Danger, Will Robinson! Danger! Danger!

Jeez... I can't believe this subject hasn't come up here yet...

This post is my own, in response to someone complaining about lack of libido after starting anti-depressants on another site. It is posted here (names edited) as a warning and also for your information.

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I've been meaning to post about this, but I kept forgetting. Here goes: READ MY LIPS - If you don't want your sex life to completely go to pot, read-up about anti-depressants before you get on them, especially regarding the sexual side-effects. There is a massive BBS at WebMD.com devoted to nothing but anti-depressants and side-effects. Go there and search for keywords like "sexual" and "prozac" (or whichever drug). You will freak how many hits you get.

(anonymous), your decreased libido is VERY LIKELY a side-effect of your anti-depressant. I've been on and off of them for years, so I know. I also used to spend as much time on the WebMD boards as I now do on this one. The newer anti-depressants, particularly a class of drugs called SSRI's, are NOTORIOUS for sexual side-effects (your doctor SHOULD have told you...). SSRI's include Prozac, Zoloft, Paxil and Celexa. You're likely taking one of those. (Even if you're not, most of them have the potential for similar side-effects). The most common sexual side effects are lack of sexual interest, problems with arousal (M=erection, FM=moisture), and inablity to achieve orgasm. And they can effect men and women, BTW.

Better ask yourself if you're depressed enough to put up with any of those side-effects. Any takers? I didn't think so...

If you really need anti-depressant medication, bear in mind also that people's reactions to these med's vary greatly, so not everyone has those side-effects, but they are very common. Also, there are newer medications that have few, if any, sexual side effects. Supposedly among them are Serzone, Effexor and and Remeron. Some even -may- increase your libido, such as Wellbutrin. But I wouldn't even THINK about messing around with any of these for that reason. You should also be aware that they all have some side-effects, like fatigue, insomnia, and many tend to have a multiplying effect with alcohol (that is, they increase the effects of alchohol).

BTW, don't stop taking them abruptly - taper yourself off of them for a few weeks. There are some other, unpleasant effects from quitting them cold-turkey. Read all about that at WebMD as well.

This has been my experience:

- Effexor - no problems at all

- Wellbutrin - couldn't keep a boner around very long

- Zoloft - can't hardly cum to save you life

I'm on Zoloft now. The sexual side-effects do indeed suck, but it makes me a little manic, which helps to counteract the side-effects. I can hardly cum to save my life, but when I do - WooHoooo! (You could liken it to intentionally delaying an orgasm for as long as you can, then SPOOOOOOGE.) Again, don't play around with this shit unless you need them for valid phychiatric reasons. You're playing with a loaded gun. BTW, Zoloft does not impair my erections. I can still keep the flag at full-staff for hours - all night if necessary. In fact, paridoxically, my sexual desire is if anything stronger. I just have to wait a little extra (like 20 minutes...) for the pay-off. It's a sacrifice, yes - just weigh your priorities carefully - and do your research on the web first.

Sorry to drag on about it a little. I was just feeling a little guilty about not sharing this shit earlier. And this is, obviously, a matter of great importance to us, is it not? I thought so...

An informed monger is a happy monger.

My experience with SSRI's has been somewhat different. When I started taking Prozac 4 years ago, I experienced similar difficulties (couldn't get erect, couldn't climax, etc.)

But then Viagra came along and changed everything. Now I have no trouble getting aroused, and best of all (for the ladies), because of the Prozac, I can go for hours without climaxing.

In summary - Prozac/Viagra has made me a much better lover.

" don't play around with this shit unless you need them for valid phychiatric reasons"

Why the heck would you take them otherwise?
They don't get you high or anything like that.

And depression is not the only problem these help with.
I happen to suffer from panic attacks (which contribute to my inability to ask "real" women out), and Paxil really helps with that.

As far as decreased sexual desire, sex is so closely tied to your mental state that reading about all the "possible" side effects would make anyone limp!

Borrador - does viagra help you cum faster, or just help with erections?

San_Puto - I just wanted to make sure that guys wouldn't be tempted to take them just to (try to) affect their sexual performance, which could easily back-fire. A lot of guys are looking for sexual enhancing drugs, and I didn't want them to get the wrong idea. I agree with everything you said.

