# SSRI's and the Sex Drive!!!!! Share your advice and experiences.



## IfWinterEnds (Jun 4, 2010)

Hey guys, I am sure this has been asked at some point. But as you all probably are aware, SSRI's are linked to the common complaint of a much reduced libido and the potential for orgasms becoming a near impossibility.

6 years ago, starting college,...Effexor was working for me. It was working so well for me that I met and started dating my first boyfriend ever. It was such a paradox: the thing that finally got me some sex made me enjoy the at-last sex less. Sigh.

My Dr.'s advice? Take less, take only enough just to not feel "trippy". And that turned into me always taking just enough to not feel the withdrawal effects, not benefit from the medication, and ultimately stop taking the Effexor.

A little while later I started taking benzos, but under my new Dr's advice I am weaning off in order to avoid being too hooked. I am soon to start slowly with Celexa. 

Needless to say, I don't a repeat of the circular path I took a few years ago. 

Has anyone found an effective way to enjoy both the benefits of sex and an SSRI? Are there better alternatives to have a sex drive other than skipping medication doses?

Share your advice, experiences, tips, and interesting links with me!


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## basuraeuropea (Jul 25, 2012)

augment with cyproheptadine, mirtazapine, trazodone, nefazodone, buspirone, or bupropion. important to note that while bupropion is a common augmentation agent used to alleviate ssri-induced sexual dysfunction, it is poorly tolerated amongst those who suffer from anxiety-spectrum disorders as it's often very anxiogenic. some physicians will also augment with dopamine agonists, typically ropinirole or pramipexole, although there is much debate as to whether this will worsen your mental state in the long run. conversely, amantadine is probably (?) used with more frequency than the two aforementioned dopamine agonists as it has a more favourable side-effect profile and mildly increases dopamine release while not being an agonist. 

alternatively, you can switch to an antidepressant with anxiolytic properties that is reputed to have less sexual side effects than the ssris/snris, e.g. mirtazapine, trazodone, or nefazodone. they each have their downsides, though, with sedation being problematic for many of those who take the first two, weight gain being extremely problematic for many who take the first, and difficulty finding the last due to rare hepatoxicity incidents. mirtazapine would probably be your best bet if switching out of class completely. 

all said, if venlafaxine is working to control symptoms, try augmentation strategies before switching out of class.


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## GotAnxiety (Oct 14, 2011)

I wonder if anyone ever became orgasmic after being on a SSRI for afew years? If it resolves depression 100% and gets ya in the best shape of your life. Wouldn't it be possible?


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## basuraeuropea (Jul 25, 2012)

GotAnxiety said:


> I wonder if anyone ever became orgasmic after being on a SSRI for afew years? If it resolves depression 100% and gets ya in the best shape of your life. Wouldn't it be possible?


i would think that it'd be possible and probably in a shorter time frame than you've provided.

i was on paxil/paroxetine for more than ten years without any sexual dysfunction whatsoever. none from the start all the way until i discontinued the medication. and paxil/paroxetine is purportedly one of the worst offenders in the sexual dysfunction arena amongst the ssris.


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## GotAnxiety (Oct 14, 2011)

My sexdrive is actually improved well being on an SSRI. I guess that why they call it PSSD. I still get some numbing but that no biggy if the plumbing works better and i can last longer pleasing a girl.

I wonder how common your responce to Paxil is that a pretty outstanding side effect.


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## GotAnxiety (Oct 14, 2011)

For me ive been reducing my dose to half to help reduce tolarance and give my serotonin recepters some down time on the weekend usually Friday till Sunday. im still testing this idea out. Im already on a low dose. It works good to keep side effects to a minium and provide down time.


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## WineKitty (Nov 26, 2004)

Celexa made me completely devoid of sexual desire. I stopped taking it for that very reason--decided I would rather have a sex life than be a lifeless robot which is what it turned me into.


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## Chuwey (Dec 9, 2011)

I never had higher libido than when on mirtazapine. I think the weight gain and fatigue from it could be eliminated by combining with modafinil (when I took modafinil with an ssri, I had way reduced appetite and, not surprisingly, was wide awake). Problem is that I don't recall mirtazapine doing much for anxiety, and modafinil would probably make that worse. 

Eltoprazine profile looks exciting as an augmenter to a good ssri, but I've no idea where to get it or how much to take.


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## IfWinterEnds (Jun 4, 2010)

basuraeuropea said:


> augment with cyproheptadine, mirtazapine, trazodone, nefazodone, or bupropion. .


Thanks. I was very sure that there were drugs out there to take along with SSRI's to improve/maintain sex drive. I wrote down what you mentioned in different sections (not just those that I quoted from you).

Do you happen to know why physicians seem to never mention (in my experience, at least) medication options to augment SSRI's when patients complain about unpleasant sexual side effects? Do they not know extensively about them, have little experience, or have other reasons to be hesitant to prescribe additional medications? Other guesses/obscure information?

Anyway, thank you for this great response. I'll take what you wrote out with me to my next visit. I am going to see a behavioral medication specialist/psychologist to talk to along with my new primary care physician.


