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Dr. Bob is Robert Hsiung, MD,
[email protected]Shown: posts 1 to 19 of 19. This is the beginning of the thread.
Posted by Joe_12 on April 26, 2002, at 12:52:21
I was diagnosed with an anxiety disorder a few months ago and was prescribed Effexor XR. While it did help with the anxiety, the side effects became just too much (insomnia, acne, muscle spasms, sexual problems). Some of them I could handle, but as a 20 year old male, the sexual disfunction was something I was not willing to deal with. It started as just delayed orgasm, but as time progressed it eventually became almost impossible to climax. There was also a lack of "fullness" in my erections making them more difficult to maintain.
I'm now off the Effexor and starting on Zoloft. I guess I'm just looking to get some reassurance. It seems that almost everyone on these boards taking SSRIs is experiencing the sexual side effects. Has anyone not had these problems? Or if not, has anyone had success taking other meds to counteract the problems? If so to what extent were the sexual problems improved? Thanks in advance for any input.
Posted by JonW on April 26, 2002, at 13:06:59
In reply to Anyone NOT have sexual side effects with SSRIs?, posted by Joe_12 on April 26, 2002, at 12:52:21
Hi Joe,
I've been on paxil, prozac, celexa, and zoloft and have had unacceptable sexual side-effects on all of them. However, recently I retried zoloft without any major sexual dysfunction. First, I thought it was because I was taking zyprexa at the time which blocks 2A. But now I'm taking luvox and no zyprexa and still no sexual problems! I also take neurontin and depakote, but I doubt these protect me from SD. During the past 6 months I've been on so many different meds maybe I've f*cked my brain up enough that I don't get this side-effect from SSRIs anymore... wouldn't that be nice! Does anyone have an explanation for this? 2 years ago I had complete anorgasmia but now it seems I can tolerate the SSRIs. I confuse myself. But Joe, good luck to you and maybe my news is good news!
Jon
> I was diagnosed with an anxiety disorder a few months ago and was prescribed Effexor XR. While it did help with the anxiety, the side effects became just too much (insomnia, acne, muscle spasms, sexual problems). Some of them I could handle, but as a 20 year old male, the sexual disfunction was something I was not willing to deal with. It started as just delayed orgasm, but as time progressed it eventually became almost impossible to climax. There was also a lack of "fullness" in my erections making them more difficult to maintain.
>
> I'm now off the Effexor and starting on Zoloft. I guess I'm just looking to get some reassurance. It seems that almost everyone on these boards taking SSRIs is experiencing the sexual side effects. Has anyone not had these problems? Or if not, has anyone had success taking other meds to counteract the problems? If so to what extent were the sexual problems improved? Thanks in advance for any input.
Posted by Mason on April 26, 2002, at 15:30:39
In reply to Anyone NOT have sexual side effects with SSRIs?, posted by Joe_12 on April 26, 2002, at 12:52:21
Hey Joe,
Unfortunately all I can do is add similar experiences; I haven't found any AD's that work for my anxiety, plus they all have the exact sexual dysfunction you describe. I've been on Zoloft, Paxil, and now Effexor. I'm 30, and very healthy, and the sexual side effects are very hard to cope with. All of them have given me the same basic sexual side effects: delayed/non-existant climax, and a softer erection. I am currently taking Wellbutrin in conjuction with the Effexor to see if it helps, but it hasn't done anything.
However, I was on just Wellbutrin without any real side effects (150mg). I also tried Buspar; no sexual side effects but it made me too light headed. Maybe you could try these; they're not used as often as the Prozacs or Zolofts, but you might get some benefit from them.
My pysch. is pretty good about understanding how difficult these effects are, so we're constantly trying to find something that works, and doesn't cripple my sex life. While it hasn't worked for me, I have read others who are on the same mix: Wellbutrin and Effexor, and have had some success.
Posted by JonW on April 26, 2002, at 15:47:44
In reply to Re: Anyone NOT have sexual side effects with SSRIs?, posted by Mason on April 26, 2002, at 15:30:39
Hi Mason,
FWIW, my psydoc has had great success treating sexual dysfunction (all aspects) with Viagra. She's treated both men and women taking both SSRIs and MAOIs. I don't know how you feel about taking something as needed, but it might be worth a try if you haven't already tried it.
