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Dr. Bob is Robert Hsiung, MD,
[email protected]Shown: posts 1 to 9 of 9. This is the beginning of the thread.
Posted by Francesco on September 27, 2003, at 12:35:20
I'm going to be polemic so, you have been advised : )
Most antidepressants meds are likely to cause sexual dysfunctions. Most doctors are not used to advise the patients about this possibility (just in the case you're the one who won't have SD).
This is fairly uncorrect because it doesn't allow you to take an informed decision based upon pros and cons. The doctor advocate for him the right to decide what is good for you. He establishes that a possibile relief from depression/anxiety is always worth the probabile SD. This should be in case a decision of yours.
Moreover it's quite stupid. Most people will get depressed in discovering they're experiencing SD so vanishing the eventual benefits of the cure.
(With the possibile exception of those who suffered of "major depression". But those are nowadays just a part of the people who take meds).If you have sexual dysfunctions and you're not taking meds you have a disturb that is supposed should be cured. If you're on meds, it's *just* a side effect.
Moreover sexual health is clearly co-related with well-being (or with the sensation of it, which is the same). I can't understand how you can *cure* something wrecking something else that has a so tight relation with the former.
To say "there is nothing else" isn't a proper answer. It's not psychiatrists' fault if there aren't alternatives. Their fault is to declaim that they can *cure* depression.To say "sexual side effects are reversibile" isn't a proper answer too because most of us will have to take meds for life.
Moreover "lack of interest in sex" is one of the diagnostical criteria of depression which is quite funny (just like weight gain, sleeping too much, and almost all the meds' "side-effects").
I'm not complaining only about the induced lack of a pleasure. We really don't know how this lack affects the rest of one's life considering the biological importance of the sexual functions (it's not just like having "dry mouth").
It's not so weird to speculate, according to Darwinist theories, that sex is strongly related with drives, for example. If our "inconscious" purpose is to spread up our genes and if we have this ability impaired this could change our entire attitude to life, even if we're not aware of it. But I'm aware this is just a speculation.
Obviously sex-side effects is just an example. Apathy induced by SSRIs is another. Claiming to be able to cure depression with something that causes apathy is as bizarre as claiming to be able to cure diabetes with candies.
Once again I want to stress that my argument is not "you shouldn't take meds" or "they have to invent something better" but: they have to stop claiming that antidepressants are a *cure*. In the best hipothesys they are a palliative, just like *other* drugs.
Which is the difference between legal drugs and illegal drugs ? The former are legal while the last are not. This is a so evident point that I won't spend more words on it.
Are we so sure that all the illegal drugs are more dangerous than the legal ? What about tobacco ? What about antipsychotics ? I don't know who drew the line, but I think it has *nothing* to do with harms/benefits and very much with economical/political aspects.
This really scares me. Given this premises how can I trust in "them" when they say this or that is the right med for me ? Maybe low doses of cocaine would be more useful all considered, who knows ?
I think it's just not an 'addiction' issue. Benzos are (supposed to be) addictive and are considered a med. Cigarettes & alcohol are very addictive but you can buy them without being jailed.
Moreover addiction is just ONE issue, it's not the whole story. There are other factors that should be considered as "quality of life expected". (I mean ... addiction is bad because it can worsen the quality of life of a human being, it's not bad because it's BAD)
Antidepressants are not physical 'addictive' but some of them can cause very bad withdrawal syntoms and, if they work, a strong psycological "addiction" (like everything that works). So, why are they SO radically different from, for ex., cocaine ? Only for the tolerance issue ?
Ok, sometimes you have to augment your antidepressant dose to reach the desidered effect and sometimes antidepressants stops to work, but let's say this has nothing to do with tolerance. Who cares ?
I think that the main reason for which they consider something a drug and something else a med is that drugs give pleasure while meds only give pain relief.
Having relief from pain can be allowed (if you have a *disease*, never mind if invented for this purpose) but only if, in doing this, you don't experience positive pleasure ... because you have to *deserve* pleasure otherwise you’re a junkie. If there is any logic in this I can’t see it.