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## IfWinterEnds (Jun 4, 2010)

WineKitty said:


> Celexa made me completely devoid of sexual desire. I stopped taking it for that very reason--decided I would rather have a sex life than be a lifeless robot which is what it turned me into.


Ugh...now I'm a little not Celexa excited. This sounds exactly why I got off SSRI's and am hesitant to try again. My Dr. said Celexa should affect my sex drive less than the Effexor I was on previously, but we can only wait and see.

I got off of Effexor because, while I never felt my extreme lows, and my severe anxiety was soothed, I also seemed to have lost my extreme excitement, passion, and intensity.

I guess I can always go back to my last doctor who'd prescribe 1mg Klonopin, enough for twice daily, for an 'as needed' basis, without a 2nd thought or any discussion at all.

Did you switch to anything else after Celexa?


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## victthoe (Jan 13, 2013)

My sexdrive is actually improved well being on an SSRI.


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## Secretaz (Sep 10, 2011)

SSRIs have made me totally numb 'there', but my mind is still filled with dirty thoughts almost all the time...


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## fashionista (Jan 7, 2013)

I have heard some (although kind of rare) guys say that Paxil actually didn't harm their sex drive one bit. My doctor told me that Paxil/Paroxetine can cause delayed orgasm, but she didn't emphasize any erectile dysfunction, so at least that was comforting to hear. I have always prided myself on having a rather large libido so I hope I am one of those guys that Paxil doesn't harm. I guess you have to weigh the potential benefits of treating the anxiety as opposed to sexual side effects, although for men, that can be a really scary thing when you talk about delayed orgasm or any numbing of the plumbing! Hey, that rhymes! lol


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## talkminusaction (Jul 16, 2012)

After I went off of Zoloft I definitely felt the thirst more, only it's very painful because my SA makes me unable to find a boyfriend, so I'm considering going back on an SSRI again just so I won't feel sexually lonely.


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## komorikun (Jan 11, 2009)

The birth control pill can kill your sex drive too.


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## Noca (Jun 24, 2005)

IfWinterEnds said:


> Thanks. I was very sure that there were drugs out there to take along with SSRI's to improve/maintain sex drive. I wrote down what you mentioned in different sections (not just those that I quoted from you).
> 
> Do you happen to know why physicians seem to never mention (in my experience, at least) medication options to augment SSRI's when patients complain about unpleasant sexual side effects? Do they not know extensively about them, have little experience, or have other reasons to be hesitant to prescribe additional medications? Other guesses/obscure information?
> 
> Anyway, thank you for this great response. I'll take what you wrote out with me to my next visit. I am going to see a behavioral medication specialist/psychologist to talk to along with my new primary care physician.


Simple, doctors don't give a rats *** about any side effects you suffer as a result of the treatment they prescribe you. They also know hardly anything when it comes to medications, how they work, and what real options are out there. The only thing a doctor is good for is their knowledge base of physiology.

I have seen more doctors(as a patient) probably in an 8 year period than anyone on this board and found this to be generally the case with almost every one of them. Where I live, doctors from all over the world come to work here, so I have a pretty good sample size and mix in which to base my opinion on.

I have caught them in countless technical errors, many instances where they just make things up, prescribe dosages that don't exist, knowing only what they read out of a CPS textbook's 1-2 paragraphs of information which is even less than the pharmaceutical company's own prescribing information pdf, many of whom have no idea how the drugs they prescribe work, prescribing drug combinations that have interactions making them totally redundant, prescribing drugs for an entirely different purpose than the drug has the capacity to affect/treat, etc etc.



IfWinterEnds said:


> Ugh...now I'm a little not Celexa excited. This sounds exactly why I got off SSRI's and am hesitant to try again. My Dr. said Celexa should affect my sex drive less than the Effexor I was on previously, but we can only wait and see.
> 
> I got off of Effexor because, while I never felt my extreme lows, and my severe anxiety was soothed, I also seemed to have lost my extreme excitement, passion, and intensity.
> 
> ...


Your doctor most likely didn't put much thought into his/her choice of Celexa at all. Their decision making process that has them arrive at a particular drug for you to take does not consist of 3 chalk boards worth of calculations that they would have you believe, they give no more thought than merely picking a medication out of a hat at random.

If you have seen more than a few doctors you will start to notice that the lack of consistency in what you are getting handed to you follows no pattern at all and seems to take nothing of the symptoms(or specific symptoms) you complained to your doctor into consideration when he/she arrives at a choice of said medication other than that they tend to throw random SSRI's at you first, and slowly move up the schedule ladder of restricted drugs over time.

One thing I may add to the suggestions given above by other members is if you take an SSRI with a short half-life such as Paxil, you can time your next daily dose to exactly AFTER you have sex. That way when you have sex, your plasma levels of Paxil will be at their lowest point in the day, and thus the side effects including sexual side effects will ALSO be at their lowest point of the day. You might be actually able to reach an orgasm using this method, I know I have been able to make it work.