Jon
> Hey Joe,
>
> Unfortunately all I can do is add similar experiences; I haven't found any AD's that work for my anxiety, plus they all have the exact sexual dysfunction you describe. I've been on Zoloft, Paxil, and now Effexor. I'm 30, and very healthy, and the sexual side effects are very hard to cope with. All of them have given me the same basic sexual side effects: delayed/non-existant climax, and a softer erection. I am currently taking Wellbutrin in conjuction with the Effexor to see if it helps, but it hasn't done anything.
>
> However, I was on just Wellbutrin without any real side effects (150mg). I also tried Buspar; no sexual side effects but it made me too light headed. Maybe you could try these; they're not used as often as the Prozacs or Zolofts, but you might get some benefit from them.
>
> My pysch. is pretty good about understanding how difficult these effects are, so we're constantly trying to find something that works, and doesn't cripple my sex life. While it hasn't worked for me, I have read others who are on the same mix: Wellbutrin and Effexor, and have had some success.
Posted by Elizabeth on April 26, 2002, at 19:36:48
In reply to Re: Anyone NOT have sexual side effects with SSRIs? » Mason, posted by JonW on April 26, 2002, at 15:47:44
I took Prozac for a couple of years and never had any sexual problems from it. Wasn't taking anything else.
BTW, Jon:
> FWIW, my psydoc has had great success treating sexual dysfunction (all aspects) with Viagra.All aspects? What do you mean by that? I have a hard time imagining that Viagra would improve libido or sexual desire, although it works great for sexual *functioning*.
Posted by TSA West on April 27, 2002, at 3:40:12
In reply to Anyone NOT have sexual side effects with SSRIs?, posted by Joe_12 on April 26, 2002, at 12:52:21
Zoloft (sertraline) may be better than SSRI's when it comes to sex:
"The results of this study provide evidence that sertraline and paroxetine have equivalent efficacy during both short-term and continuation therapy for depression in the outpatient setting. Both drugs were well-tolerated, but there was a tendency for patients receiving paroxetine to report higher rates of adverse events than patients receiving sertraline. The higher rates of constipation, dry mouth, tachycardia, orthostatic dizziness, micturition problems, and palpitations may be attributable to the higher anticholinergic effect that has been noted for paroxetine.14, 15 The higher incidence of drowsiness, fatigue, tremor, weight gain, and SEXUAL DYSFUNCTION reported by patients receiving paroxetine are consistent with previous reports 16-20 and have been hypothesized to be a consequence of lowered dopaminergic tone."
--J of Clin Psychopharmacology, December 2000
"...and I talk to God, and I remember from when I was young: faith, hope, and love are 3 things that He gave us; but the greatest is _love_." TSA WESTern Territory
Posted by jay on April 27, 2002, at 15:58:38
In reply to Re: Anyone NOT have sexual side effects with SSRIs?, posted by Elizabeth on April 26, 2002, at 19:36:48
> I took Prozac for a couple of years and never had any sexual problems from it. Wasn't taking anything else.
>
> BTW, Jon:
> > FWIW, my psydoc has had great success treating sexual dysfunction (all aspects) with Viagra.
>
> All aspects? What do you mean by that? I have a hard time imagining that Viagra would improve libido or sexual desire, although it works great for sexual *functioning*.Even though it is pricey, if you can get insurance to cover it, I think it is the best we have at this point. No, it doesn't improve the desire, but it has been shown to restore nocturnal erections in males, and increased blood flow to the female clitoris. (There is a good section on this in 'Noonday Demon'.) With a little bit of effort on our part, a good portion of overall sexual satisfaction can be achieved. And..yes that is a good thing, indeed. :-)
Jay
Posted by Dr. Bob on April 27, 2002, at 18:37:40
In reply to Re: Anyone NOT have sexual side effects with SSRIs? » Joe_12, posted by TSA West on April 27, 2002, at 3:40:12
> "...and I talk to God, and I remember from when I was young: faith, hope, and love are 3 things that He gave us; but the greatest is _love_." TSA WESTern Territory
Please avoid promotional material in your tag lines:
http://www.dr-bob.org/babble/admin/20010718/msgs/1854.html
Thanks,
Bob
PS: Follow-ups regarding posting policies, or complaints about posts, should be redirected to Psycho-Babble Administration.
Posted by JonW on April 27, 2002, at 22:15:15
In reply to Re: Anyone NOT have sexual side effects with SSRIs?, posted by Elizabeth on April 26, 2002, at 19:36:48
> All aspects? What do you mean by that? I have a hard time imagining that Viagra would improve libido or sexual desire, although it works great for sexual *functioning*.
