Good sex and depression or relief from depression and deal with the side effects?

[Thanks2HP]

Just curious what my fellow depression sufferers would choose, good, even great sex and deal with the depression or some relief from depression and deal with the side effects? For me the most noticeable side effect was delayed ejaculation.

I had the most relief from depression taking Lexapro but stopped taking it for a while and had a reaction to it when I started taking again. My doctor put me on Zoloft instead. The sexual side effects were more noticeable with Zoloft.

I asked to try Bupropion (previously/also known as amfebutamone; Wellbutrin, Zyban) and the doc complied. It's been about two months now and I've had at least two episodes of deep depression that I've just rode out. After all, I've dealt with it before.

I have a regular checkup scheduled with the Dr. this week. I'm torn between seeking relief and going back to a sex life that is impaired or dealing with the depression and having a more enjoyable sex life.

I have a supportive girlfriend who is willing to deal with the sexual side effects but I don't know if I can.

So, what would you choose?

Thanks

[nandm]

Sexual side effects also affect women. I can not relate to this from a mans perspective but can give it to you from mine, a woman's perspective.

I find that for me the sexual side effects are much easier for me to deal with than the depression mainly because my depression leads me to suicide attempts.

Have you considered talking to your doctor about Viagra. It might help offset the side effects you spoke of? Just a thought

[Live]

similar to what NandM said.

[jurneyman]

If you are mainly depressive, the Wellbutrin works differently then the Lexapro in that
it doesn't affect the Serotonin like the SSRI's. which seem to work better for just depression. Have you tried Celexa? Lexapro is just an updated version, Also maybe a combination. I have been on all the above at one time or another, and a combination
worked the best for my situation at the time. It would be impossible to recommend any particular drug, or combination, that is up to you and your Pdoc. The hardest thing to deal with, at least for me was all the trial and error I had to go through to find something that could help. BTW in my case it would not even be debatable, my depression took me into a pit of hopelessness, I don't know if I could even describe it accurately, nothing would ever be worth existing in that much mental pain again, for any reason. Don't quit looking.

[historyteach]

Have you discussed that Ambilify with your doc?
It's an adjunct therapy medication, used with your medication.
If you used it with the Wellbutrin, perhaps that would help and not cause the unwanted side effects?
At any rate, do discuss this completely with your doc. You shouldn't have to choose between the two issues.

Shalom!

[slimjim30]

I tried Cipramil, Effexor and Zoloft and all of them caused me to have retarded ejaculation. It probably only worked once a week if that :-/

I ended up stopping those and got put onto something called Aurorix (Manerix in the US I think). I must say there are no sexual side effects with this one - even after being on it for 6 years. It did wonders for my anxiety as well.

You might want to discuss other options with your doctor? RIMA's and Tricyclics don't have the same side effects as SSRI and SSNRI anti depressants.

[historyteach]

I looked up the Aurorix / Manerix your on, slimjim, as I never heard of it.
I could never take it due to the food restrictions necessary! Oy!
Here they are:

Aurorix / Manerix is a new antidepressant drug of the reversible inhibitor of monoamine oxidase type A class.

(MAOI) Monamine Oxidase Inhibitors

Used to treat depression and panic. In most cases, MAOI's should not be the first treatment choice. Rather, these drugs are prescribed for people whose symptoms have failed to respond to other common antidepression drugs. Although just as effective as heterocyclic drugs, they poses a potential problem because of the possible toxic food-drug interactions. If you are taking one of these, follow the dietary guidelines strictly.

Do NOT eat food or drink beverages with tyramine while taking MAOI's. Among the foods that should be avoided are: Lox, Pickled Herring, Liver, Dry Sausage, Broad (fava) beans, Raisins, Figs, Avocados, Cheese (cottage and cream cheese are allowed), Yogurt, Beer, Wine, Hard Liquor, Sherry, Caffiene (coffee, tea, cocoa, or chocolate), Yeast Products, Pickles, Sauerkraut, Soy Sauce, Sour Cream, Snails or Licorice.

Be careful what you eat and drink!

Shalom!

[Thanks2HP]

Originally Posted by nandm

Sexual side effects also affect women. I can not relate to this from a mans perspective but can give it to you from mine, a woman's perspective.

I find that for me the sexual side effects are much easier for me to deal with than the depression mainly because my depression leads me to suicide attempts.

Have you considered talking to your doctor about Viagra. It might help offset the side effects you spoke of? Just a thought

Thank you for responding. I was prescribed Viagra about ten years ago by the same shrink that prescribed the AD's. I was curious more than anything. I did not refill the prescription because then as now, the problem for me was/is not getting an erection. The main issue is that it takes much more stimulation to achieve orgasm. Plus, the orgasms are not the same as when I am not taking Lexapro. They are not as satisfying. Warm Regards, R

[Thanks2HP]

Originally Posted by slimjim30

I tried Cipramil, Effexor and Zoloft and all of them caused me to have retarded ejaculation. It probably only worked once a week if that :-/

I ended up stopping those and got put onto something called Aurorix (Manerix in the US I think). I must say there are no sexual side effects with this one - even after being on it for 6 years. It did wonders for my anxiety as well.

You might want to discuss other options with your doctor? RIMA's and Tricyclics don't have the same side effects as SSRI and SSNRI anti depressants.

Thanks for sharing. As historyteach points out, it looks like Aurorix is an MAOI. I've seen the "MAOI's should not be the first treatment choice" warning about them before. This causes me some concern. It seems like I've also seen a warning on OTC cold/allergy meds to not take them if one is taking an MAOI. Anyway, I would really have to research them but I'm glad to know there is an alternative, that they're working for you and that they are not know for sexual side effects.

