Posted by dodo on May 21, 2003, at 0:44:31
In reply to No Libido at all with all these meds. Help?, posted by Joanie on May 19, 2003, at 12:12:29
WARNING: Long Answer! (Based on my own experience and opinions, others may see things very differently)I don't know if this will be helpful to hear, but you are not alone. I'm a male who has been struggling with libido impairment from meds for close to 10 years. I"m married and like you am very concerned about how this affects my marriage and spouse. It seems plausible that the hysterectomy and hormones could be a major, if not the main, factor in your sex drive, and I can't speak to how that might affect things or how to address it (though I know MDs are experimenting with very low dose testosterone gel for women with purely hormonal sex drive impairment). But what you DON"T need is an antidepressant that could be making things worse, and I have lots of experience dealing with this.
Here's what I've learned: Loss of libido and/or ability to orgasm is (from what I've seen) THE biggest problem people encounter with antidepressants. It seems to be most prevalent with SSRIs (I had terrible time on Prozac) and Effexor (haven't seen enough re: Lexapro) and it seems to be rare that switching among this group solves the problem. I have heard a few, mixed things about Klonopin, but so few complaints about libido impact, so I would probably put it pretty far down on thelist of things to investigate if it was me.
So what can you do about it? The top of the mind answer is to switch to (or add to other drugs) Wellbutrin. This has a reputation, backed up by substantial research, for enhancing libido, and I certainly found that it enhanced orgasms when I was taking the "normal release" form back 8-9 years ago (as a young male, I didn't know orgasms could get any better!). I'm now taking the Sustained Release and don't seem to be getting any pro-sexual effects from it, but maybe that's just me. It is frequently added to SSRIs (like prozac) but with what degree of success in practice I don't know. Certainly taking on its own you should experience, if anything, positive sexual effects.
Other drugs that appear to have much lower incidence of libido impacts are Serzone and Remeron, and possibly some of the older antidpressants like Nortryptiline and other "TCAs". (I found these older ones effective but unpleasant -- dry mouth, somnolence, etc. I probably would have stayed on them if I wasn't asleep all the time.)
So I guess this a long way of saying you DON'T have to take libido loss lying down (ha ha). There are lots of possible remedies out there but I think it's easier to start with trying different drugs than to try "workarounds" (like Yohimbine, Bethanocal (wrong sp)? can't remember all of the "folk" remedies, but they certainly aren't effective often enough to be widely used).
Are you using your GP (or OB/GYN) for med mgmt? I don't know of many psychiatrists who would suggest waiting until *11* weeks to see if a drug works. From my experience, you tend to know in 2-4 weeks; if you are really having a problem finding a drug that works, you might wait longer, but it just doesn't seem necessary for someone who has only tried one drug! Can you try to see a "P-doc"? You deserve someone who is more experienced in both these areas (depression & loss of libido) to help you deal with this more speedily.
Good luck! -- there are so many options out there from the med side of things that *something* should work for you, just a matter of finding it.
poster:dodo
thread:227640
URL: http://www.dr-bob.org/babble/20030520/msgs/228016.html