Also over time, the therapeutic maintenance dose may be lowered to a dose lower than what you previously needed for your symptoms to go into remission, but still might be able to keep you mostly symptom free. I started on 40mg of Paxil, and years later am down to a mere 20mg a day, most of my sexual side effects are gone now. Just the SSRI induced apathy towards live remains, which might be a good thing.


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## fashionista (Jan 7, 2013)

Noca said:


> Simple, doctors don't give a rats *** about any side effects you suffer as a result of the treatment they prescribe you. They also know hardly anything when it comes to medications, how they work, and what real options are out there. The only thing a doctor is good for is their knowledge base of physiology.
> 
> I have seen more doctors(as a patient) probably in an 8 year period than anyone on this board and found this to be generally the case with almost every one of them. Where I live, doctors from all over the world come to work here, so I have a pretty good sample size and mix in which to base my opinion on.
> 
> ...


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## Chuwey (Dec 9, 2011)

This is interesting: www.ncbi.nlm.nih.gov/pubmed/17233786

Anyone tried? I imagine it would work the same for guys. 
BTW "_hypo_active sexual desire disorder" means they have _no_ interest in sex.


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## basuraeuropea (Jul 25, 2012)

Chuwey said:


> This is interesting: www.ncbi.nlm.nih.gov/pubmed/17233786
> 
> Anyone tried? I imagine it would work the same for guys.
> BTW "_hypo_active sexual desire disorder" means they have _no_ interest in sex.


that is interesting, although ssris induce sexual dysfunction via their serotonergic activity not via the reduction of testosterone and so i'm not quite sure this would work for ssri-induced sexual dysfunction.


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## imrj (Jan 20, 2009)

SSRI (lexapro) gave me the biggest libido boost ever, even more than testosterone by far....yes there is delayed orgasm but the libido increase was huge....believe it has to do something with HT1A receptor which modulates sex drive....libido is complicated, is not just about a hormone or one thing only but many working together, same for orgasm although much shorter duration (ie. orgasm needs a high spike of NE which SSRIs inhibit thus delayed orgasms happen)


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## ihateanxiety1 (Feb 8, 2012)

Every SSRI I took made my sex drive go to 0. I no longer had any interest in sex whatsoever. 22 year old male.


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## Spungo (Jul 30, 2012)

WineKitty said:


> Celexa made me completely devoid of sexual desire. I stopped taking it for that very reason--decided I would rather have a sex life than be a lifeless robot which is what it turned me into.


I was the opposite. I was keeping a journal at the time because SSRI drugs made me feel compelled to write (which is very out of character). During the Celexa months, journal entries had very strong sexual tones. What it would be like to sleep with this person, what it would be like to date someone, etc. 
That was probably the thing I miss the most about Celexa. I just had to write constantly. I wrote poetry, journal entries, and essays. I would sketch things and write a detailed explanation of the sketch. Celexa was a very creative time.


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## riptide991 (Feb 1, 2012)

Lexapro killed my sex drive completely. Zoloft may have increased it a bit in higher doses.


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## Chuwey (Dec 9, 2011)

Anyone tried, or know anything about, Rikkun****o? Supposedly a 5-HTC antagonist?

[EDIT: unreal, it actually censored the name, let me spell it out R-i-k-k-u-n-s-h-i-t-o]


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## Cletis (Oct 10, 2011)

This is the number one complaint about SSRIs and the main reason people stop taking them. Yes, they do kill the sex drive in most people. I've been on Zoloft for a long time. The sex drive does come back (slowly) over time.


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## GotAnxiety (Oct 14, 2011)

Nope. You can try Wellbutrin. That might help. But it would be a tempory fix. I wonder if Crack Cocaine would work for pssd?.


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## GotAnxiety (Oct 14, 2011)

Post SSRI Sexual Dysfunction


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## Spungo (Jul 30, 2012)

Chuwey said:


> Anyone tried, or know anything about, Rikkun****o? Supposedly a 5-HTC antagonist?
> 
> [EDIT: unreal, it actually censored the name, let me spell it out R-i-k-k-u-n-s-h-i-t-o]


Without googling to check what you're talking about, I would guess it feels a lot like mirtazapine. Mirtazapine is mostly a 5-HT2c antagonist, and it works great IMO. It made food taste really really good, and I immediately gained about 30 pounds. Mirtazapine destroyed the anxiety part of social anxiety, but it didn't make me more social. I just felt like "yeah, whatever, leave me alone so I can play games and eat and enjoy being alone"

edit 
This is the thread about sex drive. Mirtazapine didn't really lower my sex drive. It just made other things a priority. Make some pasta and eat it while playing Fallout? Hell yeah, let's do this! I couldn't really have sex after taking mirtazapine since it's a pretty hard sedative, but I could have sex before taking mirtazapine. This probably applies to your drug too.


