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Dr. Bob is Robert Hsiung, MD,
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Posted by kreedi on February 28, 2002, at 9:27:59
Went to see my psychiatrist last week, who put me on 10 mg of Paxil. It was that or Celexa; he preferred paroxetine because of its greater anxiolytic properties and potential for weight gain (a bonus side-effect, if it occurs, for me). He also said that Zoloft was the "worst" SSRI in terms of sexual dysfunction side effects, and Celexa the best, with paroxetine somewhere in between. Is that true, does it match what people have experienced or read about?
10 mg is a low dose, I know, but already (7 days)I'm experiencing pretty significant sexual side effects: very long time to achieve orgasm (I'm 29, male). Previous SSRIs: Zoloft, for a couple of weeks last year, made me virtually anorgasmic; Prozac, off-and-on for years, delayed orgasm but "dealable," mostly.
When I spoke to the doctor today, he said continue on the 10 mg for another week, wait and watch.
I'm concerned that 10 mg is not really an adult therapeutic dose and that already it's causing problems. I'm assuming (correctly?) that if we up the dose to 20, the delayed-ejaculation problem will only worsen.
Should I give serious thought to switching over to Celexa after next week if the side effect remains unchanged or worsens? (I'm aware, of course, that Celexa might have its own annoying side-effect profile; I guess one has to find something that works and that one can live with.)
The other drug that I asked my psychiatrist about was Nardil, after reading the enthusiastic posts on it on this site. But obviously we went the SSRI route. Apart from the dietary restrictions and potentially fatal complications -- is Nardil "smooth," well-tolerated? Is its day-to-day side-effect profile comparable to tricyclics or SSRIs? And can it be combined with alcohol (other than beer and wine)?
Thanks for any inputs. Kreedi
Posted by kreedi on March 1, 2002, at 8:47:31
In reply to Paxil/Celexa/Nardil question, posted by kreedi on February 28, 2002, at 9:27:59
The delayed ejaculation is DEFINITELY a problem (day 9, Paxil, 10 mg). Also, I'm feeling flu-like since last night -- sore throat, tired, feverish. Could these be paroxetine related (or this is an example of attributing anything adverse to side effects)?
Kreedi
Posted by christophrejmc on March 1, 2002, at 12:34:20
In reply to Re: Paxil/Celexa/Nardil question, posted by kreedi on March 1, 2002, at 8:47:31
I haven't known anyone who hasn't had the delayed ejaculation problem (for some, it's desired) with Paxil. When I was on it, that side-effect never disappeared. If I was going to engage in sexual activity, I wouldn't take my dose that day; perhaps you could see if it helps to take it at night, after sex?
The side-effects of the MAOIs are usually between SSRIs and TCAs. The most common one is probably orthostatic (or "postural") hypotension. The diet is really no big deal; even if there is a serious problem, it is easily treatable. Quite a few people here have complained of sexual side-effects from Nardil, but I don't know how common it is.
-chris
This is the end of the thread.
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