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Wellbutrin Add-on for Sexual Side Effects?


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Hello, this is my first post to your boards.  I am so far finding them very helpful.

I've been on high dosages of Effexor XR for years, but as I hit my mid-30s I've found the Sexual Side Effects to be too troubling as I've been dating more and I've tried virtually everything you can think of OTC to combat this side effect...I did feel much better anxious/depression/ocd wise on higher dosages of Effexor and somewhat regret going down but I've decided I can't sacrifice that part of my life any more.

I've reduced my dosages to pretty low, and I talked to my PDoc about what I can do to boost sex drive.  He suggested Wellbutrin might help with a lot of my issues and has prescribed my 150 daily to add on to the 75mg Effexor.

My question is has anyone here tried this?  Did it help with Erections, libido, both?  Do you think I'll have to just drop the Effexor XR to beat the sexual side effects?

 

Thanks in advance.

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I couldn't tolerate Effexor. It made me unbelievably jittery. Wellbutrin the first time made it impossible for me sleep, but the second time around it didn't do diddly-squat. I've never had erection issues with meds, but Prozac made orgasms impossible. Paxil made it take me a lot longer to climax, and Cymbalta is causing the same problem, but not to the same degree. As for libido, meds don't seem to effect it, but my mood surely does. When I'm depressed, sex is the last thing on my mind. But when I'm manic, I can become extremely hypersexual. It can be rather confusing for some. One moment you're devouring them, and the next you don't want to have anything to do with them.

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@BrianOCD, Be careful trying the Wellbutrin if you have any kind of anxiety disorders, such as GAD or OCD.

In some people, WB can make their anxiety problems worse......If you find your anxiety gets worse on it, the dose can always be lowered if your pdoc agrees.

I take WB and have anxiety disorders, too, but all the rest of my meds are so sedating, I think they balance out the stimulating effect of WB.

Edited by CrazyRedhead
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On 29/04/2017 at 0:40 AM, CrazyRedhead said:

@BrianOCD, Be careful trying the Wellbutrin if you have any kind of anxiety disorders, such as GAD or OCD.

In some people, WB can make their anxiety problems worse......If you find your anxiety gets worse on it, the dose can always be lowered if your pdoc agrees.

I take WB and have anxiety disorders, too, but all the rest of my meds are so sedating, I think they balance out the stimulating effect of WB.

I found it worsened my anxiety, but my mother, who initially took it to quit smoking, found it killed her anxiety dead! She raved about her newfound confidence in board meetings even. I told her it must have sent her insane because it doesn't do that XD

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  • 3 weeks later...

Ya I haven't started it yet because of the anxiety concerns.

My options are add the Wellbutrin or go even lower on Effexor eventually dropping it completely.  It's a tough choice because Effexor is very effective for my other issues like depression, OCD, anxiety.

Edited by BrianOCD
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My experience with Wellbutrin was that, yes, it did increase my anxiety. I did not find that it helped offset the sexual side effects of my other meds. It did, however, not make anything worse. That is my experience and YMMV.

A couple of observations about your meds. First, for most people the therapeutic dose for Wellbutrin is 300 mg. I took 150 mg for a while and it did nothing for me. Second, Effexor at 75 mg is basically just an SSRI. You have to be around 150 mg for it to work as an SNRI. But I guess that wouldn't be too much of a problem because Wellbutrin is largely an NRI (also a weak dopamine reuptake inhibitor).

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arteI have OCD and what my pdoc refers to as "history of GAD" (a pdoc in the ER diagnosed me with GAD but she seems to think I have something else and isn't telling me apparently). I have panic attacks from time to time, social anxiety, etc., but haven't been officially diagnosed with panic disorder of social anxiety disorder or anything.

However, Wellbutrin was the first antidepressant that I responded positively to (before I knew I was bipolar and took an AD without a mood stabilizer). Personally, it never did anything for my libido or sexual function, even when I went all the way up to 500 mg/day. But it also never increased my anxiety; rather, it decreased it, especially when Adderall was added to it, paradoxically. Now Adderall, on the other hand, when I first started it, did... lots of... things... (I cannot mention here) plus increased libido and all that stuff. Stimulants aren't a first-line option for this indication, but they are used for antidepressant-induced sexual dysfunction.

I will also say that when I was on Effexor, it was physically impossible for me to get off. My interest was drastically decreased, but when I wanted to, it was hopeless, but Effexor helped me so much that the benefits outweighed the negative side effects it gave me, until I started gaining tons of weight, which is a deal breaker for me.