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## Spungo (Jul 30, 2012)

mynameisthis said:


> ok is there aomething on the market to help libido


Anything that will significantly raise dopamine (and sometimes noradrenaline) levels will increase your sex drive.
-amphetamine (Dexedrine, Adderall)
-methylphenidate (Ritalin, Certa)
-bupropion (Wellbutrin)
-MAO-B inhibitors (Anipryl)
-ephedrine
-caffeine
-cocaine
-alcohol
-nicotine

Aside from bupropion, antidepressants are very hit or miss. I said citalopram (Celexa, Lexapro, Ciprolex) made my thoughts a lot more sexual, but others said the exact opposite. I thought sertraline (Zoloft) made me a bit of a zombie, but some people have an increase in their sex drive. Venlafaxine (Effexor) made my sex drive very high if I chewed them. Duloxetine (Cymbalta) just made me feel very anxious, probably unable to get a boner if I tried, but I wasn't in the mood to try.

I'm a very strong supporter of people trying nicotine. Don't start smoking, but get a nicotine inhaler. They're very cheap. A $50 box of them from costco lasted more than a year. Studies have shown that nicotine is a very powerful antidepressant, and it's sort of old age wisdom that it's associated with sex. 
I also just like holding a nicotine inhaler and chewing on it while I'm at work. Maybe I'm just retarded, but I love holding and chewing things.


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## Psychofarm (May 21, 2012)

I'm on day 15 with Paxil. I noticed an effect mentally almost on day 1 (I'm typically very sensitive and pick up on subtle changes in mind and body - weed has after effects for months for example). Physically no change in sex drive (mine is typically very high), but also from day 1 have had difficult getting and maintaining an erection, loss of sensation, and delayed ejaculation. Now the delayed ejaculation could be a good thing, but to add insult to injury there is NO orgasm. All this while still having a somewhat high sex drive (though not like it was in my 20's), talk about frustrating.

Pretty much the only reason I resorted to medication after years of therapy, diet, and exercise failed me was to start dating for the first time in my life (the aforementioned "performance" issues were by myself of course). I think Paxil has potential in that department for me though it may be a bit early to know for sure, but it's pointless if I have difficulty performing and/or derive little to no pleasure from sex. 

I'm going to ask my doctor in a few weeks about augmentation. I've had good results with Adderall mixed with Klonopin in social situations, so perhaps a psycho-stimulant such as Wellbutrin could help me, but I'm also worried about worsening anxiety symptoms.

What terrifies me however is the possibility of permanent loss of sexual function due to SSRI treatment, which does happen though not common. I'm angry my doctor didn't mention this, I feel this type of disclosure should be required by law.


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## Depresso (Jan 25, 2013)

Every anti depressant I've taken killed my sex drive, and I too just learned that it can be permanent in some people. I'm through with em.


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## Psychofarm (May 21, 2012)

Depresso said:


> Every anti depressant I've taken killed my sex drive, and I too just learned that it can be permanent in some people. I'm through with em.


I hear ya, it was my last resort option after everything else I've tried has failed me. I had to weigh the cost/benefits due to my quality of life, I just can't stand being alone anymore.

However learning that I'm risking permanent loss of sexual function scares the crap out of me. So what am I left with? A life with no sex or a life with no sex? Frack me running.


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## Depresso (Jan 25, 2013)

Psychofarm said:


> I hear ya, it was my last resort option after everything else I've tried has failed me. I had to weigh the cost/benefits due to my quality of life,
> 
> 
> > I just can't stand being alone anymore.
> ...


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## Psychofarm (May 21, 2012)

Depresso said:


> Psychofarm said:
> 
> 
> > I hear ya, it was my last resort option after everything else I've tried has failed me. I had to weigh the cost/benefits due to my quality of life, QUOTE]
> ...


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## Depresso (Jan 25, 2013)

Psychofarm said:


> Depresso said:
> 
> 
> > Sorry, no ad's?
> ...


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## Psychofarm (May 21, 2012)

Depresso said:


> Psychofarm said:
> 
> 
> > AD's=anti depressants.
> ...


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## Depresso (Jan 25, 2013)

Psychofarm said:


> Depresso said:
> 
> 
> > Yeah I wish it were that simple for me. May I ask how old you were? Had you any dating experience before this?
> ...


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## Psychofarm (May 21, 2012)

Depresso said:


> Psychofarm said:
> 
> 
> > Ironically, I was 35, your age, she was 33. I had experience, but no two women are the same, and my experience has not saved me from a couple of crushing disasters.
> ...


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## Depresso (Jan 25, 2013)

Psychofarm said:


> Depresso said:
> 
> 
> > It's a bit of a different world when you're my age with NO experience whatsoever. The older I get, the harder it gets. This is an all too common complaint with men in my position, as it's very demoralizing and a huge blow to one's self confidence and sense of masculinity. *It's very difficult to get past the thought that huge red flags will be thrown up for a man my age to fumble around like an awkward teenager. Most women in their right mind will run in the other direction and not look back.*
> ...


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## Anxietyriddled (Jan 5, 2013)

When I was taking prozac is actually helped with my depression and SA but it had a horrific sexual side affect. I literally became like a floppy hot dog, could not get hard and when I tried to masturbate It was numb and I couldn't orgasm no matter how hard I tried. When I stopped taking it, my sex drive came back and I could orgasm up to 10 times a day. It was to me as terrifying as one day you wake up and one of your arms or legs doesn't work. SO now I refuse to take any SSRI"s besides the one I'm on now Wellbutrin SR , supposedly is one of the few SSRI's with no sexual side affects.


