Sexuality / Sexual side effects of medication

[reverberance.livejournal.com]

Hi VagPagineers*!

Before I start I just wanted to thank everyone who make this such a wonderful place. I've posted here previously twice, during fits of anxiety about sexuality, and gotten not just good sound advice but incredibly supportive responses. Keep up the good work VagPagineers, and I certainly plan to stick around and try and help others out as you have done for me.

I've posted my question on more specific forums before, but as I'd love more info I'm asking here too.

I had never had any sexual interest, either with other people or in masturbation. I began taking anti-depressants (Lexapro, - an SSRI) when I was about 15. A few years later, I was off medication for a month during the changeover to another medication (Anafranil - a tricyclic antidepressant) and around ovulation I did masturbate and read literature with sex in it. Back on the new medication, I've never been interested in masturbation again, but don't feel as disconnected to sexuality as before. Over my teenage years I had experienced emotional attraction to people but never physical attraction.

Nearly two years on from that Hay! Sex Exists! incident, I'm nearly 20 and I've been in a relationship (my first) for about 6 months and at first had some trouble figuring out if I wasn't attracted to him or if my meds were affecting sexual attraction, and then questioned the same thing re. my meds' effects on emotional attraction/intimacy. I figured out that I felt better about our relationship during the once or twice I felt  physically attracted to him, which seemed to be during ovulation. I'm happy in the relationship right now (which I suspect was triggered by the relief that I am attracted to him but also just because I've realised we really have something special) but the situation does cause us some complications.

My psychiatrist and I have agreed that I need to do some exploring to figure out my sexuality (am I asexual/straight/gay/bi/etc? how much do the meds affect my sexual functioning? how much do the meds affect my physical attraction? how much do the meds affect my emotional attraction? what else would it be good to know about my sexuality?) but being off the medication is definitely out of the question in the near future. We tried lowering the dose recently with pretty much disastrous results in terms of my depression (for the record the month I had off-meds during the med changeover those years ago was torture OCD-wise) so we have had to hold off further experimentation until I am on holiday from study/work. I don't want to put too specific a question to you in case anyone has a completely new angle to examine this (if you do, please share! I'm open to anything), but the questions I had in mind were - anyone had experience with lowering medication dosage to reduce SSEs (sexual side-effects)? I haven't yet found any definitive info as to whether lowering the dose (as opposed to abstaining from it altogether) would help - and what else can we do to help counteract possible SSEs?

Thanks for reading!

* another user used this term and thought it was great. Hope you don't mind me using it too.

Comments

[archangelbeth]

I need to run in just a sec, typing fast -- is Wellbutrin an option for you? (I think that's the spelling...) It's generally the go-to SSRI-type (I think?) to change to, or to add to current meds, to try to restore sexual interest.

[reverberance.livejournal.com]

Oh Beth, always there to offer help (I've seen you around VP and you've helped me in the past, hope to one day be able to explain things as clearly and as knowledgeably and respectfully as you do!) -thankyou!

My psych is considering Wellbutrin, however it's not used much here (I'm based in Australia/New Zealand) so he's not really familiar with it.

[gryphonwing.livejournal.com]

Wellbutrin is my antidepressant of choice. Sadly, if anxiety is a large part of your depression (you mentioned OCD), it might not be a good thing to add - it can increase anxiety. On the other hand, it might be fine if you just add it to existing meds.

Another that is sometimes used to counter sexual side effects is buspar (buspirone). It's a weird mild anti-anxiety drug. I'm on it right now and loving it. It's considered very safe for most people; I don't know if it interacts with the tricyclics or not, but if not it might be a good choice.

A lot of what you're dealing with is less loss of sensitivity and more loss of interest, I think? Or possibly both, of course. That's a more challenging problem in some ways. Hmmmm. I definitely think the work to figure all this out will be worth it and very, very rewarding for you. :)

[acharmedlife.livejournal.com]

I took buspirone for awhile. It didn't do anything to counter my SSEs (which include reduced sensitivity and great difficulty reaching orgasm). I wish it had!

[reverberance.livejournal.com]

Was this using buspirone with other meds, or instead of?

Here's hoping you're having more luck tackling the SSEs now.

[acharmedlife.livejournal.com]

With other meds. Sadly, nothing has changed. =/

[reverberance.livejournal.com]

Ah, okay. Thanks for that info.

Oh no, sorry to hear that! I was hoping to get some responses with suggestions other than meds... If I find something that works I will come back and share!

[sweetchild92.livejournal.com]

I love my buspar :D

Had no idea it could be used in that way.

[reverberance.livejournal.com]

Glad to hear another positive review!

[reverberance.livejournal.com]

Anxiety is a large part of my depression, including OCD. I will certainly bring up adding other meds onto the current meds with my psydoc.

So is buspirone something that is substituted for anti-anxiety/anti-depressants, or something which can be added to existing ones?

Both is the right answer. At first loss of interest was the one that concerned me the most (am I not interested in him because...?) but now that we are actually happily in a relationship, loss of sensitivity (how come I don't enjoy anything he does to me physically?) is the issue at the moment.