I agree with you Elizabeth, I don't think Viagra would do much for desire (though my psydoc says *all* aspects). However, just treating anorgasmia and functioning successfully is a huge deal. I mean, if you regain the ability and pleasure... I know that alone would certainly make me more interested in sex :) I know it's not the same, but it's something...
Posted by Alan on April 27, 2002, at 23:03:16
In reply to Anyone NOT have sexual side effects with SSRIs?, posted by Joe_12 on April 26, 2002, at 12:52:21
> I was diagnosed with an anxiety disorder a few months ago and was prescribed Effexor XR. While it did help with the anxiety, the side effects became just too much (insomnia, acne, muscle spasms, sexual problems). Some of them I could handle, but as a 20 year old male, the sexual disfunction was something I was not willing to deal with. It started as just delayed orgasm, but as time progressed it eventually became almost impossible to climax. There was also a lack of "fullness" in my erections making them more difficult to maintain.
>
> I'm now off the Effexor and starting on Zoloft. I guess I'm just looking to get some reassurance. It seems that almost everyone on these boards taking SSRIs is experiencing the sexual side effects. Has anyone not had these problems? Or if not, has anyone had success taking other meds to counteract the problems? If so to what extent were the sexual problems improved? Thanks in advance for any input.
__________________________________________________All of them had the same effect on me - even when augmenting with stimulants mentioned (and not mentioned) in this thread. Sexual Dysfunction has been VASTLY under reported by the drug companies - nowhere near the original prescribing information on the package inserts. Generally speaking, most that find the problem with one will find it to varying, unacceptable degrees with most. The amazing thing to me is the amount of rationalisation that goes on that it's acceptable to live with.
If you have an anxiety disorder like me, you need to look into a benzodiazapine like klonopin or ativan or xanax. That's what works for me and millions of others - in my case klonopin daily with ativan PRN.
If you get the "addictive" BS speech from your doc, show him this or get a new doc that knows the difference and isn't commercially driven by the AD market:
http://panicdisorder.about.com/library/weekly/aa031997.htm
Alan
Posted by Mason on April 29, 2002, at 8:21:32
In reply to Re: Anyone NOT have sexual side effects with SSRIs? » Mason, posted by JonW on April 26, 2002, at 15:47:44
> Hi Mason,
>
> FWIW, my psydoc has had great success treating sexual dysfunction (all aspects) with Viagra. She's treated both men and women taking both SSRIs and MAOIs. I don't know how you feel about taking something as needed, but it might be worth a try if you haven't already tried it.
>
> Jon
Jon,
Thanks for the info. My psych. and I have discussed Viagra, but don't think it would have much benefit. I may try it and see. My libido is as strong as ever, and while getting it up takes longer, that really isn't a problem (although they are not as hard as they used to be). It's the severely delayed orgasm, going for well over an hour most times. Do you know if Viagra helps in restoring the ability to climax? My psych's worry is that it will give an erection, but not add to the ability to orgasm.Thanks for any/all info,
Mason
Posted by JonW on April 29, 2002, at 10:37:27
In reply to Re: Anyone NOT have sexual side effects with SSRIs?, posted by Mason on April 29, 2002, at 8:21:32
According to my psydoc Viagra is a wonderful drug for anorgasmia. There is plenty of research to support this in women, and at the very least that should indicate that men with this problem give it a try. As for efficacy, how long have you been on each med? A lot of us here do really short trials and give up - just wanted to put that out there. For example, it was found that many people taking paxil for social phobia were non-responders at 8 weeks but were responders at 12 weeks. Have you been on serzone alone? Might be worth a try. Or zyprexa in combination with the SSRIs seems to help some people.
Good luck,
Jon
> Jon,
> Thanks for the info. My psych. and I have discussed Viagra, but don't think it would have much benefit. I may try it and see. My libido is as strong as ever, and while getting it up takes longer, that really isn't a problem (although they are not as hard as they used to be). It's the severely delayed orgasm, going for well over an hour most times. Do you know if Viagra helps in restoring the ability to climax? My psych's worry is that it will give an erection, but not add to the ability to orgasm.