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## ILOVEXANAX (Jan 22, 2013)

Anyone have any remedies to fix the problem?


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## ILOVEXANAX (Jan 22, 2013)

Anxietyriddled said:


> When I was taking prozac is actually helped with my depression and SA but it had a horrific sexual side affect. I literally became like a floppy hot dog, could not get hard and when I tried to masturbate It was numb and I couldn't orgasm no matter how hard I tried. When I stopped taking it, my sex drive came back and I could orgasm up to 10 times a day. It was to me as terrifying as one day you wake up and one of your arms or legs doesn't work. SO now I refuse to take any SSRI"s besides the one I'm on now Wellbutrin SR , supposedly is one of the few SSRI's with no sexual side affects.


At least you have a floppy hot dog all im left with is a permanently shriveled worm and tight balls lol


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## yourfavestoner (Jan 14, 2010)

I'd suggest Luvox as an excellent drug for anyone who wishes to kill their libido.

Anyone? Okay, nevermind.


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## ILOVEXANAX (Jan 22, 2013)

Na no SSRI's for me. I can't take them


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## kaori (Jan 29, 2013)

Yea... same here... SSRI's can fudge the fudge off. I do not like how they make me feel at all.


(currently taking Buspar & Ativan for anxiety)


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## Implicate (Feb 1, 2011)

I've been on a hefty list of SSRI's and SNRI's and while I didn't notice any increase in sexual desire, I also never had any negative sexual side effects. Being female may or may not be a factor in this, it would seem males suffer more from the sexual side effects. 

On my 7th day of Celexa now, recently tested out the sexual side effects and was very pleasantly surprised to know that achieving orgasm was easier than before, and I am actually much more sensitive than I was before starting the medication. My spouse, on the other hand, couldn't even get an erection on this medication, just a testament to us all being vastly different from a physiological stand point.

No sex is a no go for me personally, and if I suffered sexual side effects from a medication it would kill my will to live. For females if you are suffering sexual side effects and are continuing treatment I would suggest trying a stimulating lubricant, they have ones with a warm effect and a cool tingling effect, this may increase your pleasure.


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## Psychofarm (May 21, 2012)

yourfavestoner said:


> I'd suggest Luvox as an excellent drug for anyone who wishes to kill their libido.
> 
> Anyone? Okay, nevermind.


I was on it about 7 years ago, and didn't have any sexual side effects believe it or not. Same with Effexor (but that was horrible for me in general, making my anxiety worse).

Everyone certainly reacts differently.


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## Skitzo (Feb 2, 2013)

my anti psychotic give me same problems seroquel


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## JSeinfeld (Jan 20, 2013)

I've been on Celexa for about 4 months, I'm fine about the depression and anxiety, I have to admit I feel a lot better, and at first it didn't affect my sex drive at all, it was even higher because my mood was better, but for the last few weeks it has been decreasing A LOOOOT... 

I used to wanna make love with my girlfriend everyday, but now I can't get aroused anymore, or the few times it eventually "goes up" it doesn't last, it goes down like a tree in the middle of sex, it's awful!! I hate it! 

I will give it a little time to see what happens, but if this stays this way I can't tolerate it for a long time...

My options are:

A) Get off Celexa and face the possible consequences of being even worse than before or B) Adding Wellbutrin to alieviate the sexual dysfunction induced by Celexa, but I don't like the idea of adding another drug and getting new side effects...

So... I'm screwed!! :mum


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## GotAnxiety (Oct 14, 2011)

JSeinfeld said:


> I've been on Celexa for about 4 months, I'm fine about the depression and anxiety, I have to admit I feel a lot better, and at first it didn't affect my sex drive at all, it was even higher because my mood was better, but for the last few weeks it has been decreasing A LOOOOT...
> 
> I used to wanna make love with my girlfriend everyday, but now I can't get aroused anymore, or the few times it eventually "goes up" it doesn't last, it goes down like a tree in the middle of sex, it's awful!! I hate it!
> 
> ...


What dosage you on?


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## JSeinfeld (Jan 20, 2013)

Celexa 20 mg


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## rg8813 (Nov 27, 2012)

Adding Wellbutrin made it even worse for me. But apparently if theres even a .000001% chance of sexual side effects, I'll feel them.


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## JSeinfeld (Jan 20, 2013)

rg8813 said:


> Adding Wellbutrin made it even worse for me. But apparently if theres even a .000001% chance of sexual side effects, I'll feel them.


Really?? Damn it!

Anyway i've been taking half of celexa for the last few days, and I started today really easy with the Wellbutrin (a quarter of a 150 mg pill). Let's see how it goes...


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## rg8813 (Nov 27, 2012)

im sure u will be ok. 

let me know how it goes. (no details tho!)


