wren

Treating SSRI-induced anorgasmia?

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Has anyone had success using Strattera to treat SSRI-induced anorgasmia? Or success using another med for this purpose?

I had success treating SSRI-induced anorgasmia when adding Wellbutrin XL 150mg to Zoloft 50-75mg, but I am now on Lexapro 15mg and the Wellbutrin has NOT reversed the anorgasmia in conjunction with this SSRI. Lexapro has otherwise been wonderful and I would really like to find a solution to this! I came off Zoloft because it sedated me terribly, so I've been reluctant to try other meds (like Trazadone) that are known for sedation. I tried switching to Lamictal as my main antidepressant (for Unipolar depression), but was unsuccessful in coming off Lexapro after trying three different times while on Lamictal, proving to me that the Lamictal is not cutting it. So now I'm back to Lexapro and need to come up with another solution to this anorgasmia. 

Edited by wren

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Have you tried the first generation antihistamine Cyproheptadine ? Old as the hills and sometimes used as a treatment for Serotonin Syndrome or  anorgasmia caused by SSRI's.

http://www.ncbi.nlm.nih.gov/pubmed/8665544

 

Edited by notloki
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I take citalopram which is essentially es-citalopram (Lexapro). Adding Remeron helped me with this problem.

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6 hours ago, jt07 said:

I take citalopram which is essentially es-citalopram (Lexapro). Adding Remeron helped me with this problem.

Remeron is a 5ht2 antagonist as is Cyproheptadine, and mianserin. We don't have mianserin in the US but Remeron is it's analogue.

http://www.ncbi.nlm.nih.gov/pubmed/9197943

Edited by notloki
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Thanks! I'll look into Remeron. Also, I'm checking out stimulants as an option.

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19 hours ago, wren said:

Thanks! I'll look into Remeron. Also, I'm checking out stimulants as an option.

Remeron realllllly helped with my depression at a time when I needed something, and fast. I was crying constantly, and two days later felt like a weight was lifting. Maybe with the lifting of depression you can get some enjoyment back. And yeah, Adderall or something similar should do it, too. Stimulants tend to have the... needed effect?

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On 8/15/2016 at 7:51 AM, wren said:

Has anyone had success using Strattera to treat SSRI-induced anorgasmia? Or success using another med for this purpose?

I had success treating SSRI-induced anorgasmia when adding Wellbutrin XL 150mg to Zoloft 50-75mg, but I am now on Lexapro 15mg and the Wellbutrin has NOT reversed the anorgasmia in conjunction with this SSRI. Lexapro has otherwise been wonderful and I would really like to find a solution to this! I came off Zoloft because it sedated me terribly, so I've been reluctant to try other meds (like Trazadone) that are known for sedation. I tried switching to Lamictal as my main antidepressant (for Unipolar depression), but was unsuccessful in coming off Lexapro after trying three different times while on Lamictal, proving to me that the Lamictal is not cutting it. So now I'm back to Lexapro and need to come up with another solution to this anorgasmia. 

Anorgasmia is the worst.  Like how do you spell torture?   

This is just my experience.  I have ZERO background but...  Have you asked your doctor about going straight Wellbutrin XL?   I went totally of Celexia and went to Wellbutrin at 150 (Didn't work)  300mg (Seemed close or ok)  and  Now 450mg which has been a good solution.  I still deal with anxiety but I'm in the cross hairs of life's crap rifle.   I went back to Diazapam for the Anxiety (As needed) and that works well for the breakthrough stuff.  Buspar helps keep the bottom from dropping out totally.

That probably sounds lke a pharmacy but sometimes you need a cocktail of meds to make things functional.

Be really vocal (proactive) about Anorgasmia.  If you don't complain loudly they won't know there is a problem and can't do anything to help you.

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32 minutes ago, HAL9000 said:

Be really vocal (proactive) about Anorgasmia.  If you don't complain loudly they won't know there is a problem and can't do anything to help you.

Very true! The squeaky wheel gets the grease! :)

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I've got anorgasmia from my Luvox :(

is there any other good antidepressants that are good for ocd that are less likely to cause it?

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I'm moving this tread to the Side Effects forum.

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On August 25, 2016 at 11:48 AM, HAL9000 said:

Anorgasmia is the worst.  Like how do you spell torture?   