Before stopping babbling let me say one more thing. One of the worst nonsensens I’ve heard is that antidepressants don’t change your personality. If personality is a by-product of brain (psychiatrists usually don’t believe in soul) and if meds affect your brain changing the level of neurotrasmitters and so on, how can they *not* change your personality ?
Let’s suppose there is a *normal* person who at a certain point of its life gets depressed. Let’s suppose also that is depression is dued to lack of serotonin. If he takes Prozac will he get back to the previous state ? Fairly improbable. Even if we assume that Prozac only affects serotonin level he’ll probably will have more (or less) serotonin circulating in his brain than before. He would be quite lucky if he’ll get the SAME level of serotonin he was once used to have.
I know this is quite semplicistic but what I’m trying to say is that your brain after Prozac can’t be the same brain you had before depression (or that this eventuality is remote). So what IS semplicistic is assuming that a med can restore your compromised brain functions. It changes them, which is quite different.
Ok, I had nothing better to do this afternoon : )
Posted by Simcha on September 27, 2003, at 13:13:15
In reply to preaching about meds, posted by Francesco on September 27, 2003, at 12:35:20
I have some things to say...
> Most antidepressants meds are likely to cause sexual dysfunctions. Most doctors are not used to advise the patients about this possibility (just in the case you're the one who won't have SD).
True. This is why I have always taken it upon myself to be well informed about medications.
> This is fairly uncorrect because it doesn't allow you to take an informed decision based upon pros and cons. The doctor advocate for him the right to decide what is good for you. He establishes that a possibile relief from depression/anxiety is always worth the probabile SD. This should be in case a decision of yours.Yes, I agree. We should not have to search to find these answers when psychiatrists can easily inform us about side effects.
> Moreover it's quite stupid. Most people will get depressed in discovering they're experiencing SD so vanishing the eventual benefits of the cure. (With the possibile exception of those who suffered of "major depression". But those are nowadays just a part of the people who take meds).
Yes, and yes. I am one of those who suffer from Major Depressive Disorder. I was so relieved not to be depressed for the first time in my life when I started with Effexor that I was willing to be numb from the waist down. After about eight months of that I got into a relationship where I wanted to be sexual. My psychiatrist and I worked together to get to a new mix of meds that allows me to be able to have sex and to remain in remission.
> Moreover sexual health is clearly co-related with well-being (or with the sensation of it, which is the same). I can't understand how you can *cure* something wrecking something else that has a so tight relation with the former.
This is absolutely true. Eventually, once the depression was gone I realized that I wanted to be a whole person again. Sexuality is part of being a whole person. I won't work with a psychiatrist who is unwilling to take a look at the entire picture when it comes to my well being.
> To say "there is nothing else" isn't a proper answer. It's not psychiatrists' fault if there aren't alternatives. Their fault is to declaim that they can *cure* depression.
Fortunately I've never had a psychiatrist who has claimed to be able to "cure" my depression. Both of my psychiatrists have been very up front telling me that I'm in remission and I'm not cured. They tell me that I need to stay on the medications and I need to continue to make healthy life choices in order to stay in remission. Both of them have explained to me that it is very likely that I will need medication for the balance of my life in order to stay in remission.
I have come to accept my condition and the necessity of taking medication to treat it over the past three years I've been on medication. Sometimes it irks me. I hate being one of those people who have to arrange my pills in one of those weekly dose organizers so that I'm sure I'm taking my medications because they save my life. Then again I'm grateful that I have found an effective treatment for my Major Depressive Disorder.
People in my family one generation back did not have the same options as me and they still suffer terribly. Treatments were terrible and they still can be depending on the case. I'm just grateful to be in an age where it is possible to treat my condition. If it shortens my life span, then that is something I'm willing to face. I'd rather be not depressed for a shorter life than have a long life depressed. (We live well into our nineties and early hundreds in my family.)
I believe that my quality of life is much better than my family members of an older generation. I know that medication does not work for everyone. I'm just grateful that for me these drugs are a miracle that allow me to have a life. Without medication I don't function. It's as simple as that.