And the shark would have a hell of a buzz.

B. wrote: "Borrador - does viagra help you cum faster, or just help with erections?"

Viagra does not do anything to make you cum. It is strictly a hardon inducer and perpetuator. You will become extremely easy to arouse and will stay stiff even after you cum. Read all about it in the Viagra threads in the Men's Health section.

Regarding anti-depressants andd anti-anxiety drugs: I lost a hard on last time because I took a doxepin tab on an empty stomach, along with Viagra. I got plenty stiff, and then it faded after 10 minutes. With doxepin, I take it only when I go to bed and in lower doses than were prescribed. It works good for anxiety/nightmares and mild depression. But you shouldn't take anything of this type with out consultation with an appropriate doctor.

Having your cake and eating it, too?

Gents, upon further research, I have learned a few more things about anti-depressant medications and sexual dysfunction.

Besides newer medications that have fewer (if any) sexual side-effects, there are some other things you can do to at least minimize them while still taking your meds.

There are some newer A/D (anti-depressant) meds you can supplement your regimen with which can at least partially negate the sexual side-effects. Ask your doctor or inform yourself about them on places like webmd.com (this site is a gold mine, gents). There are other methods as well.

I will relate my (recent) experience with Zoloft. Various medications have something called a "half-life", which is so-called because it's roughly analogous to the half-life principal in chemistry. A "half-life" refers to the amount of time that a chemical exists in it's environment. Plutonium, for example, has a half-life of hundreds or thousands of years, making it the disposal nightmare that it is. Foreign chemicals in the body also have a half-life.

The reason it is called (in both cases) a "half-life" is this: the half-life is the amount of time it takes for said chemical to reduce in quantity to 1/2. Therefore, if e.g. Zoloft has a half-life of 24 hours (it's 26, actually), only 1/2 of the Zoloft is still in your body after 24 hours. In 48 hours, only 1/4 of it is left, and so-on.

Therefore, in the case of Zoloft, 1/2 of it is out of your bloodstream in 24 hours, and 3/4 of it is gone in 48 hours. So, the sexual side-effects are (or should be) reduced in the same amount of time as well. Fortunately, the therapeutic (anti-depressant) effects do not fade as fast, but you should not skip taking you meds for more than two days, in most cases.

You can take what is called in the Psychiatric business a "Zoloft Holiday" (or insert your medication here) -- by skipping a daily dose or two. (Investigate the half-life of your medication on-line or ask your doctor what it is - this may or may not be a viable option for you).

If you're asking - yes, I tried it. Here are my results:

- Took my Zoloft this morning like a good boy >> took me 20+ minutes to cum

- Skipped my Zoloft today >> took me 7 minutes to cum

- I will skip my Zoloft tomorrow >> if I cum in about 3-4 minutes, I have proved the concept.

I was horrified that I might have to give up "the sport of kings", but there is a glimmer of hope. Other medications have a longer half-life than Zoloft (like Prozac), but it is an option, and there are others that don't entail abandoning your medication. Some herbs, for example, like Ginseng and Ginko Biloba may help, although to a more limited degree. Some stimulants may help, also, but their use for such is controversial and largely untested.

Just wanted to share with my brothers what I have learned. Part of what motivated me to learn this stuff and share it with you is that I began to lose boners (as well as having a hard time coming) - OUCH!! But I didn't want to abandon my med because in so many other ways, it is a God-send. My med has given me the cohones to do many things I was formerly afraid to do. And yes, these things are even more important to me than pussy. (Did I say that?)

So, if I can have my cake and eat it, too... Que rico...

Peace and good health, amigos.

Bubba17

Here is a post (by a doctor) taken from webmd.com.

General information on antidepressants and sexual side effects


Classic antidepressant-induced sexual dysfunction includes problems like decreased libido, orgasm problems, and "equipment failure" caused by lack of blood flow to the genitalia. These are all the result of elevated levels of serotonin. Some background...

