Are Sexual Side Effects Dose Dependent?

[tryp]

Last week, pdoc mentioned wanting to up my Celexa (or take me off it entirely, but that's another story).

SHE claims that the sexual side effects aren't dose dependent, but she's been wrong about stuff before - her theoretical knowledge doesn't always seem to match up with what actually happens.

What do you all think?

My SSEs from the Celexa actually seems to be improving a tiny bit - possibly because I tried the caffeine method today - and this is sort of a factor in my decision as to what to do with the med.

I'm sure everyone thinks I'm a gigantic idiot for continually asking about this stuff, but it's important and it's freaking bothering me.

[Velvet Elvis]

OK, I'm lightly buzzed and am going to talk frankly here.

I think my sexual side effects have always been dose dependent with me but I've never paid that much attention to them, just dealt with them.

They can get better with time and, er, practice as well. Before I was as out of shape as I am now, I looked at them as a way prolonging sex rather than an actual problem. If you've got the physical stamina you can work work around them. Experiment with techniques, lubes and sex toys and you'll figure out a way to get each other off, SSRI or no SSRI.

All things considered, I think sexual side effects are a dumb reason to come (no pun intended) off your meds. Are you in a hurry or something?

That's assuming the problem is anorgasmia. If it's libido try wellbutrin or yhombine (sp?). If it's arousal, in the female department try some extra lube.

I actually considered adding sex toys and lube to the crazy store for this very reason.

[Leafskipper]

Last week, pdoc mentioned wanting to up my Celexa (or take me off it entirely, but that's another story).

SHE claims that the sexual side effects aren't dose dependent, but she's been wrong about stuff before - her theoretical knowledge doesn't always seem to match up with what actually happens.

What do you all think?

My SSEs from the Celexa actually seems to be improving a tiny bit - possibly because I tried the caffeine method today - and this is sort of a factor in my decision as to what to do with the med.

I'm sure everyone thinks I'm a gigantic idiot for continually asking about this stuff, but it's important and it's freaking bothering me.

IMHO anytime I take a medication it's a big deal, so I don't think you are an idiot for being concerned about their effects on your sexual life. (especially!) meds affect people in differents ways so if I were your Pdoc ilu wouldn't jump to conclusions so quickly

I have taken Celexa in the past, 20 mg I think- I remember being frustrated by the SSE also. I'm no doctor or pharmacist but from what I've read about SSRIs there is an increased chance of side effects with increased dosage. When I was taking lexapro I had more suicidal thoughts with a higher dose- these decreased along with mg.

My five cents- hope you and pdoc figure it out.

What's with the "or stop entirely"?

Ls

[tryp]

Pdoc is also considering taking me off my AD entirely to see what's underneath the medication and whether the meds are making things worse/not helping.

The anorgasmia isn't the only reason I'm thinking about coming off - I haven't made my pro-con list yet, but I'm anxious as fuck and still mildly depressed, which is why pdoc wants to either up it or axe it, and I don't know if I want to up it if it's going to make things worse.

I could also try to get pdoc to augment with either Wellbutrin or buspirone, probably the latter since I don't want my anxiety to get any higher.

I can't decide whether to up, augment, or axe the Celexa.

It's mostly a problem because I'm already up to my elbows in sexual hangups and issues, and the SSEs are playing with my head and making things worse. PTSD + SSEs isn't shaping up to a great combo for me, though I'm sure that other people have dealt with it. I'm REALLY having issues and it's freaking me out and I'm starting to get into positive feedback loops with my other issues.

I've tried sex toys, by the way. Didn't help. But they do seem to be getting a bit better with time, which is why I'm wary of making it worse again by upping the dose.

[Deepster]

Tryp-

I'm male, so some things could be different. The SSEs I experienced on Celexa began on day one with 5mg, and never improved nor got worse when going up to 10mg, then 20mg.....total erectile dysfuntion, total inability to orgasm.

All SSEs completely vanished by day 3 after getting off this med.

That is the last SSRI I ever intend taking. I had the same experience with Paxil.

My best to you with whatever you and your pdoc decide.

Deepster

[LunaRufina]

I've had varied issues like this and while it's been frustrating at times, it's never ended up being a reason for me to stop or drop a med. [As in, there's always been ways to deal with/work around it. And yes lubricants are your friend.]

Also, it's definitely possible for side effects to improve if you've been on it a while. You may want to just try hanging at the dosage you're at for a little longer if you can manage it.

[tryp]

I've been on 20 mg for I think a bit over 5 weeks now, and it's definitely gotten a bit better. At first, I was just completely numb, and now it's not so bad. But except for my little experiment with caffeine today, it's not just that it takes more work, it's more that I can't get off at all. And for god's sake, I'm 19, I'm in a real sexual relationship that means something to me for the first time in my life, and I'm up to my elbows in sexual issues as it is.