At present there is no cure. Any psychiatrist who tells you that they can cure depression is lying. For if this were the case we would not be sharing on this board.
Blessings,
Simcha
Posted by francesco on September 27, 2003, at 14:02:58
In reply to Re: preaching about meds » Francesco , posted by Simcha on September 27, 2003, at 13:13:15
Thank you for the comments. You said you've accepted your condition and the limits it involves. This is what I have not done yet so I think I'll have to work on this issue. The reason why I excluded major depression is that in that case the computation of pros and cons of the treatment is easier: you have nearly anything to loose and very much to gain in trying meds. About the cure issue I wasn't referring properly to psychiatrists but rather to mass media propaganda (at least in Italy). I'm sick and tired of reading that depression is a curable illness, that you have to take meds just for a little period (what they told me ten years ago), that the new meds are virtually free of side-effects and other stupid things. Unluckly also many self-styled TV-psychiatrists say the same (false) things. By the way, what was the magic cocktail that helped with sexual dysfunctions ? : )
Posted by Simcha on September 27, 2003, at 14:20:33
In reply to Re: preaching about meds » Simcha, posted by francesco on September 27, 2003, at 14:02:58
Currently my mix is:
Am doses:
Celexa 40mg
WellbutrinSR 200mgPm dose:
Neurontin 600mgThe Wellbutrin is the key to my sexual functioning I believe. This is coupled with the Celexa having less of an effect on my sex drive and my performance.
Sex is so much better now that I'm not depressed. Orgasms are amazing. I've read that Wellbutrin can highten orgasmic intensity in men. I don't know if this is the case or if the fact that I'm not depressed has allowed me to experience orgasm intensity in a new way.
The world is very gray and lifeless when I'm depressed and not being depressed gives me all the color life has to offer.
I'm fortunate to have gotten sane and sensible assessments from two psychiatrists. Neither psychiatrist has contemplated taking me off of medication. Both of them have said that it is a necessity for me to be on medication for the forseeable future. Major Depressive Disorder is insidiously progressive if untreated. I realize that now. Things got really bad before I was willing to take medication.
The current psychiatrist says that perhaps we can start talking about lowering my doses in five years. He says there are new studies that are surfacing that long-term use of these medicatins over 7 years or so can help the brain to produce the proper balance of chemicals on its own. Basically it's retraining the brain. He said that these studies are very controversial right now and that in five years we will know more. He did not say anything definite about coming off of meds at any point.
Acceptence takes time. I'm fortunate that I've been involved in 12-step programs for eight years and therapy off and on for the past ten years. Both arenas have afforded me the tools to accept reality for what it is and to move on. I've made the most incredible progress since I've been on medication in the past three years.
Being in remission really allows me to become the person I'm capable of being. It's unfortunate that I need to use pills in order to experience this. I have come to accept that if this is so, then this is so. I'm no longer fighting treatment and it has made all the difference in the world.
> Thank you for the comments. You said you've accepted your condition and the limits it involves. This is what I have not done yet so I think I'll have to work on this issue. The reason why I excluded major depression is that in that case the computation of pros and cons of the treatment is easier: you have nearly anything to loose and very much to gain in trying meds. About the cure issue I wasn't referring properly to psychiatrists but rather to mass media propaganda (at least in Italy). I'm sick and tired of reading that depression is a curable illness, that you have to take meds just for a little period (what they told me ten years ago), that the new meds are virtually free of side-effects and other stupid things. Unluckly also many self-styled TV-psychiatrists say the same (false) things. By the way, what was the magic cocktail that helped with sexual dysfunctions ? : )
Posted by francesco on September 27, 2003, at 15:08:51
In reply to Re: preaching about meds » francesco, posted by Simcha on September 27, 2003, at 14:20:33
I did tried Celexa too and it didn't impair my sexual functioning at all (but didn't help for the rest). I tried also Wellbutrin but it made me nervous. I'm glad your life has changed so dramatically. If you managed to exit from Major Depression I must have some chances too with my ADHD : ) Thanks
Posted by emilyd on September 28, 2003, at 9:51:57
In reply to Re: preaching about meds » francesco, posted by Simcha on September 27, 2003, at 14:20:33
Thank you for your postings. I was first diagnosed with major depression, but when meds (Effexor, Wellbutrin, Lexapro to name a few) made me worse my therapist and psychaitrist began thinking bipolar. Luckily I've never had SD any worse than that experinced while depressed, but I agree with all that was said on this issue. I also am grateful that I have so many more options and chances of success than previous generations.
