libido and function--was pitifully embarrassing the entire year. I would never allow myself to tolerate that kind of punishment again. Waiting it out for over a year didn't work for me. Same situation with Zoloft, except four months instead of a year, with the addition of Buspar and Yohimbe. No good. Now if I run into sex probs with any drug, that drug is quickly trashed after a two week look-see. I'm not waiting any three months. Life's too short to put the pleasures of a sexually active relationship on hold. It's bad enough struggling with depression, not to mention losing the last intimate thing you've got left. There's always a more agreeable drug worth trying. :)
Posted by david on October 20, 1999, at 18:27:09
In reply to Re: Which SSRI causes least sexual dysfunction in men?, posted by Brandon on October 16, 1999, at 23:41:24
>
> > Flouvoxamine causes the least sexual dysfunction
>
> Is this personal opinion or do you have studies which support this?...I have heard many coin the phrase "chemical castration" when referring to Luvox.No it is not a personal opinion. I read an article (can't remember where or who wrote it though!) where a researcher tested several ssri's on men- and flouvoxamine had the least sexual dysfunction side effects- my doctor also commented on Flouvoxamine in relation to the little sexual side effects it produces. Serzone is also low on the sexual side effects- but I didnt mention it because it is not strictly a SSRI- it is a pre and post synaptic serotonin blocker.
Posted by Bob on October 20, 1999, at 23:49:19
In reply to Re: Which SSRI causes least sexual dysfunction in men?, posted by david on October 20, 1999, at 18:27:09
... and what he said was that it varies from person to person. The statistical results of studies cannot be applied to individuals, because those statistics refer to a proportion of a population, not to specific people in a population. The best that study could say is that Luvox showed the lowest rate of sexual dysfunction -- but that statement doesn't mean it won't be chemical castration for you. Not knowing the study or the numbers, such a claim can even be made if, for example, only 70% of men on Luvox had sexual side-effects as opposed to 75% or higher for other SSRIs.
It's like what Disraeli said ... "lies, damned lies, and statistics."
Bob
Posted by saint james on October 21, 1999, at 3:17:19
In reply to But did anybody try sticking it out?, posted by Rick on October 17, 1999, at 15:57:07
> Sorry, I couldn't resist...but I've read that if the user, ummm, sticks it out 3-6 months (!), anorgamsmia and sexual desire fully return in about half of male users who suffered SSRI sexual dysfunction.
James here...
Nope, it is here to stay.
j
Posted by saint james on October 21, 1999, at 3:35:08
In reply to Re: Which SSRI causes least sexual dysfunction in men?, posted by david on October 20, 1999, at 18:27:09
>
> No it is not a personal opinion. I read an article (can't remember where or who wrote it though!) where a researcher tested several ssri's on men- and flouvoxamine had the least sexual dysfunction side effects- my doctor also commented on Flouvoxamine in relation to the little sexual side effects it produces.James here...
Don't beleive it...every AD likes to report this and all SSRI's have always been proven to have sexual side effects.
To me you are asking a car to not be a car. It seems that sex function/drive and seritonin are linked, though this does vary by person so some are less effected. Study subjects are carefully chosen and statisitics can be weighted to give whatever results. Every new AD wants to say it dose not have these side effects.
So if "Joe" takes Prozac and has no sexual side effects it does not have any bearing on what would happen to me (taking Prozac) unless I like "Joe" and he is gay, then I might ask him out on a date !
It is better to pick a med and try it, and then see if it has these side effects, then try another.
j
Posted by David on October 21, 1999, at 19:59:23
In reply to Re: Which SSRI causes least sexual dysfunction in men?, posted by saint james on October 21, 1999, at 3:35:08
> >
> > No it is not a personal opinion. I read an article (can't remember where or who wrote it though!) where a researcher tested several ssri's on men- and flouvoxamine had the least sexual dysfunction side effects- my doctor also commented on Flouvoxamine in relation to the little sexual side effects it produces.
>
> James here...
>
> Don't beleive it...every AD likes to report this and all SSRI's have always been proven to have sexual side effects.
>
> To me you are asking a car to not be a car. It seems that sex function/drive and seritonin are linked, though this does vary by person so some are less effected. Study subjects are carefully chosen and statisitics can be weighted to give whatever results. Every new AD wants to say it dose not have these side effects.
>
> So if "Joe" takes Prozac and has no sexual side effects it does not have any bearing on what would happen to me (taking Prozac) unless I like "Joe" and he is gay, then I might ask him out on a date !
>
> It is better to pick a med and try it, and then see if it has these side effects, then try another.
>
> j
Look Guys, i never said flouvoxamine had NO SEXUAL side effects, only that for the majority of males who tried it found it was significantly better (caused less anorgasmia) than other SSRI'S- you could go on about statistics and test biases - but why don't you try it if your'e currently having problems on the AD you're currently on - if Flouvoxamine isnt any better then you havn't really lost much- PS - I don't work for a pharmacautical company so I do NOT have a vested interest and am not advertising flouvoxamine- only telling you what I have read and been told by my DOC- All AD's do have side effects- and probably all have sexual side effects- the trick is to find the one that best suits you-I have been informed that flouvoxamine causes the least anorgasmia (with the exception of Serzone (Nefazodone) which i dont think is referred to as an SSRI although is at least serenic (serotonergic). If I had severe sexual dysfunction (impotence, anorgasmia etc) - based on what I have read and been told- and I wanted to stay on an SSRI or my doc wanted to prescribe an SSRI- Flouvoxamine is the one I would try FIRST- O.K - Im not saying its the best SSRI or AD out there - but then i don't suffer from the same severe sexual side effects that others seem too.
