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Dr. Bob is Robert Hsiung, MD,
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Posted by Gaillardia on October 16, 2002, at 12:07:10
In reply to Re: 20%?, posted by Phil on August 1, 2002, at 6:15:48
> pharmrep, Are you saying Celexa is around 20% sexual dysfunction, mostly delayed ejaculation?
> Or are you saying only 20% will talk about it?
> I would think in the real world that it's 50-70%.
> And from personal experience, the sexual problems are more varied. I'm taking 40mg, down from 60mg and don't even think about getting as far as ejaculation. I take Wellbutrin and Adderall and Viagra occasionally and I've still written off sex. It's so frustrating, it's not worth the effort.
> I cannot believe the numbers that companies get away with putting on package inserts.
> Do you, as a rep, encourage doctors to bring the subject up with patients or does every rep say, well, patients just don't want to talk about it.
> If you know that's true, why don't $200.00 an hour psychiatrists bring the subject up? I think that nobody, including drug companies and doctors, want to bring it up. It's difficult to say anything in a 15 minute med check.
>
> Is Forest aggressively trying to overCOME this problem? The first company that makes an effective AD without this SE will never have cash flow problems again. I'm sure pharm co. are aware that they could make a fortune.
>
> What's the figure going to be on Lexapro..2%?
> Have you ever been on meds? Does your company realize that the choice we are given is semi-normalcy at the expense of sex? Semi-normalcy at the expense of 100% apathy?
> Not trying to blame you for the world's depression problems but after 20 of my best years spent on meds, it's all getting a bit tiresome.
>
> PhilAs a psychotherapist (social worker)I routinely ask about s/e to SSRI's. I routinely ask "any sexual problems?" I have strong opinions about the numbers given, and have argued with many doc's abt the true rates of sexual s/e related to orgasm/ejaculation problems and reduced sex drive. Anecdotally, I find the rate of sexual s/e's to be at least 80% to any given ssri, with Effexor perhaps being slightly lower. I want to learn much more abt these new meds for my clientele! SSRI's have changed and saved millions of lives, I expect, although I agree with the studies that indicate antidepressants aren't longterm effective without therapy. Anyone left out there reading this? Any thoughts? --Gail
Posted by emmalie on October 16, 2002, at 13:44:49
In reply to Re: 20%?, posted by Gaillardia on October 16, 2002, at 12:07:10
An anecdote: I've had many friends on SSRIs over the years and I have yet to meet a single person who doesn't complain about reduced sex drive/difficulty achieving orgasm.
Posted by pharmrep on October 16, 2002, at 14:20:35
In reply to Re: 20%?, posted by Gaillardia on October 16, 2002, at 12:07:10
What's the figure going to be on Lexapro..2%?
>
> As a psychotherapist (social worker)I routinely ask about s/e to SSRI's. I routinely ask "any sexual problems?" I have strong opinions about the numbers given, and have argued with many doc's abt the true rates of sexual s/e related to orgasm/ejaculation problems and reduced sex drive. Anecdotally, I find the rate of sexual s/e's to be at least 80% to any given ssri, with Effexor perhaps being slightly lower. I want to learn much more abt these new meds for my clientele! SSRI's have changed and saved millions of lives, I expect, although I agree with the studies that indicate antidepressants aren't longterm effective without therapy. Anyone left out there reading this? Any thoughts? --Gail** The Lexapro study donelast year showed 9%.. is that a bid selling point? No. Sexual s/e are a class effect, only Paxil seems to be a little worse than the rest (prozac/celexa/zoloft/effexor all seem to be about the same...including lexapro so far) The "volunteered" info from the FDA studies from 10+ yrs ago were grossly off since it was not commonly shared for whatever reason. so the 6% -12% range was more like 25%-50% in reality...whether the 9% from just 1 year ago for lexapro holds up (since the topic is hot and the info more readily shared) has yet to be seen...I imagine it will be higher, but not as bad as paxil...it will take time to see, but this is not at all the selling point...the greater efficacy, increased potency, quicker onset of action, s/e and discontinuation due to adverse events comparable to placebo, and least expensive branded ssri are the selling points.
