# sexual side effects on 50mg zoloft



## ka13

Have been taking 50mg zoloft for about a week after two month introductory dose of 25mg. I understand that this is the lowest dose for anxiety treatment and its really made a difference. However, I am not able to reach climax or ejaculate during sex... also having trouble when I masturbate. I get tired pretty quickly as well. Are these side effects going to resolve themselves as I adjust to the new dosage or should I be concerned. I'm loath to start taking any additional meds. Any advice?


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## UltraShy

Welcome to the not-so-wonderful world of SSRIs.

SSRIs have a VERY high rate of sexual side effects, with anorgasmia (not being able to ejaculate) being the most common. My brother got off SSRIs because of that issue. He described it as "like having a gun that's cocked & loaded, but won't fire" (and this metaphor was his, and he's not even interested in guns at all).

Oddly, my own experience with Zoloft was that I could orgasm even at 300 mg, though had no sex drive at all, thus making the ability to orgasm rather pointless. Paxil & Prozac didn't kill sex drive, though they provided the frustration you're experiencing, of not being able to orgasm. With Paxil I found the effect was clearly dosage-related. At 40 mg it was very difficult. At 60 mg, not a chance of orgasm no matter what.

SSRIs are even prescribed for the treatment of premature ejaculation due to this common side effect they have. Hell, it's hard to even call it a side effect when that's one of the things SSRIs are specifically used for. I wonder how many of the guys in porn use some SSRI (along with their Viagra) to ensure they keep going & going for the stunningly long time required in that line of work.

Drug companies are very much aware of this problem. I can tell you from personal experience that in a clinical trial they'll never ask you about sexual side effects. Being cynical, I'm sure it's because they have a don't ask, don't tell policy. They don't ask as they don't want negative information that would then be required on their official FDA-approved label. And they hope & pray trial participants don't tell them about sexual issues, such that they can officially pretend such problems are rare. They will ask about every other unlikely side effect under the sun, such as "does it give you gas?" Knowing their pills don't cause farting, I guess they feel comfortable asking stupid stuff like that.


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## TheoBobTing

There is a chance that the sexual side effects will fade eventually. I was on fluoxetine for a number of months and after about 3 months or so the sexual side effects faded a bit, but not completely. After about 5 months on that particular Selective Sperm Release Inhibitor I stopped 'cause it wasn't helping my S.A.


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## Under17

Some things you could ask your doctor about: wellbutrin, dopamine agonists, low dose amphetamine, cyproheptadine, maybe even low dose naltrexone though I dunno if it works all that well.

Some things you could take on your own: maca, yohimbe


Edit: "Selective Sperm Release Inhibitor" This made me lol


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## yes

I don't meant to change the subject, but I wonder if another brand will ever come up with a SSRI that tries to minimize this side effect? Sex sells, in this case literally, so why not? I can imagine it doing the opposite though, too much sex drive. What case would be worse?


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## Trek

Every time my dose gets upped I have a period for about a month-ish where it's really hard to reach orgasm. :-\ Possible, but takes forever, which isn't always a bad thing.


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## gordonjohnson008

yes said:


> I don't meant to change the subject, but I wonder if another brand will ever come up with a SSRI that tries to minimize this side effect? Sex sells, in this case literally, so why not? I can imagine it doing the opposite though, too much sex drive. What case would be worse?


It's here - well, it's approved by the FDA and will be released in Q2 this year. See this topic on Vilazodone:
http://www.socialanxietysupport.com/forum/f30/anyone-interested-in-vilazodone-109563/


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## Barbapapa

I was prescribed sertraline for premature ejaculation and i come quick even at 200mg  and i have regular sex (3-5 times a week) for 7 years  and my libido is also very high. i'm sooo over "sensitive" i get so excited that i cum in seconds. don't know what to do? anyone in the same boat? any suggestions? sertraline DOES help but not even close to "not able to orgasm"...


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## King Moonracer

Hahahhahhahahaha!!!!!!!!!!!!!