Posted by Rick on October 21, 1999, at 22:28:47
In reply to Re: Which SSRI causes least sexual dysfunction in men?, posted by David on October 21, 1999, at 19:59:23
> > >
> > > No it is not a personal opinion. I read an
article (can't remember where or who wrote it
though!) where a researcher tested several ssri's
on men- and flouvoxamine had the least sexual
dysfunction side effects- my doctor also commented on Flouvoxamine in relation to the little sexual
side effects it produces.
> >
> > James here...
> >
> > Don't beleive it...every AD likes to report
this and all SSRI's have always been proven to
have sexual side effects.
> >
--------
Here's a recent study I found re the incidence of
sexual dysfunction on Luvox. The bottom line is
(where else?) at the bottom:
J Clin Psychiatry 1999 Mar;60(3):187-90
Incidence of sexual dysfunction in healthy volunteers on fluvoxamine therapy.Nafziger AN, Bertino JS Jr, Goss-Bley AI, Kashuba AD
Clinical Pharmacology Research Center and Department of Medicine, Bassett Healthcare, Cooperstown, NY 13326-1394, USA. nafziger@iex.net
BACKGROUND: Current literature suggests that the incidence of sexual dysfunction secondary to fluvoxamine therapy is 1% to 8%, while other selective serotonin reuptake inhibitors may have rates as high as 75%. The objective of this study was to determine the incidence of sexual dysfunction secondary to fluvoxamine in healthy volunteers.
METHOD: 20 healthy volunteers (10 men, 10 premenopausal women) had adverse effects assessed at 6 visits while not receiving fluvoxamine, then twice while taking 150 mg fluvoxamine daily. Assessments occurred at 2-week intervals. Incidence rates for sexual dysfunction were calculated.
RESULTS: No sexual dysfunction was reported prior to fluvoxamine therapy. After 2 weeks and 4 weeks of therapy respectively, sexual dysfunction occurred in 20% (N = 4) and 35% (N = 7) of the healthy volunteers.
CONCLUSION: The incidence of sexual dysfunction during fluvoxamine therapy in healthy volunteers is 35%. This incidence is higher than previously reported and similar to that of other selective serotonin reuptake inhibitors.
Rick
Posted by Bob on October 21, 1999, at 23:14:41
In reply to Re: Which SSRI causes least sexual dysfunction in men?, posted by Rick on October 21, 1999, at 22:28:47
... didn't mean to make it sound like we were slamming *you* personally. Not at all my intention, and I'm sure the same holds for James.
[that's one problem with e-text: too black and white, no nonverbals to pick up on ... easy to read things different from how an author intends them]
Rick, thanks for the numbers ... much of my cynicism comes from the obvious underreporting that pharm companies have done on SSRIs and sexual side effects. Too bad the N of that study is so low -- must be no way of getting any statistically significant results on any gender differences (tho the docs in charge should get credit for doing a study on equal numbers of men and women).
That's one of the other problems [Dave -- duck! this isn't aimed at you ;^) ] with sadis-, er, statistics: "statistically significant" only means that the odds are heavily in your favor in saying that their is a difference. It says NOTHING about the SUBSTANCE of that difference.
Bob
Posted by david on October 24, 1999, at 20:06:37
In reply to Sorry, David ..., posted by Bob on October 21, 1999, at 23:14:41
> ... didn't mean to make it sound like we were slamming *you* personally. Not at all my intention, and I'm sure the same holds for James.
>
> [that's one problem with e-text: too black and white, no nonverbals to pick up on ... easy to read things different from how an author intends them]
>
> Rick, thanks for the numbers ... much of my cynicism comes from the obvious underreporting that pharm companies have done on SSRIs and sexual side effects. Too bad the N of that study is so low -- must be no way of getting any statistically significant results on any gender differences (tho the docs in charge should get credit for doing a study on equal numbers of men and women).
>
> That's one of the other problems [Dave -- duck! this isn't aimed at you ;^) ] with sadis-, er, statistics: "statistically significant" only means that the odds are heavily in your favor in saying that their is a difference. It says NOTHING about the SUBSTANCE of that difference.
>
> BobI'm sorry I was a little sensitive - please forgive the overeaction. David.
Posted by Bob on October 24, 1999, at 22:52:05
In reply to Re: Sorry, David ..., posted by david on October 24, 1999, at 20:06:37
> I'm sorry I was a little sensitive - please forgive the overeaction. David.
Hey, we're all a little sensitive around here. ;^)
Bob
Posted by Danny S on April 13, 2000, at 19:40:15
In reply to Re: Tried waiting it out., posted by JohnL on October 17, 1999, at 17:05:19
what dose 'anorgamsmia' mean?
Posted by Cam W. on April 13, 2000, at 22:58:14
In reply to Re: Tried waiting it out., posted by Danny S on April 13, 2000, at 19:40:15
> what dose 'anorgamsmia' mean?
Danny - anorgasmia - failure to achieve (or lack of) orgasm. - Cam W.
Posted by CosmoK on May 30, 2001, at 19:55:25
In reply to But did anybody try sticking it out?, posted by Rick on October 17, 1999, at 15:57:07
I've been on Zoloft for 2 years. My sex drive slowly went away over about 6months and didn't come back until I stopped for several months recently(unfortuately, so did my anxiety).Steve
Posted by SalArmy4me on May 31, 2001, at 1:36:26
In reply to Re: But did anybody try sticking it out?, posted by CosmoK on May 30, 2001, at 19:55:25
Did you ever try going onto the Zoloft again and see what it does?
>
> I've been on Zoloft for 2 years. My sex drive slowly went away over about 6months and didn't come back until I stopped for several months recently(unfortuately, so did my anxiety).
>
> Steve
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