>
> Thanks for any/all info,
>
> Mason
Posted by Mason on April 29, 2002, at 14:07:39
In reply to Re: Anyone NOT have sexual side effects with SSRIs? » Mason, posted by JonW on April 29, 2002, at 10:37:27
> According to my psydoc Viagra is a wonderful drug for anorgasmia. There is plenty of research to support this in women, and at the very least that should indicate that men with this problem give it a try. As for efficacy, how long have you been on each med? A lot of us here do really short trials and give up - just wanted to put that out there. For example, it was found that many people taking paxil for social phobia were non-responders at 8 weeks but were responders at 12 weeks. Have you been on serzone alone? Might be worth a try. Or zyprexa in combination with the SSRIs seems to help some people.
>
> Good luck,
> Jon
>
>
>
> > Jon,
Thanks again, Jon, for the information! You are exactly correct regarding the trial period. I was on Zoloft for about 2 months, Paxil about 2 months, and Buspar about a month. I have been on the Wellbutrin since December and have been on Effexor/Wellbutrin for a little over a month. I think I'm a bit better, but it gets hard to tell. I see my psydoc this Wednesday, and will ask him about Viagra, and maybe give it a trial to see if it is effective for me in combating the anorgasmia. I certainly hope so! I have not been on Serzone, nor Celexa, so I still have some options. I had not heard/read of Zyprexa, and looked it up on the archives here; it's a possibility. I have also read on these boards that people take Remeron specifically to help with the sexual dysfunction; my psydoc has never used this drug before and is understandably not eager to try something he has no experience with, but that's at least another option. Is Zyprexa used similarly to the Wellbutrin, as a counter to an SSRI's sexual dysfunctions, or does it aide in diminshing anxiety, depression, etc?Once again, thanks for all the great info and support!
Mason
Posted by JonW on April 29, 2002, at 19:33:53
In reply to Re: Jon, posted by Mason on April 29, 2002, at 14:07:39
Mason,
If you think your current med cocktail is helping, it probably makes the most sense to take Viagra or add something to protect you from SD before changing things altogether. IMHO, of course. However, serzone rarely causes SD so it would be an excellent alternative. Zyprexa is often combined with SSRIs (prozac in particular) to treat treatment resistent depression. The protection from SD is a bonus. On a side note, don't hesitate in changing doctors if you're not getting better. An up to date progressive doctor can be of great benefit. So many people stay with the wrong doctor far too long -- myself included.
Jon
> Thanks again, Jon, for the information! You are exactly correct regarding the trial period. I was on Zoloft for about 2 months, Paxil about 2 months, and Buspar about a month. I have been on the Wellbutrin since December and have been on Effexor/Wellbutrin for a little over a month. I think I'm a bit better, but it gets hard to tell. I see my psydoc this Wednesday, and will ask him about Viagra, and maybe give it a trial to see if it is effective for me in combating the anorgasmia. I certainly hope so! I have not been on Serzone, nor Celexa, so I still have some options. I had not heard/read of Zyprexa, and looked it up on the archives here; it's a possibility. I have also read on these boards that people take Remeron specifically to help with the sexual dysfunction; my psydoc has never used this drug before and is understandably not eager to try something he has no experience with, but that's at least another option. Is Zyprexa used similarly to the Wellbutrin, as a counter to an SSRI's sexual dysfunctions, or does it aide in diminshing anxiety, depression, etc?
>
> Once again, thanks for all the great info and support!
>
> Mason
Posted by 3 Beer Effect on April 30, 2002, at 2:05:05
In reply to Anyone NOT have sexual side effects with SSRIs?, posted by Joe_12 on April 26, 2002, at 12:52:21
Posted by JohnX2 on May 1, 2002, at 6:38:59
In reply to Re: Jon » Mason, posted by JonW on April 29, 2002, at 19:33:53
> Mason,
>
> If you think your current med cocktail is helping, it probably makes the most sense to take Viagra or add something to protect you from SD before changing things altogether. IMHO, of course. However, serzone rarely causes SD so it would be an excellent alternative. Zyprexa is often combined with SSRIs (prozac in particular) to treat treatment resistent depression. The protection from SD is a bonus. On a side note, don't hesitate in changing doctors if you're not getting better. An up to date progressive doctor can be of great benefit. So many people stay with the wrong doctor far too long -- myself included.
>
> Jon
>
>
>Hi Jon,
I was wondering how you are fairing these days? You seem
to be in better spirits posting to the newsgroup.
Did your pdoc change go better? What medicine cocktail
is working well? (sorry I haven't read your other posts).
