# Low dose SSRI to help mild anxiety and depression, without sexual side effects?



## deklan89 (Aug 29, 2012)

Hi I have mild anhodenia depression and social anxiety. Does anyone have any experiences with taking an SSRI, such as Sertraline, at a very low dose of 4x less than the normal dose, so that a mild mood lift can be attained to prevent the constant negative thoughts creating anxiety especially in social situations, without the strong sexual side effects of a normal dose?

My mood is always quite muted, but after good exercise it gets a little better and I think more positively, so I would like to replicate this mild mood lift with a low dose ssri, what are your thoughts?


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## riptide991 (Feb 1, 2012)

Why don't you first try regular dose and see if you even get side effects. Not everyone gets side effects. I got no side effects from zoloft at 200mg. The starting therapeutic dose is 50mg.


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## deklan89 (Aug 29, 2012)

hi thanks for you reply. Thats encouraging- i tried the regular starting dose of Sertraline last year and by day 4 did get sexual side effects, though at the time I had a heap of other problems such as low thyroid and other hormones. Would you say Zoloft is one of the better ssris for not having the sexual side effects?


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## deklan89 (Aug 29, 2012)

also may I ask- are you male or female?


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## riptide991 (Feb 1, 2012)

Hey, well it could be just an initial side effect that goes away. Remember that these drugs INSTANTLY change the amount of serotonin in your brain. Your brain takes some time to adapt. 

I'm male btw. I do prefer Zoloft to most SSRIs as it has some studies backing it that it has no impact on mental vigilance while other SSRIs do. I guess you could start at 25mg and stay on it for a bit if you don't get any benefits move up to 50mg. If you still have sexual side effects after 4 weeks on 50mg then unfortunately it's just bad luck.

You could also try Prozac if it doesn't work out. It's weird how differently everyone reacts to the exact same drugs. I guess because we are all individuals  But yah you may get sexual side effects on one SSRI but not on another and they essentially do the same thing. Some like zoloft do increase dopamine in some areas too and prozac has some 5-ht2c antagonism which also increases a bit of dopamine. But typically in the prefrontal cortex and not nucleus accumbens where the reward center is. heh


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## JustRachel (May 22, 2013)

I'm on 20mg prozac atm, it doesn't affect my ability to erm..get aroused, although it does make it a little harder to climax, although not impossible. But the same happened when I was on mirtazapine, it went away after a month. Plus I think because were so scared of it stopping our functioning that way, it actually makes it worse for us. So relaxing is key, trying not to think about it  hope this helps!


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## GotAnxiety (Oct 14, 2011)

Good luck.


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## Focus123 (Aug 30, 2013)

> Does anyone have any experiences with taking an SSRI, such as Sertraline, at a very low dose of 4x less than the normal dose, so that a mild mood lift can be attained to prevent the constant negative thoughts creating anxiety especially in social situations, without the strong sexual side effects of a normal dose?


If you went below the standard Sertraline starting dose at 50mg, (such as 4x which makes it 12.5mg or half a 25mg pill) you wouldn't really receive the effect of what Setraline was prescribed for, which is to reduce your anxiety. Low levels of Setraline would probably poop out on you, since your brain is not being challenged by the medication, to produce new cells that were damaged from psychological stress.

For anxiety disorder treatment, most people use a dosage between 100-150mg.



deklan89 said:


> hi thanks for you reply. Thats encouraging- i tried the regular starting dose of Sertraline last year and by day 4 did get sexual side effects, though at the time I had a heap of other problems such as low thyroid and other hormones. Would you say Zoloft is one of the better ssris for not having the sexual side effects?


_*I copied this information, below, from a previous thread about managing the sexual side effects of antidepressant usage:*_

Anorgasmia (problems with ejaculatory delay) can be a side-effect with an antidepressant (AD).

Wellbutrin (normally at 150mg) taken in conjunction with an AD has been proven to reduce anorgasmia. If you go higher on Wellbutrin, and have an anxiety disorder, Wellbutrin may escalate your anxiety.

Likewise Ginkgo biloba at 240mg, taken in two doses of 120mg, has been shown to reverse anorgasmia. However, before starting Ginkgo biloboa, a user should start at 2 X 30, and gradually build up every 5 -7 days, until the user reaches 2 X 120mg.

If you decide to take Ginkgo biloba, talk to your doctor first, if you should take it in conjunction with the current medications he is prescribing for you.

Likewise, the effects of supplements like Wellbutrin or Ginkgo biloba on reversing anorgasmia may take up to a month for you to feel their effect.

Paxil, however, has been researched to be the SSRI with the highest issues of anorgasmia. Paxil has been reported to cause ejaculatory delay (compared to being non-medicated on ADs) at 7.8 times normal. If you change to another SSRI, Fluoxetine (Prozac) has been reported to have ejaculatory delay at 6.6, Zoloft (Sertraline) at 4.4, and Fluvoxamine (Luvox) at 1.9.

So, if anorgasmia continues to be a problem, discuss with your doctor about the option to change to one of the other SSRIs.

There is also the option of taking Viagra, but often insurances will not cover it.

So although you maybe experiencing side effects on an AD, do know you can work around them, if managing your anxiety disorder is important enough for you to live a more functional life, without the crippling effects of anxiety.

Also report issues to your doctor before your next appointment, by either calling his office and having him call you back with your concerns, or emailing his medical assistant for a response, so he can make recommendations on managing your side effects.

_Also, do note, posts written on this forum should only be used as a reference._


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