(ps..I know the meds are involved, but have you considered the pre-existing % of sex s/e?...80% seems a little high.)
Posted by ANXIETY ANN on October 16, 2002, at 14:36:04
In reply to Re: 20%? » Gaillardia, posted by pharmrep on October 16, 2002, at 14:20:35
Hi
well its been 10 days now and most of my s/e are gone. I still have sexual s/e that are very frustrating. I"m hoping that the inability to have an orgasim will go away soon! My anxiety (the reason for taking Lexapro)is less, although I have yet to work up the courage to leave my comfort zone by myself. I finally got a good nights sleep last night , the first since starting Lexapro. If I had to rate my response to the drug, I would have to say I'd give it a 7.
How is everyone else doing?
Posted by Gaillardia on October 16, 2002, at 15:02:01
In reply to Re: 20%? » Gaillardia, posted by pharmrep on October 16, 2002, at 14:20:35
Once again anecdotally, because I am not citing any structured study here, I have seen hundreds of people on SSRI's from their outset. I agree that Paxil, and I think Zoloft too, are at the top when it comes to sexual s/e's. However, it is a rare occurrence when someone does NOT have sexual s/e on an SSRI in my observation. I do ask about prior experiences with sexual response, always asking "Is this a change from normal for you?" I'm actually being conservative saying 80%, but considering the people who were sexually dysfunctional previously, or for whom sexual response is not an issue, almost all people experience a decrease in sex drive and ability to have an orgasm/ejaculate. And when you say that decreasing sexual s/e is not the point, come into the ranks with me. That is definitely the main reason that people want to take something else! When people suffering from depression have to chose between decreasing their symptoms of depression and having orgasms, it becomes a very difficult choice! I am not hostile here, I just wish I could tell you exactly how many times I have struggled with that issue with clients, and they have longed for an antidepressant that worked without often severe impact on their sex life. --Gail
Posted by pharmrep on October 16, 2002, at 15:36:26
In reply to Re: 20%? » Gaillardia, posted by pharmrep on October 16, 2002, at 14:20:35
> What's the figure going to be on Lexapro..2%?
> >
> > As a psychotherapist (social worker)I routinely ask about s/e to SSRI's. I routinely ask "any sexual problems?" I have strong opinions about the numbers given, and have argued with many doc's abt the true rates of sexual s/e related to orgasm/ejaculation problems and reduced sex drive. Anecdotally, I find the rate of sexual s/e's to be at least 80% to any given ssri, with Effexor perhaps being slightly lower. I want to learn much more abt these new meds for my clientele! SSRI's have changed and saved millions of lives, I expect, although I agree with the studies that indicate antidepressants aren't longterm effective without therapy. Anyone left out there reading this? Any thoughts? --Gail
>
> ** The Lexapro study donelast year showed 9%.. is that a bid selling point? No. Sexual s/e are a class effect, only Paxil seems to be a little worse than the rest (prozac/celexa/zoloft/effexor all seem to be about the same...including lexapro so far) The "volunteered" info from the FDA studies from 10+ yrs ago were grossly off since it was not commonly shared for whatever reason. so the 6% -12% range was more like 25%-50% in reality...whether the 9% from just 1 year ago for lexapro holds up (since the topic is hot and the info more readily shared) has yet to be seen...I imagine it will be higher, but not as bad as paxil...it will take time to see, but this is not at all the selling point...the greater efficacy, increased potency, quicker onset of action, s/e and discontinuation due to adverse events comparable to placebo, and least expensive branded ssri are the selling points.
>
> (ps..I know the meds are involved, but have you considered the pre-existing % of sex s/e?...80% seems a little high.)*** i said "selling point" not just point in general. I know this is a tough se to work with, and that it is a "class effect"...I was saying that the other ssri's have the same challenge and that there are other ways lexapro separates itself from them. sexual side effects is not the main selling point.
Posted by Abacus on October 16, 2002, at 18:08:33
In reply to Re: ten days on Lexapro, posted by ANXIETY ANN on October 16, 2002, at 14:36:04
Fifteen days for me and it is going very well -- I could almost see the fog lift a couple of days ago.