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## jimmythekid (Apr 26, 2010)

I have taken all of the SSRI's and SNRI's except Luvox and Paxil. I've had reduced desire on most of them. No anorgasmia or impotence, just lowered libido. It was extreme at times, where sex started to seem like something on the discovery channel, if you know what I mean. The last three SSRI's/SNRI's I've taken haven't been that bad at all. Zoloft, Prozac and Cymbalta. Maybe over the years my body is tolerating them better. I don't think anyone should be scared off from taking AD's because of this. I've experienced this, but it's never been much of a problem.


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## IfWinterEnds (Jun 4, 2010)

Noca said:


> Simple, doctors don't give a rats *** about any side effects you suffer as a result of the treatment they prescribe you. They also know hardly anything when it comes to medications, how they work, and what real options are out there. The only thing a doctor is good for is their knowledge base of physiology.
> 
> I have seen more doctors(as a patient) probably in an 8 year period than anyone on this board and found this to be generally the case with almost every one of them. Where I live, doctors from all over the world come to work here, so I have a pretty good sample size and mix in which to base my opinion on.
> 
> ...


From what I'm starting to see, I have to agree about doctor's not thinking twice about the side effects of what they prescribe. I actually switched Dr's (leading to citalopram perscription and tapering off clonazepam). My last doctor--once diagnosed me as having something really common, and I got a call over a week later when I was in Vegas letting me know I actually had something else and needed antibiotics right away or I could have serious problems. My insurance did not cover my meds out there. Now that I know more about that, I realize how incredibly lazy she was about that.
And, even though I liked the benzo's, I knew she shouldn't be really....not enough for 2mg a day, PRN! I feel like she was on benzo's herself.
More recently, I went in and she found something out about me. She gave me one option and made it sound like the only one, when I knew there were other options also. Pretty much forcing her decision on me. She also had the information mailed to my parents house. I might have their address partially on my records there, but she knew it was something I'd want to tell them myself. Extremely awkward.

I know someone who has no ADHD, but takes 40 mg of adderall a day, eats one meal before bed, smokes, drinks caffeine, and is extremely underweight. He's super relieved because when he goes to refill his script--his provider doesn't even check his BP. Hasn't in over 8 months. She'd noted it was a little high, originally. I take this person's BP-it's high.

I guess that my new doctor's actually doing a little better, taking me off clonazepam (which I was afraid she might), starting me on an antidepressant and helping me get connected to mental health.

I should probably give doctors a chance though, because I've been listening to a lot of doctor bashing (because of what I am involved with) without having a lot of personal experience like you do.

Went up fast with Celexa, 40 mg. Sex drive is gone. But it could be the clonazepam withdrawal, and like someone else here mentioned, the birth control I just started taking.

I looked up clonazepam's half-life: it's 35 hours and Prozac's was 40 something. I only clicked on one link for each so I'll need to find more legitimate info and look into your suggestion.

And there was this Oprah article...haha. It was more about how some people need smaller doses of SSRI's than they take, but I looked into it more and found information that sounds similar to what you were saying about needing a higher dose initially, then being able to take decreased dose and still having the therapeutic effects.

The Celexa apathy is nice.....I like it a little better than the Effexor apathy.


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## IfWinterEnds (Jun 4, 2010)

Spungo said:


> I was the opposite. I was keeping a journal at the time because SSRI drugs made me feel compelled to write (which is very out of character). During the Celexa months, journal entries had very strong sexual tones. What it would be like to sleep with this person, what it would be like to date someone, etc.
> That was probably the thing I miss the most about Celexa. I just had to write constantly. I wrote poetry, journal entries, and essays. I would sketch things and write a detailed explanation of the sketch. Celexa was a very creative time.


I liked reading this, because a huge reduction in the amount I wrote when I was on Effexor (I guess it's an SNRI). That's what I meant when I told people it "made me not care," because suddenly I wasn't writing at all. I have been obsessively writing since I was an early teen.

So...a little hopeful to hear that about Celexa, and hope it works similarly to for me since it worked for you as creative person. So far, I've been blah, but I am thinking that it's from withdrawing from clonazepam and not drinking caffeine at all anymore.

So far....Celexa seems to turn off that background anxiety. Things that usually affect me emotionally don't spin out of control immediately. So far, it might be a little bit of apathy, but I'm a little happier/interested than I ever was on Effexor (which was blaahhhh).

Anyway-hearing this was nice. Celexa actually feels a little more like taking adderall (which makes me write a TON when I take it). Though of course, nowhere near as stimulating.


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## GotAnxiety (Oct 14, 2011)

Well wellbutrin can cause high blood pressure and the extra adrenaline might effect the prostate. So it can contribute to erection problems in a different way.


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## Robert Paulson (Apr 11, 2012)

Here's my experience with Lexapro. I started at 10mg/day for 2 weeks, then moved up to 20mg/day for another 6 weeks.

After the first 2 weeks, I experienced anorgasmia. I literally could not orgasm, no matter how hard I tried. After an hour of trying, I gave up in frustration. Thankfully, this torture only lasted a week.

