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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 10 of 10. This is the beginning of the thread.
Posted by Jennie W. on March 29, 2001, at 20:41:05
Hi all! Gee, I am really glad I found this site!! I have been browsing through the archives for a few days now, and you all have been really helpful and you don't even know me yet!! Thanks!! I think I'll just jump right in here, because I sure could use some support from people who have been where I am now...
I have been dealing with sexual side effects for three years now (on Prozac, on Celexa, on Celexa with wellbutrin and/or buspar added on, on Serzone, and now on Wellbutrin alone). I went to my psychdoc yesterday, armed to the hilt with printouts of info on various drug options that I had heard about in your archives here. My psychdoc's attending, however, came in and said basically that my lack of sex drive was caused because of something in my relationship with my husband; that he would not take me off Wellbutrin because it was helping the depression; and that I should exercise. And then to shut me up, I think, because I was objecting loudly, he told my doc to put me on Periactin.
Needless to say, I was crushed, and I left the doctor's office in tears. It must have been so easy for him to blame the patient instead of simply admitting he didn't know how to help me. I'm still crushed now, but mostly I'm mad for having allowed myself to be brushed off like that.
Now, I am a newlywed of 1 1/2 years. And there IS something wrong with our relationship - WE AREN'T HAVING SEX!!! But now it's eating at me, and I must admit I've wondered before, could this be my physiological reaction to something inherently wrong with our relationship? I discussed it just this week with my therapist (because how can you NOT think this at some point, right?) and we concluded that given the way I feel - never think about sex, could care less if my husband touches me, grossed out by the whole act in general, rarely achieve orgasm - that it is indeed a side effect of meds. But I was wondering if any of you have ever had the same thought and how did you deal with it? The lack of sex is hurting our relationship enough - I don't want to add to it by thinking that deep down I don't love my husband. I am so embarassed and ashamed of myself for even thinking it! I hate this attending for his attitude!!
One other thing, though. I started the Wellbutrin at Christmas, and about six weeks into it I had two GREAT weeks - my libido was back, I enjoyed being with my husband, could achieve orgasm - I haven't felt like that for 3 years!! And then it went away. We raised the dose from 300 to 400, but that feeling hasn't come back yet. We've now lowered the dosage of Wellbutrin back to 300 and added the Periactin in hopes of recapturing those two weeks. Any thoughts? (Incidentally, this particular occurrence is what makes me really believe that what I feel are indeed side effects.)
Thanks for reading and thanks in advance for your thoughts.
Jennie W.
Posted by Daveman on March 29, 2001, at 21:56:06
In reply to Newbie with question about sexual side effects, posted by Jennie W. on March 29, 2001, at 20:41:05
Hi Jeannie:
Why would your doctor prescribe an antihistamine for your condition? That's what Periactin (generic- cyproheptadine hydrochloride) is.
Dave
> Hi all! Gee, I am really glad I found this site!! I have been browsing through the archives for a few days now, and you all have been really helpful and you don't even know me yet!! Thanks!! I think I'll just jump right in here, because I sure could use some support from people who have been where I am now...
>
> I have been dealing with sexual side effects for three years now (on Prozac, on Celexa, on Celexa with wellbutrin and/or buspar added on, on Serzone, and now on Wellbutrin alone). I went to my psychdoc yesterday, armed to the hilt with printouts of info on various drug options that I had heard about in your archives here. My psychdoc's attending, however, came in and said basically that my lack of sex drive was caused because of something in my relationship with my husband; that he would not take me off Wellbutrin because it was helping the depression; and that I should exercise. And then to shut me up, I think, because I was objecting loudly, he told my doc to put me on Periactin.
>
> Needless to say, I was crushed, and I left the doctor's office in tears. It must have been so easy for him to blame the patient instead of simply admitting he didn't know how to help me. I'm still crushed now, but mostly I'm mad for having allowed myself to be brushed off like that.
>
> Now, I am a newlywed of 1 1/2 years. And there IS something wrong with our relationship - WE AREN'T HAVING SEX!!! But now it's eating at me, and I must admit I've wondered before, could this be my physiological reaction to something inherently wrong with our relationship? I discussed it just this week with my therapist (because how can you NOT think this at some point, right?) and we concluded that given the way I feel - never think about sex, could care less if my husband touches me, grossed out by the whole act in general, rarely achieve orgasm - that it is indeed a side effect of meds. But I was wondering if any of you have ever had the same thought and how did you deal with it? The lack of sex is hurting our relationship enough - I don't want to add to it by thinking that deep down I don't love my husband. I am so embarassed and ashamed of myself for even thinking it! I hate this attending for his attitude!!