> Hi
> well its been 10 days now and most of my s/e are gone. I still have sexual s/e that are very frustrating. I"m hoping that the inability to have an orgasim will go away soon! My anxiety (the reason for taking Lexapro)is less, although I have yet to work up the courage to leave my comfort zone by myself. I finally got a good nights sleep last night , the first since starting Lexapro. If I had to rate my response to the drug, I would have to say I'd give it a 7.
> How is everyone else doing?
Posted by mudbunny on October 16, 2002, at 18:33:37
In reply to Re: ten days on Lexapro, posted by ANXIETY ANN on October 16, 2002, at 14:36:04
Hi I have been on lex for 3 weeks everythings great except the orgasims that is so frustrating. I hope it changes soon Im only 31
Posted by Phil on October 16, 2002, at 19:29:27
In reply to Re: 20%?, posted by Gaillardia on October 16, 2002, at 15:02:01
Nicotine's not addictive and our products aren't harmful.
Our SSRI's don't cause over 9-5-2% sexual side effects. It's false and it's a major, major lie to the AD consumer. Tell us the real story on everything, period.
Posted by Caydi on October 16, 2002, at 20:00:52
In reply to Re: 20%?, posted by emmalie on October 16, 2002, at 13:44:49
> An anecdote: I've had many friends on SSRIs over the years and I have yet to meet a single person who doesn't complain about reduced sex drive/difficulty achieving orgasm.
i think i do have a reduced sex drive, but i've found that once i "get going" i'm alright. it doesnt take any more effort/time to get to that point either, it's just that i dont really think about it much. it hasnt become a bother for me at all.
just another 2cents from me. :)
Posted by meow mary on October 16, 2002, at 21:36:33
In reply to Re: 20%?, posted by Caydi on October 16, 2002, at 20:00:52
Posted by utopizen on October 16, 2002, at 23:04:45
In reply to I Think You All Should Be Happy You're Having Sex (nm), posted by meow mary on October 16, 2002, at 21:36:33
I was so holding that comment in my head for like 4 straight months with this board... =P
Posted by FredPotter on October 16, 2002, at 23:48:18
In reply to Re: I Think You All Should Be Happy You're Having , posted by utopizen on October 16, 2002, at 23:04:45
Posted by shakingoscar on October 17, 2002, at 1:16:02
In reply to Re: 20%?, posted by Gaillardia on October 16, 2002, at 15:02:01
Here here. I couldnt have worded that better myself.
I have been on ssri's for two years and Im thinking of trying Remeron solely to see if I get a sex life back!
Where sex is concerned, ssri's absolutely suck.
> Once again anecdotally, because I am not citing any structured study here, I have seen hundreds of people on SSRI's from their outset. I agree that Paxil, and I think Zoloft too, are at the top when it comes to sexual s/e's. However, it is a rare occurrence when someone does NOT have sexual s/e on an SSRI in my observation. I do ask about prior experiences with sexual response, always asking "Is this a change from normal for you?" I'm actually being conservative saying 80%, but considering the people who were sexually dysfunctional previously, or for whom sexual response is not an issue, almost all people experience a decrease in sex drive and ability to have an orgasm/ejaculate. And when you say that decreasing sexual s/e is not the point, come into the ranks with me. That is definitely the main reason that people want to take something else! When people suffering from depression have to chose between decreasing their symptoms of depression and having orgasms, it becomes a very difficult choice! I am not hostile here, I just wish I could tell you exactly how many times I have struggled with that issue with clients, and they have longed for an antidepressant that worked without often severe impact on their sex life. --Gail
Posted by Phil on October 17, 2002, at 6:15:35
In reply to I Think You All Should Be Happy You're Having Sex (nm), posted by meow mary on October 16, 2002, at 21:36:33
Just because someone is discussing orgasms, it doesn't necessarily mean they're with someone else at the time.
If you're lucky enough to have sex but can't orgasm, you aren't going to be happy for long.