What followed for the next 5 weeks was a complete DEATH of my sex drive. It was like I was completely asexual. I had no sexual attraction to anyone or anything. I NEVER ONCE in that 5 weeks got an erection. Even morning wood was gone! It just completely turned that whole system off.

I tried watching pornography once during this, just to see what would happen. I must have watched about 15 minutes total from 6-7 videos, and my face was filled with disgust. You know how after you orgasm, you take one last look at the once-hot pornography before closing it, and think to yourself "wow this is disgusting what is wrong with me?" This is referred to as post fappers remorse, scientifically believed to be caused by a surge in prolactin following ejaculation.

On Lexapro, I was in a state of "post fappers remorse" ALL the time. This convinces me strongly that SSRIs sexual side effects are due to them lowering dopamine levels, which result in increased prolactin. Prolactin is the bad guy responsible for this effect. In males, it functions in the "cooldown period" after a guy ejaculates.


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## starburst (Feb 5, 2013)

Psychofarm said:


> Depresso said:
> 
> 
> > It's a bit of a different world when you're my age with NO experience whatsoever. The older I get, the harder it gets. This is an all too common complaint with men in my position, as it's very demoralizing and a huge blow to one's self confidence and sense of masculinity. It's very difficult to get past the thought that huge red flags will be thrown up for a man my age to fumble around like an awkward teenager. Most women in their right mind will run in the other direction and not look back.
> ...


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## swim (Apr 4, 2011)

actually I enjoy having no sex drive


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## loophole (Apr 15, 2012)

I'm bi-polar (part of which cause me to be a sexual addict).. taking klonopin and lamictal...(dealt with this for 14 years before taking meds).... this puts my sex drive at a much "normal" level... while i still have a craving for sex I don't go "nuts" If I don't get it on a weekly basis(i'm married..).. i've gone a few months in between now and while it sucks... it's not the end of the world..... i am however lukewarm to pretty much everything in life and have issues focusing.. so dr put me on wellbutrin as well.... haven't been on long enough to really say much.. but i think i've noticed more focus... and being able to speak better...(sound smarter) thought it doesn't actually make you smart


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## Psychofarm (May 21, 2012)

starburst said:


> Psychofarm said:
> 
> 
> > There's nothing wrong with having NO experience - its actually a good thing.
> ...


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## tieffers (Jan 26, 2013)

Do you guys notice lack of sex drive being the biggest issue with SSRIs or is it mainly just anorgasmia?


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## rg8813 (Nov 27, 2012)

tieffers said:


> Do you guys notice lack of sex drive being the biggest issue with SSRIs or is it mainly just anorgasmia?


Anorgasmia.


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## pup55 (Aug 26, 2012)

on 20 mg lexapro...have had zero sex drive since i was put on it 7 years ago...downside of these meds...not sure it's worth it anymore...


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## GotAnxiety (Oct 14, 2011)

I would start with 2mg of cipralex and 150mg wellbutrin then slowly increase cipralex by 0.50mg increments a week untill your comfortable. Eventually bumping the wellbutrin up to 300mg if you feel comfortable with your ssri dosage.


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## starburst (Feb 5, 2013)

Psychofarm said:


> I'm finding womens' opinions on the matter to vary from one end of the spectrum to the other based on what I've seen online in this forum and in others, it's just very difficult to know where the majority lie. It would be interesting to see a properly controlled survey on matter (there may be something out there I haven't found), but at the same time may not be useful at the end of the day. After all, if a woman is turned off by it then she's obviously not going to be right for me and it's not going to work out. If the majority do indeed feel that way knowing that fact is only going to serve to demoralize me even further and discourage me from trying, so ignorance may be bliss.
> 
> And there is the possibility that there are women out there who would be turned off by it initially, or at least very concerned I have the emotional maturity to be worth their time (after all in my age range there is less time to waste than those in their 20's), but after getting to know me may be able to look past it. It's not like it's going to be a 1st date topic of conversation. I really don't want to lie about it either if it happens to come up, but it will most likely become obvious at some point and unavoidable to address.


At your age group (I am a few years older than you) another factor starts to come into play, and you will notice this more and more from now on - having no previous marriage or children gives you a definite advantage. A girl I used to go out with when I was in my thirties said she would absolutely hate to go out with someone who'd already had children. At the end of the day starting your life from new like you are is a pretty big advantage - 'experience' comes within a few short weeks believe me - that is so *NOT* an issue. Nature takes over in certain aspects of life.

'No experience' or virginity is an utterly trivial issue - boasting about sexual conquests is nothing more than egotism and machoism - ignore it, its totally irrelevant. Our society is drowned in a sea of false idealized images in film, music, books, advertising - but real life is really quite different.

One thing I would say if you have no previous experience of a relationship is that you will be surprised at how much of a commitment it is - you are used to having all your time and resources to yourself - but that changes when you are in a relationship, and it could require some effort on your part to adjust to that. The success of a relationship depends on considering the other person and sometimes that means sacrificing some things. The more settled you are within yourself the better - but if you are not settled within yourself it can cause great harm to a relationship. At the end of the day loneliness sucks, but to get a relationship in the real world you will have to put in a lot of effort to make it work - you really need to think hard about that, as its crucial to whether things will work out or not. Being 'in love' is the easy part - it's the nitty-gritty things of day-to-day life that makes or breaks a relationship.


