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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 Soonerbaby on February 6, 2009, at 14:38:28
I am 31 and female and have been on Effexor XR 37.5 mg for 2 weeks now. I was originally prescribed it for my lack of motivation. I am also on Wellbutrin 150mg, Abilify 5mg once daily and Xanax two 2 mg pills divided over 4 times per day. I recently have had a hard time having an orgasm, whether on my own, or with my husband. It seems the things that used to turn me on are now just "blah" to me! Being intimately touched is about as arousing as if you rubbed your arm. Will this go away? I asked my doctor and he said to give it another week and see if the symptoms go away. I am also scared of the withdrawals, if I get too much of this med in my body. Any suggestions?
Posted by janejane on February 6, 2009, at 16:06:04
In reply to Effexor XR and Anorgasmia....inability to orgasm, posted by Soonerbaby on February 6, 2009, at 14:38:28
Effexor XR numbed me up too. I was also constantly hungry.
You might want to ask about Cymbalta (duloxetine) which is another SNRI. I tolerate it a lot better myself. It would probably give you a little more of a norepinephrine boost too, which might be more beneficial for increasing energy. (As I understand it, Cymbalta effects SE and NE pretty evenly, whereas with Effexor, NE doesn't kick in until higher doses.)
When I started Cymbalta, I was instructed to stop Prozac 20 mg one day, and start with a low dose of Cymbalta (20 mg) the next. There were absolutely no problems, not even a little nausea. I would think that you would be able to do a similar switch, or at least cross-taper between Effexor and Cymbalta, to avoid having to deal with withdrawal. I'm not a doc so I'm not sure, though. I totally understand your concern Effexor withdrawal becoming more of an issue the longer you stay on it. That's one of the reasons I didn't wait to see whether my side effects on it would subside.
Posted by jms600 on February 6, 2009, at 16:44:50
In reply to Effexor XR and Anorgasmia....inability to orgasm, posted by Soonerbaby on February 6, 2009, at 14:38:28
I'm starting Effexor next week - and have to say that I'm not really looking forward to it's effects on the libido.
I have read on here that low doses of Mirtazepine can help. Some say certain antihistamines can also help - Periactin being one of them - however I'm a little dubious of this claim.
> I am 31 and female and have been on Effexor XR 37.5 mg for 2 weeks now. I was originally prescribed it for my lack of motivation. I am also on Wellbutrin 150mg, Abilify 5mg once daily and Xanax two 2 mg pills divided over 4 times per day. I recently have had a hard time having an orgasm, whether on my own, or with my husband. It seems the things that used to turn me on are now just "blah" to me! Being intimately touched is about as arousing as if you rubbed your arm. Will this go away? I asked my doctor and he said to give it another week and see if the symptoms go away. I am also scared of the withdrawals, if I get too much of this med in my body. Any suggestions?
Posted by myco on February 6, 2009, at 16:57:15
In reply to Effexor XR and Anorgasmia....inability to orgasm, posted by Soonerbaby on February 6, 2009, at 14:38:28
> I am 31 and female and have been on Effexor XR 37.5 mg for 2 weeks now. I was originally prescribed it for my lack of motivation. I am also on Wellbutrin 150mg, Abilify 5mg once daily and Xanax two 2 mg pills divided over 4 times per day. I recently have had a hard time having an orgasm, whether on my own, or with my husband. It seems the things that used to turn me on are now just "blah" to me! Being intimately touched is about as arousing as if you rubbed your arm. Will this go away? I asked my doctor and he said to give it another week and see if the symptoms go away. I am also scared of the withdrawals, if I get too much of this med in my body. Any suggestions?
Hey, Im a guy but I to have experienced complete inability to orgasm and delayed orgasm on effexor xr. I took effexor xr for over a year and sexual proplems were my number one side effect along with anxiety on it. It's gonna take longer than a week to relieve hun. For me it was dose related...at low doses, 75mg and below, there was a seriously delayed orgasm response then it increased to complete inability at high doses (i spent most of that year at 150mg). It does improve, for me anyway, in that you will be able to orgasm again but it will most likely be delayed. It might take months to come back, for me over 6 months of complete inhibition, then it came back but quite delayed...made sex last a long time (not necessarily a bad thing). This is a typical side effect (very common actually for most people) on almost all SSRI's out there, effexor is no exception. If the med works and you are happy with its efficacy, stick with it through the side effects and they will diminish.
Don't worry about withdrawals for now (seriously)...determine if the med works first...thats the issue. It's like any other psych med...you put something in your body that alters brain chemistry then when you take it away it's going to cause withdrawal to varying degrees...the trick is to just taper off slowly (reduce the dose at a speed that is comfy to you...start fast then if it makes u feel bad stop, add a lil more then go down again slower perhaps cutting the dose down in small increments by week). Doing this minimizes the side effects of coming off the med...it may still be a little bumpy but thats normal...effexor is again similar this way to other ssri's. You can also keep your xanax handy for effexor withdrawal to help you relax in case youre edgy.keep smilin,
Posted by Soonerbaby on February 6, 2009, at 17:05:36
In reply to Re: Effexor XR and Anorgasmia....inability to orgasm » Soonerbaby, posted by myco on February 6, 2009, at 16:57:15
Thanks for all the suggestions so far. This weekend I am going to (for a lack of a better term) try some sort of sexual relations, either with or without hubby and see how I am doing. Maybe things will be a little better. Luckily I have a husband that will not take any lack of orgasm personally, at least I hope so! I will keep track of any future comments! Thanks again! I have also heard of a "Effexor XR holiday" where you go off of it for 24 hours and are able to orgasm fine. Has anyone else heard of that?