The SNRI Cymbalta, on the other hand, didn't give me any problems in the sexual function department, even when I went all the way up to 120 mg (maybe a little trouble, but not much). Pristiq, the synthetic active metabolite of Effexor, I seem to remember actually increased libido and sexual function, but even at 100 mg had no effect on depression whatsoever. Fetzima... I didn't have a good experience with it, so I wasn't on it long. Savella is related to Fetzima (the racemic version of it). I haven't tried it, but it's only indicated for fibromyalgia, but that doesn't mean it can't be prescribed for depression/anxiety, because it's used for that pretty much everywhere else around the world.

There are alternatives to adding Wellbutrin for SSRI/SNRI-induced sexual dysfunction:

  • SARIs (Serotonin antagonist and reuptake inhibitor)
    • Trazodone (Desyrel)
    • Nefazodone (Serzone)
  • NaSSA (Noradrenergic and specific serotonergic antidepressant)
    • Mirtazapine (Remeron)—major weight gain, carb cravings, and sedation with this one, so watch out if you try this one! Higher doses (≥ 30 mg) are said not to have as much of the sedation and carb cravings, while lower doses (≤ 15 mg) cause more sedation and carb cravings. Either way though, you will gain weight.
  • PDE5 inhibitors
    • Sildenafil (Viagra)—I think Viagra is still brand-name only, which you may be able to get a coupon for, but under the brand name Revatio, which is the same medicine, just for a different indication (pulmonary arterial hypertension), I think you can get it as a generic. Also, I think this is the only one studied for SSRI/SNRI-induced sexual dysfunction.
      • Other PDE5 inhibitors, which would likely be beneficial (don't see why not if sildenafil is...)
        • Cialis (tadalafil)
        • Levitra (vardenafil)/Staxyn (vardenafil ODT) (Staxyn is an orally disintegrating tablet)
        • Stendra (avanafil)
  • α2 antagonists
    • Yohimbine (Yocon)—available as prescription or OTC supplement. Is a prescription, it's 5.4 mg 3x/day, and if side effects occur, decrease to ½ tablet 3x/day then back to 1 tablet 3x/day.
  • Antihistamines
    • Cyproheptadine (Periactin)—take only as needed because it can interfere with the mechanism of action of SSRIs/SNRIs, also increases appetite and can cause weight gain
  • Probably more I can't remember
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  • 3 weeks later...

Thanks for the list mikl

I'm very unsure of what I'm going to do.  Big surprise lol ocd

I feel like the problem is chemical at this point though cause I've gone in and out of having high libido low libido.  I feel like the Wellbutrin may be the best option however I feel like waiting things out right now to see where I land.

I'm very lethargic lately though and my Sex drive is pretty much absent.

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  • 2 weeks later...
On 6/9/2017 at 3:05 AM, BrianOCD said:

Thanks for the list mikl

I'm very unsure of what I'm going to do.  Big surprise lol ocd

I feel like the problem is chemical at this point though cause I've gone in and out of having high libido low libido.  I feel like the Wellbutrin may be the best option however I feel like waiting things out right now to see where I land.

I'm very lethargic lately though and my Sex drive is pretty much absent.

@BrianOCD How have you been since you posted this?

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2 hours ago, browri said:

@BrianOCD How have you been since you posted this?

Hi Browri

A little better.  I haven't added Wellbutrin because I was having severe anxiety.  So pdoc upped seroquel 50mg Ativan 1mg.  I still have a 90 day supply of wellbutrin sitting on my dresser.

I've been more relaxed.  Sexual side effects are still very much in place, my libido got a bit worse going up on the drugs. :(

I see my pdoc this week again.  It feels like a neverending mission to get where I want to be...All I really want is a stable life, sex drive, and no panic/anxiety.  Apparently I'm asking too much.

Thanks for checkin in on me, I like these boards. =)

Edited by BrianOCD
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Yanno, it's just a thought but, it may not be the effexor or not completely the effexor. When I was on seroquel it killed me sex drive and my ability to climax dead in the water even on the lowest dose. Just BLAM. That was monotherapy so I knew exactly what was causing it. It went away as soon as I stopped taking it. So, maybe it's that? Just a thought.

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You could try some of the meds I listed in the post above...

