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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 4 of 4. This is the beginning of the thread.
Posted by Tosca on May 12, 2009, at 13:40:41
I have been doing really well on Lexapro (40 mg) and Wellbutrin XL (300 mg) for depression and anxiety the last 4 months, after being on the med rollercoaster for months before that.
Everything now is really hunky dory, except for sex. I'm a 42 year old woman who has never had sexual issues of any kind, and I've now got the double whammy of anorgasmia and genital numbness. My libido is good, I'm definitely still interested. So,this sucks. No other side effects other than that. Right now I'm taking yohimbine HCL, and it's helped a *bit*, but not much.
So, I had a pdoc appointment this morning, and we talked about it. He presented a number of options:
1. Lower the Lex to 20 and increase the WB to 450.
2. Change the Lex to either Effexor or Pristiq, keep the WB.
3. Add Mirapex to the current Lex/WB combo. I'd start the Mirapex at .25 and increase it to .5 if necessary.
I'm really hesitant to change my current Lex/WB set up. I'm doing well and don't want to mess with it if I don't have to. So, it looks like we will try option #3 first. He said that what's going on is a dopamine thing. He did acknowledge that the WB is already hitting dopamine, but that the mirapex (which he said is at a pretty low dose) would help it along.
When this problem first showed up I didn't care- I was just SO relieved to be feeling myself again. Now I'm realizing that I don't want to live like a nun at 42.
Posted by bleauberry on May 12, 2009, at 17:33:14
In reply to Adding Mirapex to Lexapro and Wellbutrin?, posted by Tosca on May 12, 2009, at 13:40:41
My two cents, I don't like any of those ideas. They scare me. Why? It is too hard to get to where you are, and too easy to mess it up and never get back to where you were.
What about some simpler things? Ritalin a couple hours before sex. That hits dopamine pretty hard, and only temporary for your needs. Viagra. Yeah, for women it can do the same for men, wake things up down there. If someone else here knows of a short-lived 5ht2 blocker/antagonist, that would be a decent option too.
Go to askapatient.com and revolutionhealth.com and read the reviews of what patients who have used mirapex have to say about it. It ranks very poorly and has some scary bizarre behaviors that happen quite frequently. It looks good on paper. The real world, I dunno. If your doctor has a lot of experience with it in at least 50 different patients, well, maybe.
I would in no way change your current doses. Yes, I am empathetic for the sex troubles, but I am ten times more empathetic for the emotional stability you have. That is so important and easily lost when you go mess with a good thing.
Posted by Phillipa on May 12, 2009, at 19:33:54
In reply to Re: Adding Mirapex to Lexapro and Wellbutrin?, posted by bleauberry on May 12, 2009, at 17:33:14
Agree with above yes you are extremely lucky. My thought is that age 42 you may be starting menopause also as it lasts for years and years. I'd get my hormones checked. Seriously. Love Phillipa
Posted by desolationrower on May 13, 2009, at 10:50:17
In reply to Re: Adding Mirapex to Lexapro and Wellbutrin?, posted by Phillipa on May 12, 2009, at 19:33:54
Well, i am generally positive towards mirapex, but i'd agree with bb that there are mild options i'd try first.
a pde5i is a good idea.
For a 5ht2 antagonist, i suggest cyproheptadine, its cheap. its also an antihistamine, so it can cause tiredness and hunger, so thats not bad if you usually are hooking up right before bed, but can be a drawback if you prefer other times of the day.
-d/r
This is the end of the thread.
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