Posted by myco on February 6, 2009, at 17:23:43
In reply to Re: Effexor XR and Anorgasmia....inability to orga, posted by Soonerbaby on February 6, 2009, at 17:05:36
>I have also heard of a "Effexor XR holiday" where you go off of it for 24 hours and are able to orgasm fine. Has anyone else heard of that?
ya ive heard of it but, for me, 24 without effexor was a no no as my body went into withdrawal quickly if I missed a dosing. Not to say it wont work....try :-)
Posted by Jim45 on February 6, 2009, at 20:12:44
In reply to Effexor XR and Anorgasmia....inability to orgasm, posted by Soonerbaby on February 6, 2009, at 14:38:28
If you were just on Effexor or just one other med, a solution might be easier.
Since you're on Abilify and Wellbutrin, the one med that has helped many women with your problem - selegiline - can't be used.
Effexor and one of its common side effects - the delayed orgasm - is great for males (I loved that about FXR) but it's a real bummer for females.
Good luck. It might be hard to find a solution with you being on all those meds.
Jim
Posted by janejane on February 7, 2009, at 10:05:06
In reply to Re: Effexor XR and Anorgasmia....inability to orga, posted by Soonerbaby on February 6, 2009, at 17:05:36
Effexor has a really short half life, so you might want to be careful about taking holidays. If you decide to give it a try, make sure you have your pills handy so you can take one if you start feeling malaise or brain zaps.
I just realized that your wellbutrin dose is pretty low. An increase would've been the obvious first thing to try for improving motivation, so I'm guessing you've already attempted that. If not, definitely ask about it. You might not even need Effexor at all, in that case.
Posted by Jim45 on February 7, 2009, at 12:54:32
In reply to Effexor XR and Anorgasmia....inability to orgasm, posted by Soonerbaby on February 6, 2009, at 14:38:28
Been thinking about your problem. Can't just write it off. Been through so much myself through the years with meds I wish someone could've helped me with.
If your Husband is like me, YOUR desire, pleasure and orgasm are paramount when y'all get together. If you don't have the desire for sex, don't seem into it, and ESPECIALLY if you can't orgasm, that can make for marital problems.
So...I've thought on the meds you're on, and after a waiting a while as the Doc suggested, there are a couple of things I'd suggest that you research/try.
First of all, Effexor is a med Docs love to prescribe for some reason. However, in addition to mere serotonin reuptake, it effects norepinephrine. At high doses FXR can effect dopamine too. SO DOES WELLBUTRIN. Why do you need 2 meds that effect norepinephrine?
How about a pure SSRI? Then instead of wellbutrin I'd recommend Selegiline - but not the patch Docs like to prescribe. You'd have to take low doses of the selegiline - half a 5 mg tablet every 4-6 hours, but it effects dopamine and norepinephrine also, but has other actions that have helped many females.
Before you try something different, my final suggestion is to open the 75 mg FXR capsule and take half of it and the other half 6-8 hours later.
I'll conclude by again mentioning the common actions of FXR and Wellbutrin (Norepinephrine). I wonder if you REALLY need two meds doing that.
Good luck!
Posted by daisy467 on February 7, 2009, at 15:53:42
In reply to Re: Effexor XR and Anorgasmia....inability to orga, posted by Jim45 on February 7, 2009, at 12:54:32
Hi - just posting that I used to be on Effexor and went off when I found out I was pregnant. Got thru two weeks of the brain zaps pretty well.
I did go back on Effexor after feeling postpartum but really didn't want to stay on this as orgasms were just not happening. My doctor put me on Celexa but it didn't help - after a year. I asked him if it would make a difference taking it before bed rather than the morning. I tried and WHOA - what a difference!
Just thought I'd share that for some of those folks who I see had the same issue. Having a two and three year old doesn't do much for the libido but it's wonderful even still to FINALLY 'achieve' very easily after months and months of NOTHING.
Posted by janejane on February 7, 2009, at 17:09:04
In reply to Re: Effexor XR and Anorgasmia....inability to orga, posted by Jim45 on February 7, 2009, at 12:54:32
Jim45, I don't understand the SSRI suggestion. Wouldn't that be worse for sexual dysfunction? If the problem is motivation, why increase SE at all? Seems like DA and NE would be more useful.
Posted by Jim45 on February 8, 2009, at 18:17:01
In reply to Re: Effexor XR and Anorgasmia....inability to orga » Jim45, posted by janejane on February 7, 2009, at 17:09:04
Didn't mean to imply increasing SE.