Posted by maririp on October 17, 2002, at 7:41:17
In reply to Re: 20%?, posted by shakingoscar on October 17, 2002, at 1:16:02
> Here here. I couldnt have worded that better myself.
>
> I have been on ssri's for two years and Im thinking of trying Remeron solely to see if I get a sex life back!
>
> Where sex is concerned, ssri's absolutely suck.
>
>
> > Once again anecdotally, because I am not citing any structured study here, I have seen hundreds of people on SSRI's from their outset. I agree that Paxil, and I think Zoloft too, are at the top when it comes to sexual s/e's. However, it is a rare occurrence when someone does NOT have sexual s/e on an SSRI in my observation. I do ask about prior experiences with sexual response, always asking "Is this a change from normal for you?" I'm actually being conservative saying 80%, but considering the people who were sexually dysfunctional previously, or for whom sexual response is not an issue, almost all people experience a decrease in sex drive and ability to have an orgasm/ejaculate. And when you say that decreasing sexual s/e is not the point, come into the ranks with me. That is definitely the main reason that people want to take something else! When people suffering from depression have to chose between decreasing their symptoms of depression and having orgasms, it becomes a very difficult choice! I am not hostile here, I just wish I could tell you exactly how many times I have struggled with that issue with clients, and they have longed for an antidepressant that worked without often severe impact on their sex life. --Gail
>
It would be nice if they could invest all the money they make on these drugs on how to improve the sexual side effects. I took remeron for a while and frankly I didnt want to even kiss my boyfriend..it also put weight on me faster than any pill I have ever taken..I must have gained 15 pounds in two months. Its too early for me to tell what effects lexapro will have on my orgasms, but every other antidepressant I have taken, especially paxil ruined orgasms. Its so true too, its nice to feel better but to have to choose between that and sharing an orgasm with someone you love is not an easy choice. I didnt take any for about 3 years because i grew too frustrated.
Posted by maririp on October 17, 2002, at 7:47:41
In reply to Re: Who said anything about sex?, posted by Phil on October 17, 2002, at 6:15:35
> Just because someone is discussing orgasms, it doesn't necessarily mean they're with someone else at the time.
>
> If you're lucky enough to have sex but can't orgasm, you aren't going to be happy for long.Amen to that.I never thought sex had anything to do with luck. Its sharing intimacy with someone with the goal of orgasms. Not having any time after time does cause a great deal of frustration. Its not just about the person who can't have one its about the person that loves you as well and thinks it must have something to do with him/her. People who love each other want their partner satisfied.
Posted by shakingoscar on October 17, 2002, at 7:59:35
In reply to sex and orgasms, posted by maririp on October 17, 2002, at 7:41:17
Hi Maririp,
you said you didnt want to kiss your boyfriend whilst taking remeron...But... could you orgasm?? Does it affect males the same way do you know?
> > Here here. I couldnt have worded that better myself.
> >
> > I have been on ssri's for two years and Im thinking of trying Remeron solely to see if I get a sex life back!
> >
> > Where sex is concerned, ssri's absolutely suck.
> >
> >
> > > Once again anecdotally, because I am not citing any structured study here, I have seen hundreds of people on SSRI's from their outset. I agree that Paxil, and I think Zoloft too, are at the top when it comes to sexual s/e's. However, it is a rare occurrence when someone does NOT have sexual s/e on an SSRI in my observation. I do ask about prior experiences with sexual response, always asking "Is this a change from normal for you?" I'm actually being conservative saying 80%, but considering the people who were sexually dysfunctional previously, or for whom sexual response is not an issue, almost all people experience a decrease in sex drive and ability to have an orgasm/ejaculate. And when you say that decreasing sexual s/e is not the point, come into the ranks with me. That is definitely the main reason that people want to take something else! When people suffering from depression have to chose between decreasing their symptoms of depression and having orgasms, it becomes a very difficult choice! I am not hostile here, I just wish I could tell you exactly how many times I have struggled with that issue with clients, and they have longed for an antidepressant that worked without often severe impact on their sex life. --Gail
> >
> It would be nice if they could invest all the money they make on these drugs on how to improve the sexual side effects. I took remeron for a while and frankly I didnt want to even kiss my boyfriend..it also put weight on me faster than any pill I have ever taken..I must have gained 15 pounds in two months. Its too early for me to tell what effects lexapro will have on my orgasms, but every other antidepressant I have taken, especially paxil ruined orgasms. Its so true too, its nice to feel better but to have to choose between that and sharing an orgasm with someone you love is not an easy choice. I didnt take any for about 3 years because i grew too frustrated.
