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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 7 of 7. This is the beginning of the thread.
Posted by Prozac Pro on August 31, 2010, at 11:13:36
Hello-
I am posting to find out what SSRI users are doing these days to manage the sexual side-effects of SSRIs.I had a severe depressive episode in 1995, that was cured with fluoxetine and lithium. I tapered off of the lithium after two years, and remained depression-free on fluoxetine alone. Around 2006, I was diagnosed with adult ADHD, and started Adderall XR 30 mg/day.
My libido and erectile function gradually diminished on fluoxetine, especially over the last three years, which is, coincidentally or not, when I started the Adderall XR. I tapered off the meds AMA in April-June of this year. Sexual function was starting to return, when depression hit me like a sledgehammer. Prozac didn't touch it, but Lithium worked like a miracle drug. I'm back on the Adderall XR, too.
Those nascent sexual urges are now gone. I'm resigned to a lifetime of SSRI therapy, so I'd like to know what others have done with success (or not) to manage this problem.
A few ideas:
1. Might a short-acting Adderall as needed work (by increasing dopamine). As things are, I take Adderall XR in the AM, and it's all worn off by bedtime.
2. Pull the Adderall XR, and initiate bupropion? I know some people have had success with bupropion for both ADHD and SSRI side effects. I asked my p-doc to give me a tral od bupropion in lieu of Adderall XR, and he was resistant to the idea.
3. Try another SSRI? However, my understanding is that fluoxetine is considered to be more benign than most other SSRIs in regards to sexual side effects.
4. Try an antidote med, preferably OTC? I tried a few days of loratadine once, and all I got was a headache. Anyone try diphenhydramine?
5. Try a nutritional supplement? I've dabbled with maca, with no luck. Maybe I wasn't taking enough.
I have had an improvement in erectile function with Cialis, but it doesn't do much for libido, and it makes me head-achy and miserable for a few days afterward.
I have done quite a few searches of this board, and most of the info on this issue is a few years, or more, old. Hence, I'm starting this discussion. Thanks in advance for any suggestions.
Posted by SLS on August 31, 2010, at 11:30:06
In reply to Current thinking in SSRI sexual dysfunction?, posted by Prozac Pro on August 31, 2010, at 11:13:36
Buspar (buspirone) might be helpful for maintaining libido. It is often used as an augmenter of SSRIs.
- Scott
Posted by Phillipa on August 31, 2010, at 11:35:06
In reply to Re: Current thinking in SSRI sexual dysfunction?, posted by SLS on August 31, 2010, at 11:30:06
I always thought buspar was a very weak med used instead of benzos and at doses of about 5mg? True or are there new uses for it? Phillipa
Posted by SLS on August 31, 2010, at 11:42:10
In reply to Re: Current thinking in SSRI sexual dysfunction?, posted by Phillipa on August 31, 2010, at 11:35:06
> I always thought buspar was a very weak med used instead of benzos and at doses of about 5mg? True or are there new uses for it? Phillipa
Buspirone has been used for at least a decade for SSRI induced sexual dysfunction.
http://www.ncbi.nlm.nih.gov/pubmed/10350034
- Scott
Posted by Phillipa on August 31, 2010, at 11:46:02
In reply to Re: Current thinking in SSRI sexual dysfunction? » Phillipa, posted by SLS on August 31, 2010, at 11:42:10
The doses are so much higher now. What did they discover about buspar that led to higher doses. Not trying to hyjack thread but I guess I better do a google search. Thanks Scott seems you're also doing better and thats great. Phillipa
Posted by topcatclr on August 31, 2010, at 22:54:33
In reply to Re: Current thinking in SSRI sexual dysfunction? » Phillipa, posted by SLS on August 31, 2010, at 11:42:10
I barely care anymore! Cymbalta helps so much with depression, i would not trade it for a normal sex life. If panic disorder is your problem however, Serzone worked well with NO sexual side effects.
Posted by bearfan on September 1, 2010, at 17:19:14
In reply to Current thinking in SSRI sexual dysfunction?, posted by Prozac Pro on August 31, 2010, at 11:13:36
I have nearly the exact same problem as prozac pro and can not figure out how to solve the problem.
This is the end of the thread.
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