Before you mentioned that you were having difficulties with
medicines causing rapid-cycling. I was wondering if you came
to some secret cocktail?Take Care,
JX2
Posted by JonW on May 1, 2002, at 10:43:15
In reply to Re: Hey Jon » JonW, posted by JohnX2 on May 1, 2002, at 6:38:59
Hi John,
Thanks for asking! Well, I'm working with Dr. Liebowitz now and he is incredible -- or atleast I'm impressed with his approach to everything. Unfortunately, I'm yet to see a significant improvement in myself but I know everything takes time. He has stopped all of my mood stabilizers except for depakote which has given me a lot more energy! Currently I take Neurontin (3600mg) + Depakote (1000mg) + Luvox (150mg). He wants to see how I react to the Luvox. I seem to be cycling but without as much agitation as Zoloft. If the cycling doesn't settle down he wants to try me on Nardil and stabilize me with thyroid. He seemed to imply that Nardil is easier to control (by adding thyroid) than the SSRIs. For some reason I refuse to believe that Luvox or any SSRI will be effective for social phobia for me. I keep thinking Nardil is the answer to all of my problems, but then, I've thought that about every new drug I've tried. Nonetheless, Dr. Liebowitz definitely feels that Nardil is special. I really *don't* want to take this drug if I don't have to. I mean, I don't want to have to worry about alcohol, etc. But if I'm going to have sexual dysfunction, it might as well be worth it! Anyway, thanks for asking about me and I hope all is well with you :)
Still Searching,
Jon> Hi Jon,
>
> I was wondering how you are fairing these days? You seem
> to be in better spirits posting to the newsgroup.
> Did your pdoc change go better? What medicine cocktail
> is working well? (sorry I haven't read your other posts).
> Before you mentioned that you were having difficulties with
> medicines causing rapid-cycling. I was wondering if you came
> to some secret cocktail?
>
> Take Care,
> JX2
Posted by JohnX2 on May 1, 2002, at 16:08:16
In reply to Re: Hey Jon » JohnX2, posted by JonW on May 1, 2002, at 10:43:15
> Hi John,
>
> Thanks for asking! Well, I'm working with Dr. Liebowitz now and he is incredible -- or atleast I'm impressed with his approach to everything. Unfortunately, I'm yet to see a significant improvement in myself but I know everything takes time. He has stopped all of my mood stabilizers except for depakote which has given me a lot more energy! Currently I take Neurontin (3600mg) + Depakote (1000mg) + Luvox (150mg). He wants to see how I react to the Luvox. I seem to be cycling but without as much agitation as Zoloft. If the cycling doesn't settle down he wants to try me on Nardil and stabilize me with thyroid. He seemed to imply that Nardil is easier to control (by adding thyroid) than the SSRIs. For some reason I refuse to believe that Luvox or any SSRI will be effective for social phobia for me. I keep thinking Nardil is the answer to all of my problems, but then, I've thought that about every new drug I've tried. Nonetheless, Dr. Liebowitz definitely feels that Nardil is special. I really *don't* want to take this drug if I don't have to. I mean, I don't want to have to worry about alcohol, etc. But if I'm going to have sexual dysfunction, it might as well be worth it! Anyway, thanks for asking about me and I hope all is well with you :)
>
> Still Searching,
> Jon
>
>Hey Jon,
I'm glad you found a new pdoc you really like!
You were on quite a "mood-stabilizer-bonanza"
from your other docs. I hope the keep-it-simple
strategy pays off.I was wondering about the Nardil and how it is less/more likely to induce cycling? Know anything
about this?I'm cycling like nuts. I can't take any mood stabilizer besides Lamictal and Neurontin, and they don't help much with agitation. I dropped
Topamax because it made me very hypomanic and
agitated. I'm going to be giving lithium a trial (I keep saying this, but I don't do it..). Li or bust. Otherwise I can restart Zyprexa, which helped a lot but I felt it may had been causing
twitching (this has completely subdued).Take care and keep us posted,
JX2
Posted by Elizabeth on May 3, 2002, at 0:26:38
In reply to Re: sexual side effects with SSRIs Viagra » Elizabeth, posted by jay on April 27, 2002, at 15:58:38
> Even though it is pricey, if you can get insurance to cover it, I think it is the best we have at this point.
I agree, if the problem is with sexual functioning (and yes, I can confirm that it's at least somewhat effective for anorgasmia). If it's a libido/desire thing, something else is in order. (If it's ambiguous which type of problem it is, Vitamin V is still probably worth trying.)
I keep hearing these commercials advertising that you can get free samples of Viagra from your doctor. Anyone encountered these famous free samples? :-)
-elizabeth
This is the end of the thread.
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