This is just my experience.  I have ZERO background but...  Have you asked your doctor about going straight Wellbutrin XL?   I went totally of Celexia and went to Wellbutrin at 150 (Didn't work)  300mg (Seemed close or ok)  and  Now 450mg which has been a good solution.  I still deal with anxiety but I'm in the cross hairs of life's crap rifle.   I went back to Diazapam for the Anxiety (As needed) and that works well for the breakthrough stuff.  Buspar helps keep the bottom from dropping out totally.

That probably sounds lke a pharmacy but sometimes you need a cocktail of meds to make things functional.

Be really vocal (proactive) about Anorgasmia.  If you don't complain loudly they won't know there is a problem and can't do anything to help you.

Thank you to all the people who have responded to me! It means so much! I really appreciate it!

 

in response to Hal...

I have tried Wellbutrin XL by itself, without any other meds. At the time, I was at a 150mg dosage and had a return of my depression on this. Instead of increasing the Wellbutrin, another SSRI was added instead, as my Pdoc thought that I should have shown some sort of improvement on 150mg Wellbutrin. Not sure how true that is.

I have complained loud and clear about my hoo ha being broken. LOL! But seriously, I think I must be one of the few people willing to speak up about every stinking side effect that I have on these meds (restless legs at night, increased jaw clenching, dry mouth (Wellbutrin at 300mg), increased thirst, apathy, inability to concentrate, fatigue, anorgasmia, loss of libido...) That there was a list of all worst side effects of all the psych meds I've been on.

So... Pdoc told me last week that she thought I was highly sensitive to meds because of all the side effects I keep announcing to her. She said that she thought I would have side effects to all of them, since I have side effects to Lexapro, which she said pretty much no one has side effects on. Because of this, she saw no point in trying me on any other SSRI than the three I've already tried (Prozac, Zoloft, and Lexapro) and that I should just pick one.

If it weren't for the anorgasmia with the Lexapro, I would love this one. If it weren't for the sedation on Zoloft (and consequential inability to concentrate or even stay awake), I would love that one. And Prozac is a question mark. I was also taking Valium while on Prozac, so I do not think that I should write it off as completely sucking--despite that, on it, I experienced my life as a zombie for 8 weeks.

My latest idea is to see if I can get by on a lowered dose of Lexapro (maybe 7.5mg?) with the augmentation of Lamictal (150-200mg). I am not fine on just one or the other, but maybe with lowered Lexapro, I can find a happy place where I am both *not depressed* and can still experience sexual arousal and orgasms. Lexapro does a kick ass job on my depression, so I'm reluctant to mess with that too much, but I'm willing to edge down slowly and see if I can make that work. I think I might have a chance, since in my latest attempt to get off Lexapro, I had a return of sexual arousal at 10mg, 7.5mg, and 5mg... And did not get a return of depression until I hit 2.5mg. (I was on 200mg Lamictal during this time.) Previously, when I was on half that dose of Lamictal (100mg) and tried to get off Lexapro, I had a return of depression at 7.5mg Lexapro. So, I can tell the Lamictal is doing *something*. I just can't use it as a monotherapy at 200mg.

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I think that was a rather odd reaction on the part of your pdoc because all these meds are known to have side effects, even Lexapro. The thing is that most of the side effects abate with time. Sexual side effects can be tough to get rid of though and I'm shocked that she isn't more understanding on this. 

As I mentioned, Remeron helped me, but it is a heavy hitter in the sense that it will knock you off your feet for several days when you start it. I'm not trying to sell you on Remeron, and if you are indeed sensitive to side effects then it  probably wouldn't be the med for you.

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On August 26, 2016 at 8:47 PM, jt07 said:

I think that was a rather odd reaction on the part of your pdoc because all these meds are known to have side effects, even Lexapro. The thing is that most of the side effects abate with time. Sexual side effects can be tough to get rid of though and I'm shocked that she isn't more understanding on this. 

As I mentioned, Remeron helped me, but it is a heavy hitter in the sense that it will knock you off your feet for several days when you start it. I'm not trying to sell you on Remeron, and if you are indeed sensitive to side effects then it  probably wouldn't be the med for you.