Thankyou so much for reminding me. There are definitely times I'd like to go Pfft, sexuality, who needs it! Not me! but I'm going to assume that sexuality (including asexuality) is an important part of anyone's identity, I'd guess.

[gryphonwing.livejournal.com]

I think it's fair to say that sexuality is important to most of us one way or another. What that means varies.

Buspirone can be added to other meds; I think that's actually how it's usually taken. I have no idea if it would work for you without interactions, but it's something worth mentioning to the doctor.

Best of luck figuring it all out... if you find something that works, I'd love to know about it.

Oh, and in the meantime, maybe incorporate as much non-sexual pleasurable touch as you can? Massage is pretty awesome, and you can build physical intimacy that way too.

[reverberance.livejournal.com]

Thankyou!

Sounds good to me. :)

[somniumdraconae.livejournal.com]

So, is it mainly the OCD or do you have depressive symptoms too?

Anyhoo... I use Cymbalta, which is a combo serotonin-norepinephrin reuptake inhibitor. I have never had any libido problems on it, although I'm not sure what the general consensus is. But Cymbalta is approved for both depressive and anxiety-type symptoms, as well as chronic pain. So its sort of a silver bullet for a lot of the symptoms that come along with this kind of thing, one little pill instead of a handful.

I know i sound like an ad, but I take like 6 other pills a day besides this so I'm really glad it does the work of several things and saves me even more pills.

Not sure what the availability is worldwide - I'm in the US. Its made by Lilly if that helps.

[fallconsmate.livejournal.com]

i had to giggle at "six pills a day beside this" and went to peruse my pill bottles. 45 pills a day! meds plus suppliments to help with conditions i cant take meds for (because statins crap out the liver even more, yay cholesterol) plus a nasal spray plus two different injectables.

and my chronic pain still isnt being treated. ;)

[somniumdraconae.livejournal.com]

6 was the random number i hit I'm not sure what it is really lol. I think it is closer to 11 or 12. Still nowhere near your 45 though! :)

My chronic pain is being "treated". I still have pain, but it isn't as bad as if I weren't taking anything. The cymbalta does make a difference, so it might be a good option for you.

[fallconsmate.livejournal.com]

I'm not good on antidepressants, so I am wary of it, unfortunately. What I need is a decent GP or pain specialist...but since a whole s**tload of life just dumped all over me, that isn't going to happen any time soon! *massive eyeroll*

Thank you for the reccomendation, though! :)

[reverberance.livejournal.com]

Augh, life can do that. Best wishes. :)

[gryphonwing.livejournal.com]

Cymbalta killed my ability to orgasm but left my libido intact. :) That was fun!

[fallenfaun.livejournal.com]

My boyfriend had the same issue, his refractory period quadrupled too. Anti-depressants have some crazy side effects.

[reverberance.livejournal.com]

Ohhh yeah. To me the one that takes the cake is still the causing of suicidal ideation as a side-effect.

[reverberance.livejournal.com]

Oooh, I've heard of that happening. Oof. If you don't mind my asking, how did you manage to remove/lessen that SSE?

[gryphonwing.livejournal.com]

I'm not sure 'cause the threading isn't loading right, but I think this might have been about my no-orgasms-on-Cymbalta. And the answer is: I didn't. I put up with it for about a year and a half because I needed it for pain, but I never had an orgasm while I was on it despite quite a lot of attempts.

:(

[reverberance.livejournal.com]

Oh. I'm sorry to hear that. Thanks for answering my question.
Here's hoping things in that aspect are better for you now.

[reverberance.livejournal.com]

The OCD is more severe and what I was originally put on anti-depressants for, but depression certainly manifests from the anxiety. My recent experiment with lowering the dosage ended up with me very depressed but not having a significant difference in OCD symptoms (pure-obsession, for the record).

I will mention that to my psydoc as well. It's a little hard for me to look at substituting my current meds completely considering my bad experiences off- and on lowered doses of my current meds, but I definitely know that it's unlikely I can just find one that I can stick with forever.

Useful to have that kind of info, thankyou!

[isee23s.livejournal.com]

I didn't personally like Wellbutrin, made me kind of jittery, but it didn't have any SSE's. I did take buspirone alongside the Prozac, and it worked pretty well. I won't say I was 100%, but I could enjoy sex and even orgasm, which I couldn't before when it was just Prozac (for OCD/anxiety/depression, btw). Just took longer, I had to still be patient, but at least I could do it.

You honestly never know until you try. Everyone is so different. I feel a little irresponsible offering my own experiences because it's not really accurate for you to place any stock in them. However, I did want to offer some hope that it can be overcome somehow, at least enough to feel functional.

It can be a difficult journey with a lot of experimentation. That's why it's called the med-go-round, unfortunately --just gotta try 'em. As far as I know, Wellbutrin and buspirone are likely candidates for this problem, though. Best of luck!