I was trying to say that since Effexor is an SNRI which effects Norepinephrine in addition to Serotonin (and also effects Dopamine at high doses), and Wellbutrin acts on Dopamine and Norepinephrine, that I wondered if Soonerbaby really needed that much Norepinephrine reuptake.
I was implying that switching from the Wellbutrin to Selegiline (which while it's inconvenient to take, has actions similar to Wellbutrin but is better for sex drive/orgasm) might benefit Soonerbaby. I don't think guys need to take Selegiline or they may end up being 5 minute buzzkills :)
The FXR to a pure SSRI switch was kinda tangential to the anorgasmia. BUT - FXR is notorious for slowing/stopping orgasm. Great for guys, but not females. I've just noted through the years that a lot of Docs - especially when one's not dealing with a Psych Doc but a Med Doc - give out or prescribe psych meds in combinations that often make no sense. Again, didn't know if Soonerbaby really needed that much NE(?).
I've even known people to get dangerous med combos etc. from Med Docs.
Regardless, I want folks to consult their Doc and/or do research before doing what I mention.
We're as different neurologically as we are physically. Different needs for different people.Jes trying to help. While I'm not a newbie to psych meds and other neurologically active substances, I am new here and I don't get the SE, DA, and NE lingo. I'm guessing SE is Serotonin, DA is Dopamine, and NE is Norepinephrine.
Hope this made sense.
Jim
Posted by janejane on February 8, 2009, at 20:55:02
In reply to Re: Effexor XR and Anorgasmia....inability to orga, posted by Jim45 on February 8, 2009, at 18:17:01
Jim, I'm new here too! :) And pretty much a neophyte when it comes to this brain mumbojumbo. I decided about a month ago that I really ought to understand this stuff better so I can play a more active role in my treatment. This place has been a great resource, the only drawback being that the info isn't really organized in a way that makes for systematic learning. To help with that, I bought myself a primer, called "Depression and Bipolar Disorder: Stahl's Essential Psychopharmacology, 3rd edition." It's a few chapters out of a larger volume on psychopharm. In hindsight, I wish I had gotten the whole thing, because some of what I've been reading is over my head so I wish I had the foundation provided by the first few chapters of the master volume. Oh well.
Anyway, according to Stahl, both dopamine and norepinephrine seem to be implicated in motivation, so more NE may not necessarily be a bad thing for Soonerbaby.
Posted by janejane on February 8, 2009, at 21:20:07
In reply to Re: Effexor XR and Anorgasmia....inability to orga, posted by Jim45 on February 8, 2009, at 18:17:01
Aha! I figured out the source of my confusion. I think you typed "SSRI" when you probably meant "MAOI," which is what Selegnine is, no? I guess when saw "SSRI" I kind of got hung up on that bit without reading the rest of your post very carefully. Sorry about that. This is part of the learning process, though, right? I've never though about MAOIs as a anything but a last ditch option until I read so many success stories about them here and elsewhere.
Posted by Soonerbaby on February 9, 2009, at 6:43:48
In reply to Re: Effexor XR and Anorgasmia....inability to orga » Jim45, posted by janejane on February 8, 2009, at 21:20:07
I go to the doctor in a few weeks and will give him a report. I re tried sexual relation with no luck this weekend. I am tired of this numbing effect. Effexor seems not to have given me as much motivation as I am willing to trade off for lack of orgasm. I will keep my chin up, but it is frustrating! Thanks for all the posts!
Posted by janejane on February 9, 2009, at 9:31:57
In reply to Re: Effexor XR and Anorgasmia....inability to orga, posted by Soonerbaby on February 9, 2009, at 6:43:48
Sorry Effexor's not working out. I can totally relate. If you're pretty sure you don't want to be on it, maybe you should give your doc a call now instead of waiting for your appointment. A few weeks is a long time to be sexually frustrated.
Posted by Soonerbaby on February 9, 2009, at 13:54:56
In reply to Re: Effexor XR and Anorgasmia....inability to orga » Soonerbaby, posted by janejane on February 9, 2009, at 9:31:57
You are right a few weeks is a long time to be sexually frustrated. Heck, this week has been uncomfortable enough! Thanks to all the posters and suggestions. I am calling my doc now.
Posted by soonerbaby on February 15, 2009, at 22:00:58
In reply to Effexor XR and Anorgasmia....inability to orgasm, posted by Soonerbaby on February 6, 2009, at 14:38:28
I went off the Effexor XR for 2 days........and hallelujah, I was able to orgasm again! It was not only a physical release, but an emotional one too. I am calling my doc tomorrow and telling him that this med is a terrible match for me. It is not worth giving up enjoying sexual intimacy. The Effexor is not helping the motivation THAT much!
Thanks!
Posted by Jim45 on February 16, 2009, at 17:46:10
In reply to Re: Effexor XR and Anorgasmia....inability to orga, posted by soonerbaby on February 15, 2009, at 22:00:58
YAAAY !!!!
:)
I'll bet you've got one happy and sweeter hubby again too!!
This is the end of the thread.
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