Ya u have to trade your sexual function for an ssri. Lexapro killed my libido. It took me
an hour of exhaustion an sweat just to reach a ****ty climax. I quit
lexapro recently and my libido is back..... Its not like i use it anyway though.


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## BrianR

ka13 said:


> Have been taking 50mg zoloft for about a week after two month introductory dose of 25mg. I understand that this is the lowest dose for anxiety treatment and its really made a difference. However, I am not able to reach climax or ejaculate during sex... also having trouble when I masturbate. I get tired pretty quickly as well. Are these side effects going to resolve themselves as I adjust to the new dosage or should I be concerned. I'm loath to start taking any additional meds. Any advice?


I took 100mg Zoloft for about a year. Couple things I noticed:

- Every time I changed dosage, whether up or down, I had about 1-2 weeks of severe fatigue. It always went away though. During these periods of fatigue, I found one thing that consistently helped: EXERCISE.

- Before taking Zoloft, I had a very strong sex drive. Also, I would last 5-10 minutes in bed on average. While taking it, my sex drive all but disappeared, and I would last literally 60-90 minutes in bed, if I orgasmed at all. That was consistent the entire time I was on Zoloft. When I finally stopped taking it (I stopped cold turkey - not the best idea btw) it took about 2 weeks for me to get back to normal.

I wouldn't be concerned about the fatigue. My roommate also takes Zoloft and has similar issues with it. I once dated a girl who was also on Zoloft and she had the same issues as well. My psychiatrist told me that it was pretty common. It always goes away.

The delayed ejaculation probably won't go away until you stop taking it though. In fact, Zoloft has an off label use as a treatment for premature ejaculation (Google "sertraline premature ejaculation").

BTW, when my girlfriend and I were both on Zoloft, sex was a little weird. We would go for a few hours until we were both finally like "All right this is ridiculous, let's watch TV instead." But, it was still fun - it helps when you have a partner with a sense of humor. 

So, to summarize, for me and the other I've known who have taken it:

- Fatigue on dosage miss/change: Goes away after a few weeks; exercise helps a lot, sunlight, stay active - all good things to do anyways.
- Delayed orgasm: Very common, sticks around until you stop taking it.


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## BrianR

BTW, a couple more things to say about Zoloft:

1. For the fatigue, if you really can't deal with it at all, ask your doctor about Provigil (modafinil). It's normally prescribed to treat narcolepsy and sleep apnea-related fatigue, but I would take it as-needed and it helped me get through some rough Zoloft fatigue some times and did not make me jittery or "stoned". http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0000196

2. You know, IMO, drugs like Zoloft are a valuable *tool*. For me, Zoloft would not have solved my problems forever, and I didn't expect it to. In fact, it didn't "solve" my problems at all. But, it really put me in a space where I could concentrate on learning more about myself, and gave me an opportunity to develop great new tools for dealing with my own anxieties and problems. I was only on it for about a year, and when I got off it, even though the same old emotions came back, I was in a great position to deal with them, and really had permanently improved a lot. I really felt I used the opportunities it gave me, and I stopped it when I felt I was ready to go on my own again. I went into it with that attitude and, knowing it was just a temporary tool I think really helped me accept any of the other side effects. Lasting an hour and a half in bed for a year was kind of worth the lifetime of positive changes I ended up making. 

Note: I had another post I made before this that's still waiting for moderator approval. This one might make more sense after reading that one, which will probably be posted after this one, lol. Oh well.


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## Bacon

Paxil is the worst for Sex Drive and Ejaculation Problems. The Most reported side effect with Paxil is Ejaculation problems........destroys your libido. And a interesting little thing from Wikipedia on paxil (Paroxetine) Several studies have suggested that paroxetine can be used in the treatment of premature ejaculation. In particular, intravaginal ejaculation latency time (IELT) was found to increase with 6-13-fold, which was somewhat longer than the delay achieved by the treatment with other SSRIs (fluvoxamine, fluoxetine, sertraline, and citalopram So if your having bad luck with using Zoloft as your premature ejaculation med try Paxil it cant fail. Literally everyone on paxil has sexual side effects, If you don't get sexual side effects Go buy lottery tickets, your lucky. Zoloft has partial effects on dopamine. Paxil is all Serotonin and very selective at 5HT Sites.