Serotonin, dopamine and norepinephrine are substances which occur naturally in the brain. When levels of these are raised, depression and anxiety tend to ebb. Receptors for serotonin are found in many parts of the brain and body. Serotonin is a "neurotransmitter", a chemical bridge which relays signals between nerves. One activated nerve cell (with a "message" to send) releases serotonin, which drifts across to the receptors for serotonin on another nerve cell. The serotonin fits into the receptors, and this activates the second nerve. Many different receptor types for serotonin have been identified. These can be divided into type 1, type 2, and type 3 (oversimplified a bit). These different types of serotonin receptors turn on nerves responsible for different things.

Type 1 receptors are responsible for reducing depression and anxiety. When serotonin levels rise, type 1 receptors get activated, and several weeks later depression and anxiety tend to abate. We have no idea exactly why this happens or how it works. Type 2 receptors are responsible for a host of side effects which are classically associated with serotonin. These include sexual side effects, anxiety and "akathisia" (severe restlessness or agitation). Type 3 receptors are located in the gut, and these speed up gut movements when activated. Type 3 receptors are responsible for nausea and diarrhea associated with serotonin.

So, sexual side effects occur when raised serotonin levels cause an increase in "type 2" receptor activation. All medicines which raise serotonin tend to cause sexual side effects, unless they also prevent the type 2 receptors from receiving the increase in serotonin.

Now, there are also medicines which can help sexual function. Dopamine is a different neurotransmitter which when elevated tends to improve sexual function (a generalization), especially with orgasm and libido. Viagra and yohimbine can improve erections by different mechanisms and improve blood flow to female genitalia, but aren't effective directly on libido or orgasm. Medicines which block type 2 serotonin can restore sexual functioning lost to increased levels of serotonin.

Now, let me again review the current antidepressants approved in the USA. Remember, you get sexual side effects if you raise serotonin, and don't block the type 2 receptors for serotonin. Knowing this, you can predict the antidepressants with sexual side effects.

1) "SSRI" antidepressants. These Selective Serotonergic Reuptake Inhibitors raise levels of released serotonin by interfering with the releasing cell's ability to reabsorb it. This class includes Prozac (fluoxetine), Paxil (paroxetine), Zoloft (sertraline), Celexa (citalopram), and Luvox (fluvoxamine).

2) Effexor (venlafaxine)-this raises levels of serotonin and norepinephrine, and even dopamine to a smaller extent (at high doses).

3) Serzone (nefazodone)-this raises levels of serotonin and norepinephrine, and blocks type 2 serotonin receptors.

4) Remeron (mirtazapine)-this indirectly raises serotonin levels, and blocks type 2 and type 3 serotonin receptors. It also raises norepinephrine levels.

5) Wellbutrin (bupropion)-this raises dopamine and norepinephrine levels, but doesn't effect serotonin levels significantly.

6) "Tricyclic" antidepressants. This is a broad older class of antidepressants, with many different members. They raise serotonin and norepinephrine. This class also affects other transmitter systems, which explains the high incidence of certain side effects.

7) "MAOI" antidepressants-MonoAmine Oxidase Inhibitors interfere with the enzyme which breaks down serotonin, norepinephrine, and dopamine. This raises levels of all three. MAOIs require a particular diet, and interfere with a ton of other medications. They are seldom used anymore, but often very helpful when other medications don't work.

As you might guess, Wellbutrin has few sexual side effects because it doesn't raise serotonin. Serzone and Remeron have few sexual side effects because they block type 2 serotonin receptors.

Now, with all of this background, let me lay out the options a person has when they have sexual side effects from an antidepressant, and want to do something. Note that some of these additions have the added benefit of additional antidepressant actions, and the added risk of additional side effects and expense. No one particular strategy works more than 50% of the time, but most people will find that one of these works for them if they try enough different options. I have not ranked these in any particular order...

1) Decrease the dose. Sometimes a lower dose can still be effective, but not cause sexual side effects. Alternatively, you can take a drug "holiday" (skip a dose) once a week and see if the decreased blood levels allow sexual side effects to abate. Always work with a doctor before trying this at home. Prozac doesn't fade from the body very quickly, so drug holidays don't usually work for Prozac.

2) Switch to an antidepressant which doesn't tend to cause sexual side effects. This allows for simplicity. Switching isn't as practical if the offending antidepressant is working great in all other respects.

