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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 14 of 14. This is the beginning of the thread.
Posted by paulb on September 15, 2015, at 22:08:40
in peoples experience which of the ssris cause the most sexual dysfunction at dose equivalents and do ssri just stop performance or do they affect arousal as well
Posted by Lamdage22 on September 16, 2015, at 1:52:52
In reply to ssris and sexual disfunction, posted by paulb on September 15, 2015, at 22:08:40
For me they delay orgasm.
Nothing else.
Posted by SLS on September 16, 2015, at 6:27:53
In reply to ssris and sexual disfunction, posted by paulb on September 15, 2015, at 22:08:40
Paxil is the SSRI most likely to produce both sexual side effects and weight gain. I don't know which SSRI is least likely to produce these things. I would guess either Zoloft or Prozac.
- Scott
Posted by Lamdage22 on September 16, 2015, at 12:46:39
In reply to Re: ssris and sexual disfunction » paulb, posted by SLS on September 16, 2015, at 6:27:53
Not Brintellix?
Posted by paulb on September 16, 2015, at 13:18:03
In reply to Re: ssris and sexual disfunction » paulb, posted by SLS on September 16, 2015, at 6:27:53
I think your right paxil is the most likely to increase weight gain and sexual dysfunction because it inhibits nitric oxide synthetase. zoloft and prozac will also reduce libido but just because of increased serotonin
Posted by SLS on September 16, 2015, at 15:01:47
In reply to Re: ssris and sexual disfunction, posted by Lamdage22 on September 16, 2015, at 12:46:39
> Not Brintellix?
You are right.
It gets complicated. Brintellix is not generally considered to be "selective", and I have not yet seen it listed as a SSRI. Brintellix does have the reputation of being less liable to produce sexual side effects than the SSRIs. However, it is difficult to categorize drugs when they have so many different actions.
1. Inhibitor of serotonin (5-HT) reuptake transporter
2. Agonist at 5-HT1A receptors
3. Partial agonist at 5-HT1B receptors
4. Antagonist at 5-HT3 receptors
5. Antagonist at 5-HT1D receptors
6. Antagonist at 5-HT7 receptorsMaybe there are more. I don't know. It is hard to guess which properties are the most important.
It may be that the properties of Brintellix as a ligand (substance that binds) to 5-HT receptors helps to reverse any sexual impairments brought about by its serotonin reuptake inhibition properties.
- Scott
Posted by SLS on September 16, 2015, at 15:09:58
In reply to Re: ssris and sexual disfunction, posted by paulb on September 16, 2015, at 13:18:03
> paxil is the most likely to increase weight gain and sexual dysfunction because it inhibits nitric oxide synthetase.
I didn't know that. I just figured that the severity of side effects were due to Paxil being the most potent inhibitor of the serotonin transporter.
What aspects of sexual function does nitric oxide affect?
- Scott
Posted by former poster on September 16, 2015, at 20:12:26
In reply to ssris and sexual disfunction, posted by paulb on September 15, 2015, at 22:08:40
Luvox almost ruined my marriage. Sex was impossible. 5 years after stopping to get back to normal. Sadly it was the most effective AD. Cymbalta was bad too. Pristiq equally bad. Brintellix is another bad one. Fetzima almost as bad as Luvox.
Posted by paulb on September 16, 2015, at 22:34:11
In reply to Re: ssris and sexual disfunction » paulb, posted by SLS on September 16, 2015, at 15:09:58
I just read it in "Stahls Illustrated Antidepressants" but i think it might be true.
Posted by SLS on September 17, 2015, at 6:12:30
In reply to Re: ssris and sexual disfunction, posted by paulb on September 16, 2015, at 22:34:11
> I just read it in "Stahls Illustrated Antidepressants" but i think it might be true.
I am guessing that he was talking about one's ability to get an erection of the penis only. One can still have libido. One can still get aroused. One can still have an orgasm. They just can't maintain blood supply to the corpus cavernosum. A male can achieve orgasm without having an erection. I imagine blood supply is also important for clitoral function.
- Scott
Posted by FloydAS on September 17, 2015, at 13:26:43
In reply to ssris and sexual disfunction, posted by paulb on September 15, 2015, at 22:08:40
Zoloft ruined me. My libido was halfway non-existent but my ability to gain an erection was almost nill. I was on dosages from 50 mg up to 200 mg and back down to 50 mg and experienced issues at all dosages.
I'm now on 20 mg of Brintellix and I would claim that my libido is actually even worse than it was on Zoloft. But the erection issue not nearly as bad. It's not normal, but not as bad as it was with Zoloft, and Brintellix has been much more effective for me in the prescribed areas than Zoloft ever was so I'm willing to deal with the side effects.
Posted by Thomas4779 on October 2, 2015, at 12:52:47
In reply to ssris and sexual disfunction, posted by paulb on September 15, 2015, at 22:08:40
Luvox gave me the least sexual dysfunction
Posted by Thomas4779 on October 2, 2015, at 13:20:43
In reply to ssris and sexual disfunction, posted by paulb on September 15, 2015, at 22:08:40
Luvox gave me the least sexual dysfunction
Posted by Timebomb on October 30, 2015, at 17:08:26
In reply to Re: ssris and sexual disfunction, posted by Thomas4779 on October 2, 2015, at 13:20:43
I found Brintellix, for the short time I tried it, to be neutral on sex. But it made me feel completely exhausted, apathetic and more depressed. It seems to have similar action to antipsychotics on a couple of receptors, hence why some including me find it too numbing to deal with. Some love it though so worth a try.
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