Wellbutrin

[bendymind]

Hi

I am on seroxat and its killed my sex drive

I have been surfing and found Wellbutrin has no sexual side effects

But I have also found that it is only licenced in the UK as Zyban for people who want to quit smoking

Further to this - it can't be prescribed to anyone on Anti Depressants !!

As I smoke like a chimney, would it be worth asking my GP to put me on it after coming off seroxat ?

Any thoughts ?

[SteveW]

Firstly there is a point about licensing. Although every drug has a licensed purpose and dose, doctors aren’t legally or ethically compelled to prescribe within license conditions if they consider it in their patients interest. So you wouldn’t need to actually or pretend to give up smoking.

Many doctors are reluctant however to prescribe off license in case something goes wrong. They would be on shaky ground  if they got sued. I'm not even sure the anti smoking and the anti-depressant doses are the same.

I think you need to think things through in a couple of areas. Firstly is seroxat successful with your depression. It is an SSRI. Zyban has a completely different mode of action, on dopamine. You could loose your anti-depressant effect , assuming you have had one.

The second thing is Zyban isn’t exactly benign. Sexually good, quite high rate of epilepsy bad. You could swap one problem for an arguably worse one.

Third thing is don’t assume that coming off Seroxat will solve your sexual problems. There is accumulating evidence that SSRI’s can cause problems long after you stop them, in some cases permanently.

Fourthly coming off an SSRI isn’t the only solution. Sexual problems are so frequent on them that there are various augmentation strategies to try and ameliorate them. You might be better off on one of those.

I wouldn’t advise you either way but I would say don’t assume you’ve got a simple solution.

[bendymind]

Hi Steve

Many thanks for the informative post....

''Fourthly coming off an SSRI isn’t the only solution. Sexual problems are so frequent on them that there are various augmentation strategies to try and ameliorate them. You might be better off on one of those.''

Could you please suggest some other strategies ?

My Dr seems to thing SSRI's are the only AD and sexual problems are just the price to pay !

I was on 10mg seroxat for many years and my sex drive was ok but since last year I started having anxiety attacks so Dr upped me to 20mg and my sex drive has gone to pot.

To be honest I do now feel the occasional period where I seem to be on the edge of a depressive period which has not happened for many years (when on 10mg)

[SteveW]

Here is a link to an article on SSRI sexual dysfunction, orientated towards women but much applies across gender. I was very lucky I developed a problem, stopped the SSRI, and the problem sorted itself out. There is a paragraph on incident rates of sexual difficulties among different drugs which may be of interest to you ranging from Paroxetine in the 70% level to Moclobamide at 3.9%. Pity Moclobamide has a few hassles of its own.
Anyway here is the link:
  http://www.bermansexualhealth.com/sexual-health/lack-of-libido/27-sexual-side-effects-potential-treatment-strategies-of-ssri-medications-for-depression

[Catbrian]

I was on Seroxat and, yes, it did have an effect on sexual function.  Other AD's did have the same effect to a lesser degree but vanished after a few weeks.  I also smoke and found that once I take AD, Mirtazapine, in the evening, I cannot smoke afterwards.

[bendymind]

Steve, cat

Your posts have given me great hope that there could well be an answer out there

I really appreciate you sharing your experiences

This weekend I have actually had feelings of anxiety coming back !!

I am wondering if I am developing immunity to seroxat

More research (on the meds you both mention) then back to the doc I think ?

 

[SteveW]

Good luck,I hope you cope with an SSRI obsessed GP. I wondered what I would do in your position. Given that Seroxat is the worst SSRI for sexual side effects of the lot, I think I would be off it pretty sharpish. Even a change from Seroxat to Prozac would lower your chances of sexual effects from the 70’s % to the 50’s %.

I’d probably go for Moclobamide which at 3.9% gives you a swap from a high probability to a low one.The only trouble with Moclobamide is that it comes with food restrictions. You have to avoid tyramine containing food. It isn’t too onerous. When I was taking it Cheese was my problem,I  love it. Marmite, Broad Beans, and Red Wine didn’t prove insuperable. Failing that Mirtazepine and Seroxat is supposed to reduce sexual side effects quite substantially as well as well as making for a more potent anti-depressant mix.

My real interest in all this is side effects that don’t disappear when you stop taking the drug. Try reading the following link on PSSD –post SSRI Sexual Dysfunction. SSRI and sexual dysfunction may be such a case.

     http://en.wikipedia.org/wiki/Post-SSRI_sexual_dysfunction