3) Add Wellbutrin. This often requires a low dose only, perhaps 100 or 150 mg of the sustained release preparation once per day. It can work for all types of serotonin-induced dysfunction in both genders, but may work less well on erectile dysfunction or the female equivalent.

4) Add Buspar. This mild anxiety medicine activates type 1 serotonin receptors. It can work on both genders, for all types of serotonin sexual dysfunction. Some nice studies showing efficacy. I don't know how it works on sexual dysfunction, maybe by tricking cells into releasing less serotonin to act on type 2 receptors.

5) Add Serzone or Remeron. Very little published evidence, but these are used. They make intuitive sense because they block type 2 serotonin receptors. In theory they would block all types of serotonin sexual function in both genders. In practice they work perhaps a third of the time (my guess-timate)

6) Add a stimulant. Options include any dopamine and norepinephrine raiser, such as Ritalin or Dexedrine. These are helpful in some people, and have the advantage of being effective when just taken as needed before sexual activity in many people. These still work less than half of the time in my experience. In practice these are controlled substances, and some physicians are reluctant to use these as first line agents. One could also use an illicit drug such as methamphetamine or cocaine, but I would strongly recommend against this because of the terrible side effects these have.

7) Add Viagra. This can often improve erectile problems (caused by serotonin or otherwise), but doesn't directly improve libido or anorgasmia.

8) Add Yohimbine. This herb/drug targets erectile dysfunction, whatever the cause. I do not believe this helps directly with libido or anorgasmia.

9) Add Ginkgo Biloba. Low incidence of side effects (GI upset is the most common and even that is unusual). This is can be used over the counter, although I would always recommend consulting with your doctor. I haven't been as impressed with this option, although it may be that it is often taken at too low a dose. The studies I've seen cite most people needing over 200 mg per day. One might start this at 60 mg every morning, and then increase by another 60 mg every few days as tolerated to a dose of 120 mg twice daily. Reportedly many people must wait for 4-8 weeks before the pro-sexual effects take place.

10) There are a variety of other medications (cyproheptadine, amantadine, others...) which act on either the serotonin or dopamine systems. I've not seen these used enough to make any educated comments other than mentioning that some doctors report effectiveness some of the time.

Dear Advice Giver:

Drug Holidays are a huge mistake for the meds you have talked about. Drug Holidays will only serve to create an imbalance and possibly serve only to confuse your body. The most dangerous side-effects of self-medicating and doing drug holidays are rebound. Only the physician who is treating you should recommend when to quit and with these types of drugs, tapering off is the best way.

Never, never, never stop cold turkey with anti-depressants, especially if they are being taken for psychiatric reasons.

Not just mho, it's well known that people have caused injury to others and themselves when taking "drug holidays" off of these kinds of drugs. They cannot help how they feel because these drugs have kept them stabilized and now they crash.

Drug holidays are only ok with wake promoting stimulants (unless they are being given for ADD), pain killers and meds that do not adjust brain function and your endocrine system.

Good article tho, and thanks for the good info.

regards,

ptp

So from what i gather when one is blowing it out on the chicas and would prefer to delay ejaculation for the length of the session to get ones moneys worth or don't mind not coming every session because thats one more chica he can bang later then the prozac/Viagra cocktail would be the way to go.Would prozac start these effects within a few hours of a first dose or does it build up to these effects?What do the TJ pharmacy's get for one prozac?

The advice above about NEVER stopping cold turkey with anti-depressants reminds me of something I just recently read regarding rock musician Kurt Cobain. I read that Kurt was a problem child who was put on Ritalin, and (allegedly?) abused Ritalin into adulthood. Some believe Ritalin was instrumental in him blowing his brains out with a shotgun.

Even though I sometimes go the fast lane route myself, and am a hypocrite, I do firmly believe in the natural, wholistic approach to having the best times...

Hypocrite

Dolomite -

You are wise to send your warning regarding drug holidays and quitting cold turkey. I warned about quitting cold turkey in my original post, but thanks for reiterating it.

Regarding drug holidays - it is supposed to be relatively benign for some drugs, and simply ineffective or dangerous for others. That's why I said never to skip more than a day or two - and only w/ certain meds. In the case of Zoloft, many MDs (including my own) say that it's okay, but only skip one day, and only once in a while.