>
> One other thing, though. I started the Wellbutrin at Christmas, and about six weeks into it I had two GREAT weeks - my libido was back, I enjoyed being with my husband, could achieve orgasm - I haven't felt like that for 3 years!! And then it went away. We raised the dose from 300 to 400, but that feeling hasn't come back yet. We've now lowered the dosage of Wellbutrin back to 300 and added the Periactin in hopes of recapturing those two weeks. Any thoughts? (Incidentally, this particular occurrence is what makes me really believe that what I feel are indeed side effects.)
>
> Thanks for reading and thanks in advance for your thoughts.
>
> Jennie W.
Posted by ItsJustMe on March 29, 2001, at 22:09:55
In reply to Newbie with question about sexual side effects, posted by Jennie W. on March 29, 2001, at 20:41:05
hi - its hard for me to remember what prozac and wellbutrin did to my sex drive, but when i was on effexor xr, i had absolutely NO desire - the weird thing is that i dont even wake up with the ol' morning "wood" anymore *deep in thought* hmmmm...
anyway, since im not in a relationship, i guess i consider myself to be lucky (i dont have to feel like im going without sex), but since you are married, im sorry that you are having these side effects
anyway, i dont really know what to tell you, other than you are not alone
dave
> Hi all! Gee, I am really glad I found this site!! I have been browsing through the archives for a few days now, and you all have been really helpful and you don't even know me yet!! Thanks!! I think I'll just jump right in here, because I sure could use some support from people who have been where I am now...
>
> I have been dealing with sexual side effects for three years now (on Prozac, on Celexa, on Celexa with wellbutrin and/or buspar added on, on Serzone, and now on Wellbutrin alone). I went to my psychdoc yesterday, armed to the hilt with printouts of info on various drug options that I had heard about in your archives here. My psychdoc's attending, however, came in and said basically that my lack of sex drive was caused because of something in my relationship with my husband; that he would not take me off Wellbutrin because it was helping the depression; and that I should exercise. And then to shut me up, I think, because I was objecting loudly, he told my doc to put me on Periactin.
>
> Needless to say, I was crushed, and I left the doctor's office in tears. It must have been so easy for him to blame the patient instead of simply admitting he didn't know how to help me. I'm still crushed now, but mostly I'm mad for having allowed myself to be brushed off like that.
>
> Now, I am a newlywed of 1 1/2 years. And there IS something wrong with our relationship - WE AREN'T HAVING SEX!!! But now it's eating at me, and I must admit I've wondered before, could this be my physiological reaction to something inherently wrong with our relationship? I discussed it just this week with my therapist (because how can you NOT think this at some point, right?) and we concluded that given the way I feel - never think about sex, could care less if my husband touches me, grossed out by the whole act in general, rarely achieve orgasm - that it is indeed a side effect of meds. But I was wondering if any of you have ever had the same thought and how did you deal with it? The lack of sex is hurting our relationship enough - I don't want to add to it by thinking that deep down I don't love my husband. I am so embarassed and ashamed of myself for even thinking it! I hate this attending for his attitude!!
>
> One other thing, though. I started the Wellbutrin at Christmas, and about six weeks into it I had two GREAT weeks - my libido was back, I enjoyed being with my husband, could achieve orgasm - I haven't felt like that for 3 years!! And then it went away. We raised the dose from 300 to 400, but that feeling hasn't come back yet. We've now lowered the dosage of Wellbutrin back to 300 and added the Periactin in hopes of recapturing those two weeks. Any thoughts? (Incidentally, this particular occurrence is what makes me really believe that what I feel are indeed side effects.)
>
> Thanks for reading and thanks in advance for your thoughts.
>
> Jennie W.
Posted by Jennie W. on March 30, 2001, at 4:29:00
In reply to Re: Newbie with question about sexual side effects, posted by Daveman on March 29, 2001, at 21:56:06
Hi Dave,
Well, from what I've read on this board and on the internet, Periactin can be used sort of as an 'antidote' for sexual side effects. I guess it can also be used to decrease nightmares. Go figure, huh? Haven't filled the prescription yet, but I'll let you know if it works.Jennie
Hi Jeannie:
Why would your doctor prescribe an antihistamine for your condition? That's what Periactin (generic- cyproheptadine hydrochloride) is.
