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Dr. Bob is Robert Hsiung, MD,
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Posted by Roo on February 4, 2002, at 13:44:20
In a new relationship. contemplating going off meds at
some point so I can enjoy sex. am doing DBT therapy.
sometimes wonder if my depression is what causes me to
suffer or if what causes me to suffer most is my FEELINGS
about my depression. (I.E thinking that depression makes
me unlovable, etc, that people don't want to be around me and that
having these sorts of thoughts make my depression worse than it
otherwise would be). Or if these thoughts are a PRODUCT
of depression. I guess I feel like if I could build some cognitive
skills to deal with these sorts of thoughts and feelings, maybe
I would be able to take lower amounts of meds, and evenutally
go off altogether. The main reason being I want to have a sex
life. If these drugs didn't take away such a vital part of
my being, I really wouldn't care if I had to be on them
for life. I get so frustrated, sad and angry about it
sometimes. I've vented about it before in posts. Tried
the AD's that don't have sexual side effects (wellbutrin
and serzone) and they make my depression worse. SSRI's work
best for me. But of course they all have the sexual side
effects. I am thinking about trying Remeron as a last resort,
b/c I've already put on so much weight in the past year
from mood stabilizers that the thought of gaining any more
weight is really depressing to me. And most people gain lots
of weight on remeron.any thoughts? Resonance?
Posted by medlib on February 4, 2002, at 17:35:27
In reply to Venting about various stuff--meds, sex,dbt therapy, posted by Roo on February 4, 2002, at 13:44:20
Hi Roo--
This thread probably should be on PB, but...
You mentioned trying Wellbutrin and Serzone, but did you try these meds by themselves or as augmenters with SSRIs? The link below is to a slide in a med school CME presentation; it summarizes rxs for sexual dysfunction common in SSRIs.http://www.cme.wisc.edu/online/depression/tsld015.htm
Some have suggested that escitalopram, [the S enantiomer of citalopram (Celexa) just released by Forest Labs], may have fewer sexual (and other) side effects than Celexa. This is based on one clinical study which found that, while 6% of males on Celexa experienced delayed ejaculation, those on escitalopram reported this side effect at a rate no greater than placebo (1%). Might be worth asking your pdoc about.
BTW, I don't think Remeron has had much success as a stand-alone AD; it's usually used as an augmenter (often with Effexor). Starting dose should be 30 mg. if weight gain is a concern, because lower doses are associated with increased appetite more often than higher doses.
Well wishes---medlib
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