I will also re-state re: quitting cold turkey - DON'T do it for any reason - talk to your Dr first.

DON'T take my advice - go to webmd, then talk to your doctor!!

BOTTOM LINE - ALWAYS talk to your doctor FIRST (before playing with your meds).

Better yet - go to webmd.com and do your research - then talk to your Dr. If you go to your Dr. armed with a wealth of information, you will have more/better questions, and more answers. If I had taken the med my Dr wanted me to take - I fear I might have ended up worse off. I did my own research and got on the med *I* wanted - and it's working like a f***ing charm. Props to ME ;-)

Taxibob -

Be VERY careful taking anti-depressants for the sexul side-effects. They are generally very safe, medically - but they can be dangerous, psychologically. Most have a smorgasboard of OTHER side effects (like, oh, anxiety, insomnia, fatigue, weight loss/gain...)

Generally, the therapeutic effects (anti-depressant) take 2-4 weeks to kick-in. The side-effects unfortunately usually begin right away (well, a couple days or so - NOT hours).

Also, bear in mind that these meds are notorious for being a crap-shoot - two people may have completely opposite results.

You may not be inclined to talk to a doctor about it for the reason you might want to take them. My advice - go the the webmd.com boards (there is one devoted to anti-depressant meds and their side-effects). Read the horror stories - then think twice. If you still got the guts to try it, just be informed and prepared for what might happen. I don't want to scare you, just want you to go into it with your head up. You might be able to achieve exactly what you want to - just be careful, m8.

PS - if you do try Prozac or Zoloft - take VERY low doses and ramp up SLOWLY if you need to. Don't even try it if you're not willing to take a month or two to find the right dose.

PPS - Some meds (like Prozac) are starting to be prescribed for premature ejaculation - in low doses. This is to get the otherwise irritating side-effects of the drugs for people who would actually appreciate a delayed orgasm.

PPPS - also, be warned that you might lose your boner on these meds... GULP...

I've been on Paxil, Wellbutrin, and Effexor for major depression. For those reading this who aren't familiar with what this means, look here:

http://www.healthyplace.com/communities/depression/site/major_depressive_disorder.htm

It ain't fun, and worst of all, it affects every aspect of your life. No one knows why some people are affected by major depression. For those of us who are, SSRIs have been a godsend. Don't let a doctor prescribe you anti-depressants. Go see a clinical psychiatrist. Get a referral from your doctor. Not a psychologist or other form of counsellor - psychiatrists are doctors who specialize in mental illness. This is what they are trained to diagnose, and they are up-to-date on treatments, and not just drug-based ones.

I'd like to share my experiences with anti-depressants, particularly with respect to the effect they had on my libido:

Paxil

Call me Mr. Softie. The most wood I could get was balsa, and it wouldn't last. It also caused me to become slightly manic. Add to that the full run of SSRI side-effects and it was not a fun experience. Plus, it has some pretty fucked-up withdrawal symptoms. My advice is to stay away from this one. There are more modern drugs available.

Wellbutrin

I was horny all the time, and my orgasms were SO fucking intense. Downsides were feeling spaced out for a few hours after taking the dose, oh, and it doing jack for my depression. Wellbutrin is also marketed as Zyban, the quit-smoking-drug. Apparently it kills the cravings. Wouldn't know, don't smoke. But if you do and you'd like to quit, I highly recommend the experience.

Effexor

This is a slightly different class of SSRI as it also increases norepinepherine (related to focused thinking and mental drive). My psychiatrist recommended it as it has been found to be less likely to interfere with libido. Not so for me, unfortunately. However, I found the side-effects (including decreased libido) to be MUCH less than those I experienced on Paxil. I can get it up and go, no problem. Sensation is less, so it takes me a lot longer to finish. My sex drive is somewhat reduced, which I am not at all happy with. Luckily, symptoms have decreased a bit over time (although I might just be forgetting what I'm missing). I'm looking forward to halving my dosage.

cheers,
mckinley

Thanks for the post...fyi, the Paxil has the same effect on women (decreased libido) and is probably a large reason why my ex-girlfriend is my EX-girlfriend...not to be a dick, but I was patient for years and her anti-depressants started to severely depress me...