On 5/22/2017 at 10:28 AM, mikl_pls said:

 

  • SARIs (Serotonin antagonist and reuptake inhibitor)
    • Trazodone (Desyrel)
    • Nefazodone (Serzone)
  • NaSSA (Noradrenergic and specific serotonergic antidepressant)
    • Mirtazapine (Remeron)—major weight gain, carb cravings, and sedation with this one, so watch out if you try this one! Higher doses (≥ 30 mg) are said not to have as much of the sedation and carb cravings, while lower doses (≤ 15 mg) cause more sedation and carb cravings. Either way though, you will gain weight.
  • PDE5 inhibitors
    • Sildenafil (Viagra)—I think Viagra is still brand-name only, which you may be able to get a coupon for, but under the brand name Revatio, which is the same medicine, just for a different indication (pulmonary arterial hypertension), I think you can get it as a generic. Also, I think this is the only one studied for SSRI/SNRI-induced sexual dysfunction.
      • Other PDE5 inhibitors, which would likely be beneficial (don't see why not if sildenafil is...)
        • Cialis (tadalafil)
        • Levitra (vardenafil)/Staxyn (vardenafil ODT) (Staxyn is an orally disintegrating tablet)
        • Stendra (avanafil)
  • α2 antagonists
    • Yohimbine (Yocon)—available as prescription or OTC supplement. Is a prescription, it's 5.4 mg 3x/day, and if side effects occur, decrease to ½ tablet 3x/day then back to 1 tablet 3x/day.
  • Antihistamines
    • Cyproheptadine (Periactin)—take only as needed because it can interfere with the mechanism of action of SSRIs/SNRIs, also increases appetite and can cause weight gain
  • Probably more I can't remember

 

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One of my main issues atm is getting off effexor, I've heard nothing but horror stories about it.  I'm not stable enough to come off Effexor.  I was on 300 mg for about 5 years up until last year.  I've weaned down to where I'm at now and my anxiety symptoms have reemerged a bit...

Ya Yohimbe definitely helped, but have you ever taken it?  It can cause some strange feelings, anxiety-wise.

I also have some PDE5s to try.  But the the issue is my libido.  The ED issues are secondary...The drugs like Effexor and sedatives I've taken over the years have definitely had a negative impact.

10 hours ago, 100catscrazy said:

Yanno, it's just a thought but, it may not be the effexor or not completely the effexor. When I was on seroquel it killed me sex drive and my ability to climax dead in the water even on the lowest dose. Just BLAM. That was monotherapy so I knew exactly what was causing it. It went away as soon as I stopped taking it. So, maybe it's that? Just a thought.

Ya the problem is all the meds I'm taking can potentially cause the problem.  I'm really not even on high dosages and still have problems.  But removing the seroquel is a thought...just to see what happens.  I might talk to my pdoc about that when I'm feeling better...

I know for a fact Effexor is a big factor, I went up on Effexor one time to 150mg and everything went numb.  Then when I take the sedatives they also make it worse.  But I do suspect seroquel.  I suspect seroquel and effexor are both libido killers, at least for me.  Ativan not so much.  But the combination is crushing me.  Excellent for anxiety and making me feel more comfortable though...

So I'm in this purgatory where I take meds and have little to no sex drive, or dont take meds and become a panicky mess.  Sucks....

Do any of you know if any of the drugs I'm on are known to lower Testosterone?

Edited by BrianOCD
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5 hours ago, browri said:

Can't say I've heard of Effexor, Seroquel, or Ativan lowering testosterone levels. HOWEVER, Seroquel can raise prolactin levels which in and of itself can be "desexualizing".

Ugggh I've tried literally everything but the Wellbutrin for my libido.

It feels impossible to find anti-anxiety meds that don't ruin it...

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On 6/24/2017 at 3:41 AM, BrianOCD said:

Ya Yohimbe definitely helped, but have you ever taken it?  It can cause some strange feelings, anxiety-wise.

Oh yeah, it can definitely be overstimulating. But it could be some insight as to how you might respond to Wellbutrin. Their mechanisms of action are different, but both increase norepinephrine (with Wellbutrin increasing dopamine too).

I know this website focuses on pharmaceutical treatment, but there is a supplement called Eurycoma Longifolia Jack (or just Longjack for short, AKA Tongkat Ali) that is supposed to be an aphrodisiac, pro-erectile, and supposedly anxiolytic supplement. No boosts in testosterone though. I've never taken it, but I've read a lot about it.

https://examine.com/supplements/eurycoma-longifolia-jack/

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