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## privateuser

*There is an answer!*

I have been on zoloft since Decemeber and eventhough it helped me desire my husband more, I found I couldn't get aroused or ever reach orgasm. After about 6 months of frustration I finally found a website that offered herbal remedies. I had heard about taking Wellbutrin to offset what zoloft was effecting sexually, but I do not like to take Rx medicines if I can help it so I wanted a more natural alternative. I found this website site http://www.tinamariebernard.com/201...s-and-supplements-to-enhance-a-womans-libido/ and I tried the first supplement mentioned, the arginine. I purchased it from Amazon because I was willing to give it a try. It's been three weeks and I've been taking it once a day and I am able to get aroused and I've reached orgasm twice! This is exactly what I ordered. http://www.amazon.com/Super-Strengt...TF8&qid=1370989355&sr=8-5&keywords=l+arginine I feel so good about taking something natural that's good for me to begin with let alone something that helps my relationship with my husband! There is hope! I felt very torn....depression vs sex life. I don't believe we have to chose! This also helps with natural secretions as they were gone as well. I was always having to use a lubricant. I hope this helps you like it's helped me!


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## AlexP7

SSRIs do suck with their awful sexual side effects. It sucks having anxiety but having to choose between that or sex drive. They really need to come up with a good anti-depressant/anti-anxiety med that is NOT an ssri and not a benzo that will improve anxiety but not create other problems like sexual issues. I'm in my 30s and paxil has worked great for me for anxiety but the sexual side effects really suck. I don't really think about sex often anymore anyways, but even if I did, I doubt I could do much about it. I wonder if ssris affect females as badly in that respect as they seem to males.

I hope the drug companies come up with some better options in the future.


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## lela

it does affect females too...no orgasm on ssris for me. im now on trimipramine, which does alot against my anxiety, but it makes me drowsy  after the tiredness of the first weeks, i didnt really notice. but now i have to study for exams, and i just cant remember anything. this is terrible, bc ssris are no option for me anymore. im now trying to reduce the dosage of trimipramine (50mg now) and then see if i can handle my emotions. i already got alot better, even tho i had a dosage reduction. so staying positive...

still: does anyone have experience with imipramine and sexual side effects/ concentration issues?


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## RichieL

*Similar situation*



Barbapapa said:


> I was prescribed sertraline for premature ejaculation and i come quick even at 200mg  and i have regular sex (3-5 times a week) for 7 years  and my libido is also very high. i'm sooo over "sensitive" i get so excited that i cum in seconds. don't know what to do? anyone in the same boat? any suggestions? sertraline DOES help but not even close to "not able to orgasm"...


I understand your frustration, suffered with it for many years! I also used to be a quick shot...been on 50mg zoloft for about 2 years, on 100mg for the last year or so. Cured my problem, last a long time now, sex drive is good too. I am also a regular cannabis user and I'm sure that helps a lot as well. I know it's not an option for everyone, but from my experience, (and others I know), it does help.


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## ineverwipe

Yea same happened to me. It sucked because the girls I was with were freaks like 3 times a day freaks. But I was able to finish sometimes. Had to turn down sex a lot which they took personal


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## JSeinfeld

AlexP7 said:


> I wonder if ssris affect females as badly in that respect as they seem to males.
> 
> I hope the drug companies come up with some better options in the future.


Yes it does. I had a female friend on celexa.

No lubrication (painful sex). No orgasms. And eventually no sex drive.


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## Finch127

Yeah I have gotten that since I started taking SSRI's 5 years ago. 

Unfortunately its a catch 22 really. Its nearly like it takes those good feelings away and gives them to you over the course of your day lol


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## Ejack

*sexual side effects on partner*

My wonderful girlfriend is taking Zoloft as a way to deal with pelvic pain.
We have started seeing each other since she began taking it. It's helping.

But it does take time for her to reach orgasm. And that's okay..