Dave
Posted by Greg A. on March 30, 2001, at 14:16:33
In reply to Newbie with question about sexual side effects, posted by Jennie W. on March 29, 2001, at 20:41:05
Jennie,
After quite a few years on various ADs my experience is that there is a range of sexual effects. Like you I am married, but for a considerably longer period. After 21 years we are hardly newlyweds. Our sex life prior to ADs was pretty good. It was something we both enjoyed. The immediate effect of SSRIs on me was difficulty in reaching orgasm, which for a male could be bad news. The effect was more pronounced with some drugs than with others. Wellbutrin does not seem to have nearly the effect on orgasm. Neither does Remeron. Both are of course non SSRI. When you say that your libido returned – that’s good news, even for a two week period because I am sure you can experiment and tweak the meds. to allow you those same feelings for a longer term. When you say you were “generally disgusted by the act” it brings to mind other problems. I know after we had our children and my wife put on weight I kind of lost interest in sex for awhile. The change in her appearance made her feel less desirable, so she did little to arouse my interest, and dealing with small kids takes a lot of the energy that used to remain at the end of the day at bedtime. Have a look at some of the other things going on in your life as well as the meds. Talk to you husband about how you are feeling. If he just feels rejected, he may decide to ignore you and then nothing will happen.
Good luck
Greg
Posted by Jennie W. on March 30, 2001, at 14:41:00
In reply to Re: Newbie with question about sexual side effects, posted by Greg A. on March 30, 2001, at 14:16:33
Thanks Greg, for your honesty! I think the weight issue that you touched upon is fairly accurate for me. I have felt really awful about my appearance because since I met my husband five years ago, I have put on about 25 lbs. due to the meds and depression in general. However, a positive about Wellbutrin is that I have now lost 7 pounds, and i am feeling SO much better about myself! I'm hoping this will help in the grand scheme of things.
I must admit that he is terrificly understanding about my low libido. He insists that it doesn't matter to him. I think I now just have so much anxiety over not fitting that newlywed 'myth' of having sex all the time, that this must somehow be affecting my desire on some level. And we did used to enjoy sex before the meds and depression came into the picture, so I have hope.
I also agree that I should just be able to tweak my meds and hopefully regain some of that two week period. I'm just not sure what the right dosage would be.
Thanks again,
Jennie> Jennie,
>
> After quite a few years on various ADs my experience is that there is a range of sexual effects. Like you I am married, but for a considerably longer period. After 21 years we are hardly newlyweds. Our sex life prior to ADs was pretty good. It was something we both enjoyed. The immediate effect of SSRIs on me was difficulty in reaching orgasm, which for a male could be bad news. The effect was more pronounced with some drugs than with others. Wellbutrin does not seem to have nearly the effect on orgasm. Neither does Remeron. Both are of course non SSRI. When you say that your libido returned – that’s good news, even for a two week period because I am sure you can experiment and tweak the meds. to allow you those same feelings for a longer term. When you say you were “generally disgusted by the act” it brings to mind other problems. I know after we had our children and my wife put on weight I kind of lost interest in sex for awhile. The change in her appearance made her feel less desirable, so she did little to arouse my interest, and dealing with small kids takes a lot of the energy that used to remain at the end of the day at bedtime. Have a look at some of the other things going on in your life as well as the meds. Talk to you husband about how you are feeling. If he just feels rejected, he may decide to ignore you and then nothing will happen.
>
> Good luck
>
> Greg
Posted by Sunnely on March 30, 2001, at 23:21:37
In reply to Re: Newbie with question about sexual side effects, posted by Jennie W. on March 30, 2001, at 4:29:00
Hi Jeannie,
Cyproheptadine (Periactin) is an antihistamine and a serotonin receptor antagonist (5HT2). It is one of the agents prescribed to alleviate antidepressant-induced sexual dysfunctions (e.g., decreased libido and lack of orgasm). Sexual disturbances are common side effects of SSRIs. These are supposedly due to their serotonin-enhancing effect which cyproheptadine supposedly counteracts. For SRI-induced (serotonin-reuptake inhibitor) sexual side effects, cyproheptadine is usually prescribed between 2 to 8 mg daily or 4 mg to 12 mg as needed, 1-2 hours before sexual activity. A couple of caveats though: 1) because of its histaminic- and serotonin-blocking effect, it can cause sedation; also increase one's appetite and subsequently, weight gain, and 2) due to its serotonin antagonism, may decrease the antidepressant effect of the SRIs, hence causing relapse of depression. (There have been anecdotal reports of depression and suicidal thoughts with use of cyproheptadine.)
If you are no longer on an SRI (currently on Wellbutrin), I am not clear as to why cyproheptadine was added since Wellbutrin does not have serotonin-enhancing effect and therefore does not induce sexual side effects via this pathway. In fact, because of its dopaminergic effect (mediates pleasure, increases sex drive, and promotes orgasm), Wellbutrin is sometimes considered a pro-sexual drug.
There have been reports that cyproheptadine is effective for treating PTSD (posttraumatic stress disorder)-related nightmares. On the other hand, in one VA study in 1999, cypropheptadine was found generally ineffective for treating nightmares and was often poorly tolerated (fatigue, restlessness, worsening nightmares).