I have no idea what to do - my brain is totally spinning its wheels, I'm supposed to be using extra Seroquel to control my anxiety, but it hasn't been working for the past couple days - I'm still bouncing off the walls all the time, and I've been thinking about death a lot. I really want to cut even though I'm not THAT depressed and cutting isn't even something I DO but it's all over my head these days and I need to make a decision about my stupid meds and I have no idea what to do!

I feel crummy. But LESS crummy. Do I feel less crummy enough to stay on a med that's fucking with my sex life and leaving me climbing the walls with anxiety? Do I try to axe the anxiety and zap the remaining depression by increasing the dose and risk fucking up my sex life even more? Do I come off and risk getting really sick and taking another two months to get back on an AD and get it working? Do I continue to medicate something that possibly doesn't require medication? Do I augment and make my drug cocktail even bigger and go down the asthma medication pathway? What if anything I do makes me even sicker and it's my fault? I feel like any decision I make will be the wrong one and I don't know what to do!

I'm really scared. Everyone keeps saying I sound better and I feel like nobody believes me that my head is exploding on the inside!

[Velvet Elvis]

First off, are you sure the celexa is causing anxiety for you? If so that could mean you're mildly bipolar and it's causing a mixed episode of some kind. If an SSRI is causing anxiety I'd say drop it because they aren't supposed to do that, at least not after the first few weeks.

The seroquel alone should be enough to counter any severe anxiety caused by the wellbutrin, particularly if you nudge the dose up to 300mg or so.

Wellbutrin might also make it possible for you to take prn benzos without dysphoric side effects (you had those didn't you?)

That's only if the celexa is in fact making your anxiety worse, however.

[tryp]

I don't know! I'm so confused - it's possible that it caused the anxiety, it's possible that the depression is lifting, and so this is my high-anxiety baseline coming out, it's possible that I'm having a flareup of some kind for some completely other reason.

I have no freaking idea! I keep obsessing that I might be bipolar. I have no idea why I'm so anxious and the Seroquel isn't keeping it down. Either that or it is keeping it down and what's under the Seroquel is so horrible that I'm like this on the Seroquel.

I also wonder if maybe the Celexa is somehow giving me akathisia?

And yes, I had the dysphoria on the benzos.

I don't know - I don't want to be on more meds than I need. Every time I try to think of what I should do, I get really agitated and I'm feeling really anxious and weird in general and then sometimes I convince myself that I'm imagining the whole thing and that there's nothing wrong at all and then I think maybe because I'm borderline I'm just being manipulative and screwing everyone around even though I know the manipulative thing is actually a myth.

Ed. to remove the really stupid bits.

[null0trooper]

I also wonder if maybe the Celexa is somehow giving me akathisia?

And yes, I had the dysphoria on the benzos.

The usual bet is that any akathisia would be the result of an antipsychotic, but it is a possible side effect of SSRIs, so the second most likely possibility is that it's the SSRI/AAP combination. Not helpful, but hopefully that makes it easier to see where your doctor is coming from in wanting to reexamine your baseline (which could suck horribly - I'm not minimizing your concern.)

Also, some people do get "tore the hell out of the ER" dysphoric on benzos. If you fall in that category, it's something you'll have to watch out for as time goes on - hospitals love to administer Valium and the like to cardiac patients to calm them down.

[Caillech]

Zoloft has this affect on me. I didn't really notice until my tdoc said something about it. And then I thought, yeah, that's my problem. For me, it is definitely dose dependant. the higher I get, the more problems I have. When I came completely off the medication in Jan 2008, and everything came back with avengence, thats when it was clarified for me.

I don't know if it goes away the longer i've been on it. I haven't had any for well over a year. But when I was with my ex, I think I seemed to remember it wasn't that bad after awhile. I did start having pain with orgasm (that took a long time to acheive thanks to the SSRI). That wasn't fun at all. But shortly after this I stopped having sex, so....*shrugs*

Did your pdoc seem to think this was a problem? I guess it seems to always come down to what your willing to live with verses what benefit you get from the med.

[tryp]

Pdoc thinks it's a problem mainly because of the aforementioned other sexual problems. She says she doesn't want it getting any harder for me to have sex.

The anxiety is an issue too. I hope it's not akathisia from the AAP/SSRI combination. Taking more Seroquel PRN seems to help it, and I don't think Seroquel would help akathisia. But then, the Seroquel isn't helping as much these past few days. It used to take out the problem entirely and now it doesn't.