However, it also seems that I am taking longer to ejaculate . That means I can go for hours, but it also is a really new and quite different experience for me.

Any chance that some of the dosage is passing to me through kissing and 'other activties'? 
Any one have that experience or hear of it?

We're very curious.

Thanks all.


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## BeautyBeast623

JSeinfeld said:


> Yes it does. I had a female friend on celexa.
> 
> No lubrication (painful sex). No orgasms. And eventually no sex drive.


I'm a girl and currently on 75mg of zoloft and i cant orgasm. At all. A few depression/anxiety meds I've been on have had the same effect. I feel bad for my boyfriend...he tries so hard. We need a medicine without the bad side effects but there will always be something bad about each medication.


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## Teflondon

Paxil was hellish in this regard. Always at half mast and unable to ejaculate to save my life. TMI maybe, but it's worth putting out there. It wouldn't surprise me at all if SSRIs and other anxiety-related meds cause a whole host of other physical problems that aren't very well documented yet since many of them have only been around 20 years or so. Although being a semi-alcoholic I'm not so sure I have any real basis to be worried about any toxins I'm putting into my body.


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## bad1980

My boyfriend has been on 100mg of zoloft for few years, it's mostly he's getting off within 5mins and not so much not being able to. Everything I have read is men don't get off at all or takes forever verse to quick. Does anyone have any tips on how to help... Very frustrating to a man that can't get his girl off....
_Posted via Mobile Device_


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## Hordak

*You can have it...*



AlexP7 said:


> SSRIs do suck with their awful sexual side effects. It sucks having anxiety but having to choose between that or sex drive. *They really need to come up with a good anti-depressant/anti-anxiety med that is NOT an ssri and not a benzo that will improve anxiety but not create other problems like sexual issues.* I'm in my 30s and paxil has worked great for me for anxiety but the sexual side effects really suck. I don't really think about sex often anymore anyways, but even if I did, I doubt I could do much about it. I wonder if ssris affect females as badly in that respect as they seem to males.
> 
> I hope the drug companies come up with some better options in the future.


https://en.wikipedia.org/wiki/Mirtazapine

And what about Bupropion?
Opipramol?
Tradozone?


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## Gillman fan

I feel like going on a rant re: SSRIs but usually when these threads are migrated from another forum the original posters disappear.

Your doctor has plenty of other options for antidepressants that do not cause sexual dysfunction and apathy, as well as medications that can ameliorate these side effects. The "accepted wisdom" among doctors seems to be that the serious long term side effects of apathy and sexual dysfunction are not a problem. The best thing you can do as a patient is point out how serious these side effects are and demand that your doctor discuss alternatives you have researched.


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## Hordak

I've been on Sertraline 50mg for 3 weeks and my sex drive / libido is totally gone. :serious:

Even if Cara Delevingne jumped at me, I wouldn't want to have sex with her. Totally messed up.


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## SFC01

adding mirtazapine got rid of my sexual dysfunction from zoloft immediately but it comes with its own side effect of weight gain so probably better ones out there


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## Hordak

SFC01 said:


> adding mirtazapine got rid of my sexual dysfunction from zoloft immediately but it comes with its own side effect of weight gain so probably better ones out there


I've talked to my GP a few days ago and he also suggested Mirtazapine (standalone or as augmentation). It's a pretty interesting AD (tetracyclic, NaSSA, atypical).

weightgain and more hunger shouldn't be a problem. I look like someone who has just exited the concentration camp.... :grin2:l


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## Gillman fan

Nortriptyline is the answer. Nortriptyline is always the answer. Quite similar to Mirtazepine except it isn't sedating and doesn't make you obese.

And yes, for the rare super skinny / anorexic person who also can't sleep, Mirtazepine is great!


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## Hordak

Gillman fan said:


> Nortriptyline is the answer. Nortriptyline is always the answer. Quite similar to Mirtazepine except it isn't sedating and doesn't make you obese.
> 
> *And yes, for the rare super skinny / anorexic person who also can't sleep, Mirtazepine is great!*


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## Hordak

Gillman fan said:


> Nortriptyline is the answer. Nortriptyline is always the answer. Quite similar to Mirtazepine except it isn't sedating and doesn't make you obese.


