Repost: Antidepressants and sexual dysfunction – some suggestions
Question:
Sexual dysfunction from antidepressants (ADs) medication can be one of the most troublesome of their side effects. All of the antidepressants can produce some form of dysfunction, with perhaps the SSRIs having the greatest affect. Although individuals who develop these side effects on one AD are likely to develop it on other related agents, there are occasions when someone will not have sexual side effects after simply switched to another antidepressant, often within the same group. The estimates of sexual side effects vary widely, from 20%-80% of patients treated. Antidepressants can inhibit sexual interest and the ability to achieve or maintain an erection or delay ejaculation and orgasm. Although some of the newer AD, like Serzone and Celexa, may be less likely to cause these side effects, it’s becoming clear that they are not the great breakthrough their manufacturers would have us believe. The most obvious way to overcome AD induced sexual dysfunction is to avoid the problem by using other forms of medication, notably benzodiazepines. However, these have other side effects that may make life difficult and benzo-phobic doctors can prevent their ongoing use. Alternatively, therapy may be all thats required for some. For those who must, for whatever reason, be treated with an antidepressant, there are several ways of minimising the sexual dysfunction of these meds. Firstly, this side effect sometimes diminishes with time, usually within 2 to 3 months of beginning treatment. Another ploy that sometimes works is to slightly reduce the daily dose by 10-20% after being on the med for a while. This can be enough to kick start the hormonal processes. Sometimes a break from taking an antidepressant for a while is enough to break the cycle. This seems to work best with the short half-life SSRIs, Zoloft (sertraline), Paxil (paroxetine) and Luvox (fluvoxamine). For those (both genders) that are only affected by inability/difficulty in achieving orgasm while taking a SSRI, a change to either a Tricyclic or MAOI, will solve this problem in the majority of cases. However, both classes of ADs can produce other sexual dysfunctions. 
Problems with ejaculatory delay (anorgasmia) may be eased or even eliminated by changing to another SSRI. During research into meds that may reduce premature ejaculation the SSRI with the least effect on this condition, and therefore the least likely to cause delayed ejaculation, was fluvoxamine (Luvox) with an ejaculatory delay response of 1.9 times the non medicated response (those taking the placebo reported a 1.5 times delay). Sertraline( Zoloft) delayed things by 4.4 times, Fluoxetine (Prozac) delayed matters by 6.6 times normal and paroxetine (Paxil) had the worst results at 7.8 times normal. So if this is your problem then Luvox might be worth considering. Problems with erectile disorder are produced mainly by the TCAs and the SSRI Paroxetine (Paxil). Switching to a SSRI (except Paxil) will often overcome this disorder, although other dysfunctions may occur. If these measures fail than using an adjuvant agent such as Ritilin (methylphenidate), Wellbutrin (bupropion) and Buspar (buspirone) can alleviate sexual dysfunction in about 50% of cases. However, these meds, particularly Ritilin, are not without side effects, and you need to thoroughly discuss these with your doctor. Ritilin should not be used by those with cardiac complications, a family history of Tourette’s disorder or with a history of substance abuse. A daily dose of between 10 and 20mg is usually sufficient. Wellbutrin is a antidepressant with a some general anti-anxiety affect, but of less value in treating PAD. The doses required in a adjuvant role are far less than when used on it’s own as an anti-anx/depress med. Daily intakes of up to 75mg are usually sufficient. The newer sustained release formulation is considered to be better in adjuvant use. Buspar is often prescribed either on its own as an anti-anxiety med, or in combination with an antidepressant. While its usefulness as a treatment for panic disorder is debatable, it can alleviate sexual dysfunction. Doses to 30mg/day are recommended. More details on all of the above, plus other less researched adjuvants, can be found at: www.mhsource.com/edu/psytimes/p980828.html http://php.silverplatter.com/physicians/opinions/A180100.htm Viagra has proved useful in men with erectile dysfunction, but far less so in women or men with lack of desire and sexual aversion disorder. HERBS The herbal preparation Ginkgo Biloba (and possibly Ginseng) has been shown to be useful. 240mg of Ginkgo, in a divided dose of 120mg-twice daily- has been shown to reverse anorgasmia and decreased libido in both men and women, plus erectile failure in men. Ginkgo biloba should not be used by those on anticoagulants or with a known allergy to Ginkgo. Dosage should be increased from an initial 60mg/day. As with all herbal/natural supplements discuss their use with your doctor before taking them as there may be other factors that preclude their use. Additional info on Ginkgo is at: www.priory.com/pharmol/gingko.htm Both Ginkgo and Ginseng are briefly mentioned at: www.mhsource.com/edu/psytimes/p980828.html Another "natural"? remedy can usually be found in the "Adults Only" section of your local video rental store. This remedy, however, does need to be taken with caution and some of the gymnastic sequences should not be copied by those of limited fitness. :-^) Hope this helps Ian DISCLAIMER: I will not be responsible for any strained muscles, bad backs, cardiac arrests or terminal exhaustion that result from following any advise given above. Nor will I consider claims for financial help in raising any offspring born as a result thereof. <G
Response:
Sexual dysfunction from antidepressants (ADs) medication can be one of the most troublesome of their side effects. All of the anti- depressants can produce some form of dysfunction, with perhaps the SSRIs having the greatest affect. Although individuals who develop these side effects on one AD are likely to develop it on other related agents, there are occasions when someone will not have sexual side effects after simply switched to another antidepressant, often within the same group. The estimates of sexual side effects vary widely, from 20%-80% of patients treated. Antidepressants can inhibit sexual interest and the ability to achieve or maintain an erection or delay ejaculation and orgasm. Although some of the newer AD, like Serzone and Celexa, may be less likely to cause these side effects, it’s becoming clear that they are not the great breakthrough their manufacturers would have us believe. The most obvious way to overcome AD induced sexual dysfunction is to avoid the problem by using other forms of medication, notably benzodiazepines. However, these have other side effects that may make life difficult and benzo-phobic doctors can prevent their ongoing use. Alternatively, therapy may be all thats required for some. For those who must, for whatever reason, be treated with an antidepressant, there are several ways of minimising the sexual dysfunction of these meds. Firstly, this side effect sometimes diminishes with time, usually within 2 to 3 months of beginning treatment. Another ploy that sometimes works is to slightly reduce the daily dose by 10-20% after being on the med for a while. This can be enough to
