Sexual Side Effects And The Use Of SSRI's
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I would like to inquire as to whether there is any substantiated evidence as to whether certain SSRI's are less capable of producing anorgasmia in men that others. I have used all currently available SSRI's on the market and have experienced severe cases of delayed or impaired ejaculation and anorgasmia as well as total loss of libido. I've used all current known anecdotal cures such as Yohimbine, Cyproheptadine and Amantadine to no avail. At least could you give me the hierarchy of intensity of such side effects per each med. I personally have had great antidepressant benefit from Paxil, Luvox, and Zoloft. Less so with Prozac and Effexor, Serzone. At this time, what is the best medication with the greatest "sexual side effect profile" on the market.
Answer:
I'm on 26 mg Prozac, which has been a life-saver, but cost me a 40% loss of sexaul feeling. Ginko brought it back about 15%, but, Lilly has a new prozac, out within a year, that supposedly cuts out the nasty sexloss. I had the same problem. The short answer seems to be that everybody is different, so there is not one profile. Among the prescription SSRIs, for me Prozac had less effect than the others but was still pretty bad. The best I could do was cut the dose to the minimum that had the antidepressant effect, which for me was 10 mg four times a week plus 200 mg Wellbutrin per day. This reduced the effect, but did not eliminate it. I am currently using St. John's Wort plus Wellbutrin. So far, it seems pretty good, but I have had to increase the SJW dose to 300 mg 6 times a day, which is twice the "recommended" amount. The side effects have gone away, and I am keeping my fingers crossed that it will remain effective. No question in my mind, PAXIL is the worst for ME. I have total anorgasmia, with a moderate decrease in libido. What a pain in the ass, so to speak.
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