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## Psychofarm (May 21, 2012)

starburst said:


> At your age group (I am a few years older than you) another factor starts to come into play, and you will notice this more and more from now on - having no previous marriage or children gives you a definite advantage. A girl I used to go out with when I was in my thirties said she would absolutely hate to go out with someone who'd already had children. At the end of the day starting your life from new like you are is a pretty big advantage - 'experience' comes within a few short weeks believe me - that is so *NOT* an issue. Nature takes over in certain aspects of life.
> 
> 'No experience' or virginity is an utterly trivial issue - boasting about sexual conquests is nothing more than egotism and machoism - ignore it, its totally irrelevant. Our society is drowned in a sea of false idealized images in film, music, books, advertising - but real life is really quite different.
> 
> One thing I would say if you have no previous experience of a relationship is that you will be surprised at how much of a commitment it is - you are used to having all your time and resources to yourself - but that changes when you are in a relationship, and it could require some effort on your part to adjust to that. The success of a relationship depends on considering the other person and sometimes that means sacrificing some things. The more settled you are within yourself the better - but if you are not settled within yourself it can cause great harm to a relationship. At the end of the day loneliness sucks, but to get a relationship in the real world you will have to put in a lot of effort to make it work - you really need to think hard about that, as its crucial to whether things will work out or not. Being 'in love' is the easy part - it's the nitty-gritty things of day-to-day life that makes or breaks a relationship.


Thanks, I appreciate the advice. I've actually thought about the day to day commitment quite a bit, having gleamed enough from watching 2 sisters and many friends go through their trials and tribulations with relationships. I realize it will be an adjustment and likely involve challenges I haven't anticipated, but I'm fed up enough with being miserable to make whatever sacrifices are necessary.

While the physical aspect of 'no experience' is still intimidating and scary and all the rest, it doesn't concern me as much as what I've missed in my emotional and interpersonal development. I may be projecting, but I fear many women my age would feel the same way. Physical intimacy can be learned relatively quickly, but I've missed out on decades of the day-to-day nitty-gritty as you call it.

But aside from the mundane (but important) details, my greatest fear is the bigger emotional stuff, having never been in love or anything even close, I worry about quickly becoming a clingy overly emotional basket case. And being of the type who lacks assertiveness and self confidence, assuming I can even attract a women long enough to get to the relationship part, I see myself becoming overly passive, and her either getting frustrated by it or worst case take advantage of it.

...well there I go catastrophizing again. I end up going down this road every time I think about this stuff. Even if some of it is true it can't be useful to dwell on it. Guess I just needed to vent, my apologies for derailing the SSRI discussion.


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## starburst (Feb 5, 2013)

Psychofarm said:


> But aside from the mundane (but important) details, my greatest fear is the bigger emotional stuff, having never been in love or anything even close, I worry about quickly becoming a clingy overly emotional basket case. And being of the type who lacks assertiveness and self confidence, assuming I can even attract a women long enough to get to the relationship part, I see myself becoming overly passive, and her either getting frustrated by it or worst case take advantage of it.


Been there and done all that, and made all these mistakes. It can be off-putting to be too 'clingy' - but being too stand-offish is equally bad! Its better to think of there being 'no rules', because everyone is different and no-one is perfect - we all make mistakes.


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## IfWinterEnds (Jun 4, 2010)

Am on 40 mg of Celexa (Citalopram), started taking Wellbutrin (Bupropion) at the beginning of March....and it works for me. Not back to how it used to be, but things work again.


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## millenniumman75 (Feb 4, 2005)

tieffers said:


> Do you guys notice lack of sex drive being the biggest issue with SSRIs or is it mainly just anorgasmia?


It can be either or both. You would likely get a different answer from different men. lol


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## JSeinfeld (Jan 20, 2013)

tieffers said:


> Do you guys notice lack of sex drive being the biggest issue with SSRIs or is it mainly just anorgasmia?


Both for me. I was on Celexa for 6 months, the first 2 months I was great, lots of sex drive, it was a little harder to ejaculate but it was fine, it was nice to last longer! :b

Around the third month all went downhill, at first I started having problems ejaculating, it wasn't just delayed, it was almost impossible. And then my sex drive started decreasing and eventually... puff! it was gone. It was impossible to get aroused by my girlfriend, I didn't have any libido at all, I was like asexual.

Now I'm off Celexa and my libido has returned. The thing is now I'm being a little "premature" if you know what I mean...

Being on a SSRI was a total disaster for my sexuality.


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## llodell88 (May 15, 2011)

Usually just anorgasmia for 6 months or so but I had some weird intense masturbation phobia on Prozac, and I had a really intense feeling of discomfort while trying it, like my body was really trying to tell me hard not to do it, on top of that I would get a really distinct empty space type of feeling in my frontal lobe while trying it too.


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