>
>
Posted by mills on October 17, 2002, at 9:08:07
In reply to Re: Who said anything about sex?, posted by maririp on October 17, 2002, at 7:47:41
Imagine the money we could make if we could come up with an SSRI that did not cause sexual side effects. Zowee! You've got to know "they" are working on it, and if not, pharmrep should be banging on his President's office door and forwarding them these posts.
Posted by johnj on October 17, 2002, at 9:10:19
In reply to Re: sex and orgasms, posted by shakingoscar on October 17, 2002, at 7:59:35
I could have an orgasm while on remeron, but they were not satisfying at all. Something was blunted, well everything was blunted on remeron. Sometimes I think having an orgasm on remeron was more frustrating than not having sex. That crap about remeron not affecting orgasm is bull. Yes, you might have them, but they felt like nothing.
johnj
Posted by pharmrep on October 17, 2002, at 10:27:40
In reply to Re: Drug company / Tobacco company. » Gaillardia, posted by Phil on October 16, 2002, at 19:29:27
Just because someone is discussing orgasms, it doesn't necessarily mean they're with someone else at the time.
If you're lucky enough to have sex but can't orgasm, you aren't going to be happy for long.
> Nicotine's not addictive and our products aren't harmful.
> Our SSRI's don't cause over 9-5-2% sexual side effects. It's false and it's a major, major lie to the AD consumer. Tell us the real story on everything, period.** one step at a time Phil..."real" story...it's no secret that many ad's have sexual side effects, the people that have them often have a tough balance, but would rather be able to get out of bed, have a life, keep a job, and actually have sex (with somebody)....why are you ripping on me? Im here to help, not be your punching bag.
Posted by trmpqwn on October 17, 2002, at 10:54:45
In reply to Re: sex and orgasms » shakingoscar, posted by johnj on October 17, 2002, at 9:10:19
note my earlier post...I am not having sexual side effects on Lexapro!!!!! I did initially but after a few weeks, back to normal. Have hope....and patience.
Posted by maririp on October 17, 2002, at 11:29:51
In reply to Re: sex and orgasms » shakingoscar, posted by johnj on October 17, 2002, at 9:10:19
> I could have an orgasm while on remeron, but they were not satisfying at all. Something was blunted, well everything was blunted on remeron. Sometimes I think having an orgasm on remeron was more frustrating than not having sex. That crap about remeron not affecting orgasm is bull. Yes, you might have them, but they felt like nothing.
> johnjI agree with john completely, I had orgasms but they were not good ones and frankly at times i would think is that it?? I also had no desire for allot of forepay. On remeron all i did was eat constantly...too bad that doesnt give orgasms..hahaha..anyway..I would not recommend remeron.
Posted by pharmrep on October 17, 2002, at 12:11:19
In reply to Re: sex and orgasms, posted by maririp on October 17, 2002, at 11:29:51
*** anyone heard of this one? I asked this one DR what hid did for people having difficulty w/ orgasms...and he told me that for guys, he would give an injection once a month of testosterone (250-500mg)...he said that after that his male pts did have ejac. probs anymore.
Posted by meow mary on October 17, 2002, at 12:12:12
In reply to Re: Who said anything about sex?, posted by Phil on October 17, 2002, at 6:15:35
Boy, you really can't say anything around here without getting into trouble with someone. Of course I realize the tragedy of inability to orgasm on SSRI's--I experience it myself. Maybe I meant it's all a matter of perspective--if you're with someone who's caring about whether you do or don't orgasm I still think you're lucky. And having sex with yourself isn't the worst thing in the world either.
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