Finally, since cyproheptadine has serotonin antagonism, it is sometimes used as an "antidote" to serotonin syndrome, a potentially serious reaction usually engendered by the combined use of serotonin-enhancing drugs.
+++++++++++++++++++++++
> Hi Dave,
> Well, from what I've read on this board and on the internet, Periactin can be used sort of as an 'antidote' for sexual side effects. I guess it can also be used to decrease nightmares. Go figure, huh? Haven't filled the prescription yet, but I'll let you know if it works.
>
> Jennie
>
> Hi Jeannie:
>
> Why would your doctor prescribe an antihistamine for your condition? That's what Periactin (generic- cyproheptadine hydrochloride) is.
>
> Dave
Posted by hopko on March 31, 2001, at 10:51:52
In reply to Newbie with question about sexual side effects, posted by Jennie W. on March 29, 2001, at 20:41:05
Jennie, when I was on effexor xr I lost my ability to have an orgasm (but not my desire to try!) Before saying anything else, I will say my dose was very low (75mg) compared to what many people take. Actually, my orgasms stopped at 37.5 mg within 3 days of starting this med! Anyway, I do not have the study to back up what I am going to tell you (maybe someone else does) but here is what my psychiatrist told me (about the only good thing he did for me!). He says that there was a study that proved that ginkgo biloba helped restore sexual function in over 50% of people that had sexual dysfunction as a result of the use of AD. To try this approach, the starting dose was 60mg in the morning and 60 at night and that it can take up to 4 weeks to be effective. After 4 weeks if this dose is not working it can be doubled and then doubled again.
I started with this regime but found that taking 60mg of ginkgo at night was too stimulating and bothered my sleep (I have sever insomnia) so I took 120 in the morning. Sure enough, after 4 weeks, I was able to achieve orgasm again.
This seems to be a simple thing to try and perhaps safer than adding more meds to your body. I do know that ginkgo can interact with other meds and is contraindicated with some medical conditions, so it would probably be prudent to ask someone (like a pharmacist) before you try this.If anyone out there has more concrete information about this, I am sure it would be appreciated but I do know it worked for me.
Posted by Jennie W. on April 1, 2001, at 14:42:59
In reply to Re: Newbie with question about sexual side effects » Jennie W., posted by Sunnely on March 30, 2001, at 23:21:37
Hi Sunnely,
Now that is really interesting! I have not started taking the Periactin yet, and now I'm not sure if I ever will...this just underscores my belief that this attending didn't have any answers for me and didn't care...and my resident psychdoc told me flat out that she'd never heard of Periactin, so she didn't know how it worked, either. I SO need another doc!!!! Thanks so much for the info!!Jennie
> If you are no longer on an SRI (currently on Wellbutrin), I am not clear as to why cyproheptadine was added since Wellbutrin does not have serotonin-enhancing effect and therefore does not induce sexual side effects via this pathway. In fact, because of its dopaminergic effect (mediates pleasure, increases sex drive, and promotes orgasm), Wellbutrin is sometimes considered a pro-sexual drug.
Posted by Jennie W. on April 1, 2001, at 14:48:25
In reply to Re: Newbie with question about sexual side effects, posted by hopko on March 31, 2001, at 10:51:52
Hi Hopko,
I have heard of this before...actually, I think there is a good article by Gitlin, I believe, which is available on Medscape that discusses some of these findings. The article in general talks about Wellbutrin as the solution to SSRI sexual side effects, but reviews other antidotes like yohimbine and ginko as well. He suggests Wellbutrin over both of these, but now that I know that Wellbutrin isn't really helping me, it may be time to try ginko. Thanks for reminding me.Jennie
Anyway, I do not have the study to back up what I am going to tell you (maybe someone else does) but here is what my psychiatrist told me (about the only good thing he did for me!). He says that there was a study that proved that ginkgo biloba helped restore sexual function in over 50% of people that had sexual dysfunction as a result of the use of AD. To try this approach, the starting dose was 60mg in the morning and 60 at night and that it can take up to 4 weeks to be effective. After 4 weeks if this dose is not working it can be doubled and then doubled again.
>
> I started with this regime but found that taking 60mg of ginkgo at night was too stimulating and bothered my sleep (I have sever insomnia) so I took 120 in the morning. Sure enough, after 4 weeks, I was able to achieve orgasm again.
> This seems to be a simple thing to try and perhaps safer than adding more meds to your body. I do know that ginkgo can interact with other meds and is contraindicated with some medical conditions, so it would probably be prudent to ask someone (like a pharmacist) before you try this.
>
> If anyone out there has more concrete information about this, I am sure it would be appreciated but I do know it worked for me.
This is the end of the thread.
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