Yeah, I thought it was odd for her to say that Lexapro has pretty much no side effects for most people. Maybe most of her patients don't complain about it as much as I do? I was also disappointed that she did not have a ready list of other meds to try with the Lexapro to see if it would address the sexual side effects. She pretty much gave up after Wellbutrin did not work to effectively alleviate that side effect of the Lexapro. Meanwhile, I am able to do simple google searches and come up with a list of no less than a dozen medications known to counteract this side effect, including the one that works for you, Remeron.

Knowing how easily I get sedated, I have been reluctant to try Remeron without trying some other meds first. I also worry about the weight gain associated with Remeron. I will consider it, though, if the Lamictal/Lexapro combo does not pan out and, also, the stimulants I want to try do not work. Thanks for your advice on this!

 

 

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2 hours ago, wren said:

Yeah, I thought it was odd for her to say that Lexapro has pretty much no side effects for most people. Maybe most of her patients don't complain about it as much as I do? I was also disappointed that she did not have a ready list of other meds to try with the Lexapro to see if it would address the sexual side effects. She pretty much gave up after Wellbutrin did not work to effectively alleviate that side effect of the Lexapro. Meanwhile, I am able to do simple google searches and come up with a list of no less than a dozen medications known to counteract this side effect, including the one that works for you, Remeron.

Knowing how easily I get sedated, I have been reluctant to try Remeron without trying some other meds first. I also worry about the weight gain associated with Remeron. I will consider it, though, if the Lamictal/Lexapro combo does not pan out and, also, the stimulants I want to try do not work. Thanks for your advice on this!

 

 

If you're worried about the drowsiness from Remeron, you can totally take it before bed. :)

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I'm not going to lie to you. Remeron is a highly sedating med, especially at first. However, that sedation side effect largely goes away as you get used to the med (a couple weeks or so). I am able to take my dose during the day now which I sometimes do on days when I'm very anxious without being sedated. But it can cost you a weekend when you first start it.

Weight gain is also an issue but you can combat that by having plenty of healthy snacks and vegetables around. 

In general, the way to avoid the worst side effects of Remeron is to take it literally right before you intend to sleep, That way you sleep through the worst of the munchies and the sedation helps you get a good night's sleep.

Really, those are the only side effects that you would likely notice. It's a good med for me because it combats the problem you have but that is not the reason I take it. I take it because it is a great med for anxiety and maybe it helps with my depression (though antidepressants don't do much for my depression).

Again, I want to say that I'm not trying to sell you on Remeron. I'm just giving you information about how it affects me and from what I've gleaned from others. Whether it is the med for you is between you and your doctor.

Edited by jt07
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On 27/08/2016 at 10:47 AM, jt07 said:

I think that was a rather odd reaction on the part of your pdoc because all these meds are known to have side effects, even Lexapro. The thing is that most of the side effects abate with time. Sexual side effects can be tough to get rid of though and I'm shocked that she isn't more understanding on this. 

As I mentioned, Remeron helped me, but it is a heavy hitter in the sense that it will knock you off your feet for several days when you start it. I'm not trying to sell you on Remeron, and if you are indeed sensitive to side effects then it  probably wouldn't be the med for you.

I had plenty of sides from Lexapro. I couldn't take enough of it for it to be effective without feeling so hyped up I couldn't sleep at all (I would go days and days without sleep at just 10mg), anorgasmia from the 1st dose (actually i've had this with ALL the meds I've taken, even Doxepin), chest pain upon startup and med induced panic attacks the 2nd time around, hours of them back to back so bad I couldn't take more than 2.5mg. Interestingly I did well on Citalopram for 10 months which is very similar. But again, anorgasmia was terrible and didn't return for a couple of weeks after my last dose. Doctors in Australia don't seem interested in adding anything to combat this side effect, they just take you off it and put you on something else. It's a little frustrating.

Edited by Jessamine

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Paxil anorgasmia: just started taking 10mg Paxil CR after no meds for a couple of years other than Klonopin. Anorgasmia set in - I've been horny but just could not ejaculate. Read about various antihistamines helping, and tried Benadryl but I just fell asleep. Had some Zyrtec and decided to give it a try - BOOM! 15 minutes after taking 10mg on an empty stomatch,  I had a great release. Whew!!!   It was a different feeling than normal, more of a gradual buildup and a longer orgasm - it didn't have as much "force" as normal, almost as if my muscles were tired. Kind of oozed out rather than squirted five feet.

Absolutely thrilled I found something that worked. Hope this helps someone!

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