I never lost the conscious desire to lead a full, balanced life, but have not been able to find the physical strength/confidence/motivation to get back to a healthy lifestyle. I've gained at least 40 pounds. Thank god I have an incredibly supportive partner, family, therapist and doc. It's been 7 months since I started taking meds and have been through at least 6 in different combinations and dosages. I've been on disability the entire time. Those around me say I am doing better and do continue to improve, but I often cannot see it. With each new drug I swear it's the last I'll try, but maybe you're right that I need to stop fighting my treatment. It's just that on the occassions that I have, while I am more comfortable, I fear that comfort won't ever allow me to return to advancing the successful career and complete life that I had been buiding before all of this started.
Posted by linkadge on September 28, 2003, at 18:10:12
In reply to Re: preaching about meds » Simcha, posted by emilyd on September 28, 2003, at 9:51:57
There was a recent study done, that I read somewhere. It was quite extensive, questioning thousands of people.
Those who scored the lowest on ratings of depression, anxiety, and insomnia, also scored the lowest on scales of sexual drive. Meaning those who weren't depressed didn't care all that much about sex anyway.
One doctor joked that its almost as if they already had prozac in their brains.
I have found this true as well. Acording to my mother, my father always had a low sex drive, he was also one of the happiest men alive.
The times when I was nondepressed in my life, I thought about sex very rarely. Perhaps 2-3 times a week at most. As my mood began to sink, and my anxiety rose, I became more obsessive about sex and sexual thoughts. From that point, obsessions and depression went through the roof.
I honestly think that when you are non depressed that you really don't need sex very often at all. I think that when you remit from depression you become more interested in higher order cognative thoughts, and less in sexual ones.
When I started taking SSRIs. I was actually glad about the sex drive reduction. Finally I could go about my daily activities without assigning a sexual connotation to everything.
Thats just my view.
Linkadge
Posted by Festus on September 28, 2003, at 22:26:57
In reply to preaching about meds, posted by Francesco on September 27, 2003, at 12:35:20
I think I got 2 cents worth here,in regards to your post,Francesco,you struck a HUGE nerve when I got to the part about the meds that had that gosh-awful side-effect of making one"feel good"when they took them.This has long been a staple in the dismal world of the folks cursed with Chronic Pain.In addition to spending days and nights aching or burning or writhing in spasmodic agony,most suffer from severe depression and anxiety,to add to their physical pain.They can go to the Dr.,the ER,the clinics,anywhere that they can get into in search of someone who with a simple few waves of an ink pen on a little white piece of paper,could relieve them of such terrible suffering.The sad truth is that when they leave the office,medical facility,or wherever they went,all too often,they ain,t a bit better off than before they somehow managed to get there.Some "Medical person with RX writing authority"sends them away with scripts for Motrin 800mg and some Paxil.I know,I know,it,s all "because of the junkies"that these poor Dr.,s are scared to dispense appropriate Pain Meds to comfort these folks.What I fail to understand is after 8 or more years of frickin school,they STILL can,t tell if a person is truly in need of such meds?Why did they bother swearin their Hippocratical Oath,if they was,nt gonna honor the damn thing!!(told ya you hit a nerve)I,m sorry for venting,I,just wish this lack of compassion on their parts,would get changed,somehow,so they,d have to help these folks.I thought they passed a law in 2000 makin Pain a vital sign.What the heck happened to it?Festus
Posted by HenryO on September 28, 2003, at 23:04:47
In reply to preaching about meds, posted by Francesco on September 27, 2003, at 12:35:20
Good rant. I'm with you most of the way.
This is the end of the thread.
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