[reverberance.livejournal.com]

Well one piece of advice I take from this is 'don't give up in terms of the physical enjoyment of sex even when there are SSEs'.
Thanks for the offering of hope. :) I'm honestly not as fussed about this as my boyfriend is, at this point, but it's certainly good to know this anyway.

Yes of course, I definitely won't be taking everyone's accounts to mean that I will experience the same thing. It's just good to get a little background info, particularly because as Wellbutrin isn't really used in Australia/New Zealand my doc isn't really familiar with it.

The 'med-go-round'! I've never heard that phrase, but I love it! I've been fairly lucky meds-wise, it only took me a few to get to the point I'm at now, which is functional (although a few years on I've realised my current situation is not ideal) but I've certainly gone through my fair share of doctors!

Thankyou!

[sweetchild92.livejournal.com]

I'm not going to be of much help, I'm afraid, but maybe can offer *something* in this realm

I'm on an SSRI, have been for 4 years (I'm 20 too :D) and from what i can tell...have never had any SSEs. I did assume I couldn't orgasm from it, but from reading this community, I found out I WAS having orgasms and me and my vibrator have been in a serious relationship ever since. I DID get side effects from lamictal-it started off great but upping the dosage mean no attraction whatsoever. Lowering it back down did help.

[reverberance.livejournal.com]

Always good to have some input, thankyou!

I didn't know I had any SSEs on my previous medication until I tried not being on them because I hadn't had anything to compare to.
me and my vibrator have been in a serious relationship ever since.
Hehe! Clearly, from this post, that's not something I have in my life, but if I did, I would use that phrase!

Ooh, I learnt 2 very useful things from your comment.
1) It's very useful to know that lowering the dosage did help. I'd never heard if anyone had any success from lowering the dosage rather than removing it altogether.
2) Someone else has experienced the 'no attraction' under meds! *dances* Um, sorry, I didn't mean that at all, it's just really good info to know as my psych isn't too sure how much of an effect SSEs can have on sexuality altogether, seeing as apparently it's only reported to cause sexual dysfunction, eg. inability to have orgasms.

[withyoures.livejournal.com]

took seroquel and lexapro together -- very low libido and difficulty with climax. removed the lexapro and substituted some other meds -- libido returned to normal and climax was so much easier. I don't know if seroquel is an option for you. I take it for bipolar disorder, but I think it can be prescribed for depression also. it's definitely the drug that has worked best for my depressive symptoms.

[reverberance.livejournal.com]

I've heard particularly bad things about libido and Lexapro.
(I didn't think I had any SSEs when I was on it myself, but then I went off them and BAM, so I guess I just had never known any better, since I started them before I'd ever had any sexual interest.)

[rhnthegreat.livejournal.com]

SSEs can depend on the dosage as well as how long you've been taking the medication. With Celexa, I experienced SSEs at 20mg that I didn't experience at 10mg. My physician assistant said I could lower my dosage and the SSEs would likely decrease. However, after 6 weeks at 20mg, my sensitivity and ability to orgasm returned to close to no-Celexa levels.

I received some wonderful advice from the lovely VagPagineers in the meantime. For me, being completely relaxed helps the most. Is your partner aware of your situation? Your level of comfort with your partner can influence SSEs.

Oh! And having sexytimes before your next dose is helpful. In my case, SSEs are least noticeable right before I need to take my next dose.

[reverberance.livejournal.com]

Ohh, everything you mentioned is very useful information, thankyou!

Yes he is, and I'll definitely keep that in mind.

[smokeline.livejournal.com]

This comment is a little late, but I thought I'd chime in.

I was prescribed the generic for celexa at the beginning of the year for extreme nausea that (after many physical tests that made no sense) my doctor attributed to anxiety/depression. I was starting a new relationship at the time and have a major family history of anxiety, so I'm pretty sure that was at least a part of it. My relationship is very healthy and good, but was long distance at the time and I would get anxiety thinking about sex because short visits made physical contact seem sudden. I had no anxiety about masturbation, though, because I've been doing that for years.

Anyway within a few days I was still getting turned on all the time bc of the relationship, but stopped being able to orgasm. It sucked. I called my doctor and the partner on call switched me to wellbutrin right away. It fixed everything. I felt better (even though I'm pretty sure the core cause was anxiety, not depression) and I could orgasm again. It was like a little miracle drug.

I wonder if you've just been on the drugs so long that you're used to feeling all the sexual side effects and that has become your normal? They can manifest in a lot of different ways. You may want to think about switching to or adding wellbutrin because I think a lot of people have had success with that, even for anxiety.

Good luck!

[reverberance.livejournal.com]

More responses are always good, so thankyou for chiming in and sharing your experience!

Guess I'm not the only one whose anxiety/depression began with the purely physical symptoms of nausea then.

Well I certainly never knew I had SSEs before I went off medication for a month - just a month!- and BAM! Different. And then even though I'm back on them again, I reckon what I experienced during that time has changed how I experience things now.

I will definitely be mentioning it to my doc.

Thankyou!