Sounds interesting.
What's the difference between Nortriptyline and Amitriptyline?


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## Gillman fan

Actually like many TCAs the parent molecule is metabolized into a child molecule that is also potent in its own right. Nortriptyline is a metabolite of Amitryptyline, so if you are prescribed Amitryptiline you will have effectively have both meds in your system at once. I think Imipramine and Desipramine have the same relationship. 

Amitryptiline does not have SSRI side effects, but it is pretty heavily sedating and has moderate anticholinergic side effects like dry mouth, constipation, and urinary hesitancy. I think most patients would prefer this type of side effect to total loss of sex drive lol. Amitryptiline is more effective as an antidepressant, and it has a few unusual properties that I am not too familiar with, It isn't very potent with Serotonin but has a lot of rather unusual properties that I do not understand. 

Nortriptyline does not have the same antidepressant potency, but it also has fewer side effects, and a few properties that make it an ideal augment for treating serotonin side effects.

I have no doubt that the strongest 3 TCAs (Chlomipramine, Imipramine, Amitryptiline) are stronger than SSRIs. You won't find this data in a scholarly publication because drug companies thoroughly massage and manipulate their experiment results in order to make SSRIs look good.


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## SFC01

Duckbruck said:


> Sounds interesting.
> What's the difference between Nortriptyline and Amitriptyline?


Not tried nortriptyline but have been on a low dose of amitriptyline (50mg) for pain - didn't do much for pain but even at a low dose I certainly felt an uplift in mood. In fact, if i am ever taken off nardil then, along with imipramine, amitriptyline would probably my next two choices.

Re Mirtazapine, think the jury is out on whether its an effective anti depressant or not so if you decide on that one, maybe try it as an addition to zolft rather than stand alone.

One other side effect I remember well from mirtazapine was an increase in anger.


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## Hordak

Gillman fan said:


> Amitryptiline does not have SSRI side effects, but it is pretty heavily sedating and has moderate anticholinergic side effects like dry mouth, constipation, and urinary hesitancy. I think most patients would prefer this type of side effect to total loss of sex drive lol.


hahaha indeed. :lol
I've never understood that Angst when it comes to dealing with TCAs _(Granted, you can overdose on them, but a suicidal person will always find ways: 10x tablets 500mg Paracetamol/acetaminophen combined with a few beers will do the trick)_

That's how SSRIs are marketed:
constipation, dry mouth, urinary hesitancy, weight gain = servere side effects that will probably kill you. 
no libido, no sex drive, insomnia, anhedonia, nausea, no appetite, headaches, discontinuation syndrome = mild side effects, way better than TCAs...

*lol*?
where is the logic?



Gillman fan said:


> Amitryptiline is more effective as an antidepressant, and it has a few unusual properties that I am not too familiar with, It isn't very potent with Serotonin but has a lot of rather unusual properties that I do not understand.


I've read a lot of good things about Amitriptyline. A few years ago there was a statement from some German League of psychiatric hospitals or so (?) and they praised Amitryptiline as very efficient and significantly superior to SSRIs, especially in inpatients.



Gillman fan said:


> I have no doubt that the strongest 3 TCAs (Chlomipramine, Imipramine, Amitryptiline) are stronger than SSRIs. You won't find this data in a scholarly publication because drug companies thoroughly massage and manipulate their experiment results in order to make SSRIs look good.


Where do Tetracyclics stand when compared to TCA, SSRI and so on? (in your opinion)


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## Hordak

SFC01 said:


> Re Mirtazapine, think the jury is out on whether its an effective anti depressant or not so


Doesn't it work for most people? :rain



SFC01 said:


> if you decide on that one, maybe try it as an addition to zolft rather than stand alone.


That was my initial plan: heroic combo :smile2: (let's hope that my psychiatrist will go for it)
I've read about some potent synergetic combos, for example the famous California rocket fuel :grin2:


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## cigpk

I've been taking 50 mg of zoloft for only 3 days and my ability to orgasm or maintain is already preettttyyyy much shot unless I want to put some unnecessary effort into it. I also take wellbutrin and buspar. 

I used to take remeron but it did nothing for me in the ways of SA/OCD. 

It has not even been a week but I'm afraid that if I'm having this side effect so soon then it has to be a bad sign right?


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## Gillman fan

Well the TCAs aren't really a "class" in the same what that SSRIs are. SSRI refers to what the drugs *do*, TCA just refers to the shape of the molecule. In general the most potent TCA antidepressants will share similar side effects, their development originated from studies of substituted antihistamines.

The "top 3" TCAs I just listed actually work in very different ways. Chlomipramine is like a super SNRI, it is what Effexor wants to be, but never will be. It is the most potent serotonin reuptake inhibitor across all classes of meds, period. As I said about Amitryptiline it works in mysterious ways, possibly involving AMPA receptors or neurotrophic growth hormone or other mechanisms of action that are quite uncommon. And when I look at Imipramine's receptor affinity page, I see nothing special about it at all, but it has been proven extremely potent and effective. SFC had good results with Imipramine.

Really the only thing these top 3 share in common is side effects - anticholinergic and antihistamine. Chlomipramine's potency with serotonin may cause sexual side effects, but its potency with norepinephrine may reduce them. Note that I just listed THREE and there are actually something like 2 dozen TCAs, there are a few other second generation TCAs available in Europe but not in the US that might be interesting too.

In the long run anticholinergic side effects can be bad, they have been linked to dementia. But there is a way to treat the anticholinergic side effects - acetylcholinesterase is the enzyme that breaks down acetylcholine, and there are drugs that inhibit it (sort of like an MAO I). I literally have never heard of this being prescribed to treat the side effects, it is simply my idea but I am pretty sure it would be worth a shot at least. These drugs are well-tested and have an established safety record but the "niche" has always been geriatric patients.

Tetracyclics - fewer medications and they are even more varied, not worth grouping together as a class.

I am sorry you guys have to suffer through SSRI bull****. As I have said in other posts my cocktail improves my sexual functioning, your suffering is by no means inevitable or required. Your best bet is to complain loudly and frequently about these side effects. No one has mentioned apathy, but it is also quite common. It is easy to confuse apathy for an improvement in depressive symptoms. It might feel better, but you are simply putting a fresh coat of paint on rotten wood. If you complain enough you might get something like Nortriptyline or Mirtazepine to help with these side effects, or maybe you can choose a different class of medication. It is pretty easy to get prescribed Buproprion, may be worth a shot, it is a good, if not phenomenal, medication.


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## Hordak

Gillman fan said:


> I am sorry you guys have to suffer through SSRI bull****.


:hs

It is a horrible suffering and not worth it :mum

Additionally to my other side effects I've been having headaches and upset stomach for the last 3 days. I am going to discontinue that s**t. With Sertraline I am feeling far worse than without it :x



Gillman fan said:


> As I have said in other posts my cocktail improves my sexual functioning, your suffering is by no means inevitable or required. *Your best bet is to complain loudly and frequently about these side effects.*


I will do that! :yes
The side effects outweigh the benefits by far.
For some people it may work, but for me it's r*t poiso*.



Gillman fan said:


> If you complain enough you might get something like Nortriptyline or Mirtazepine to help with these side effects, or maybe you can choose a different class of medication. It is pretty easy to get prescribed Buproprion, may be worth a shot, it is a good, if not phenomenal, medication.


:thanks

I am feeling so ****ty right now.
Should any doctors suggest SSRIs again, I will kick their butts :whip


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## Katy Kat

I have found the sexual side effects get better over time. Also, I am currently on a "drug holiday", basically taking a few days off from Sertraline, and I have had great success with this. On the second day of not taking the med, things are pretty much back to what they were prior to starting the med. And perhaps strangely, I'm not having any symptoms of withdrawal (I normally take 150mg of Sertraline). I just wanted to throw this out there in hopes it might help someone else.


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