[Thanks2HP]

Originally Posted by jurneyman

If you are mainly depressive, the Wellbutrin works differently then the Lexapro in that
it doesn't affect the Serotonin like the SSRI's. which seem to work better for just depression. Have you tried Celexa? Lexapro is just an updated version, Also maybe a combination. I have been on all the above at one time or another, and a combination
worked the best for my situation at the time. It would be impossible to recommend any particular drug, or combination, that is up to you and your Pdoc. The hardest thing to deal with, at least for me was all the trial and error I had to go through to find something that could help. BTW in my case it would not even be debatable, my depression took me into a pit of hopelessness, I don't know if I could even describe it accurately, nothing would ever be worth existing in that much mental pain again, for any reason. Don't quit looking.

I have tried Celexa before and like Lexapro it helped. It took some time before I felt some relief. This was several years ago before Lexapro was available. I changed jobs and health plans & stopped taking AD's. I just dealt with the depression for as long as I could. When I went to my pdoc for help in 2004, he suggested Lexapro and told me about it being connected with or a derivative of Celexa. He felt that it was less likely to have side effects than Celexa. I remember getting a headache the first two days after taking it but started feeling better almost immediately. Maybe it was a placebo effect initially, I don't know but Lexapro worked for me for several years. At the time I was prescribed Lexapro I was not in a relationship so sexual side effects were not an issue. I am now in the healthiest relationship of my life. She's said that she will work around any side effects which is comforting to know, but I'm not ready to go back to SSRI's yet. I don't get as much relief with Welbutrin as I did with Lexapro but I'll take the compromise of dealing with a bout of depression from time to time and not experiencing the sexual side effects the SSRI's cause (for me anyway). There are no sexual side effects with Welbutrin. I saw my pdoc today and told him about the depressed episodes. He increased my dosage from 150mg twice a day to 150mg three times a day. Like you said, it's sometimes a matter of finding the right combination of AD's. Funny though, I never got that magic combination right when I was out there "self-medicating". I always overshot the mark! -- Thanks again for your response. I appreciate it.

[Thanks2HP]

Originally Posted by historyteach

Have you discussed that Ambilify with your doc?
It's an adjunct therapy medication, used with your medication.
If you used it with the Wellbutrin, perhaps that would help and not cause the unwanted side effects?
At any rate, do discuss this completely with your doc. You shouldn't have to choose between the two issues.

Shalom!

Thank you. I have not discussed Ambilify with my doc. When I saw him today he did mention that it might take a combination of AD's to get relief but didn't mention anything specific. He's of the mindset that he'd prefer for me to take one AD at a time at the lowest dosage possible, increasing the amount if necessary. I prefer to start out taking the least amount possible too. After telling him about the last two bouts with depression, he bumped up my Welbutrin to 3 times a day @ 150mg from 2 times a day. I'll research Ambilify so that I'm prepared to discuss it at the next checkup should the Welbutrin not work out. - Thanks. - R

[Freedom1990]

Depression can be debilitating. Lack of nookie, however, will not kill me.

[Thanks2HP]

Maybe so but I get depressed when I don't get nookie and when I get nookie I'm usually not depressed!

I consider myself one of the "walking wounded", functioning at a fairly high level. I've thought about suicide while depressed but I doubt very seriously I would ever act on it. . I was exposed to the Catholic Church at an early age. On top of feeling that just about everything I did or wanted to do would lead me to hell, committing suicide was (is?) an express ticket. No insult meant to anyone and/or their religion.

Anyway, I just bite the bullet and ride out the depression which does occur less when taking Welbutrin. It doesn't seem like it when I'm going through it but after the fact it seems worth it, especially since the sex is so much improved when not taking an SSRI.

[Freedom1990]

Well, I was raised Catholic too, and I had plenty of suicidal thoughts in my darkest depression. Guess it didn't have that much influence over me because suicide looked pretty good a few times to me. Thank God I'm still here today.

[slimjim30]

Hey guys - Aurorix is not a normal MAOI it's a RIMA:

Reversible inhibitor of monoamine oxidase A - Wikipedia, the free encyclopedia

There's no food interactions to worry about, you just can't mix it with SSRIs or Stimulant drugs (i.e. illegal ones). i.e. the no mix chemicals are the same as with SSRIs. I eat many of the things on the MAOI exclusion list with the blessing of my doctor.

I'm not a doctor though so it's best to discuss your concerns with one.

[historyteach]

Originally Posted by historyteach

I looked up the Aurorix / Manerix your on, slimjim, as I never heard of it.
I could never take it due to the food restrictions necessary! Oy!
Here they are:


Be careful what you eat and drink!

Shalom!

Here's the website:
Inhouse Pharmacy Aurorix / Manerix is a new antidepressant drug of the reversible inhibitor of monoamine oxidase type A class
It has the food/drink restrictions listed.

Shalom!

[Thanks2HP]

Originally Posted by Freedom1990

Well, I was raised Catholic too, and I had plenty of suicidal thoughts in my darkest depression. Guess it didn't have that much influence over me because suicide looked pretty good a few times to me. Thank God I'm still here today.

I'm thankful you are still here too. Something my sponsor once shared with me about an occasion when he was wrestling with pulling the trigger or not. He said the question of "what if it's worse?" popped into his mind. I try to remember that question when I get down. Wouldn't it be a terrible thing if it was worse, whether one commits suicide or not? I hope, pray and believe it will be better on the other side but I don't plan to speed up the process.

[slimjim30]

Originally Posted by historyteach

Here's the website:
Inhouse Pharmacy Aurorix / Manerix is a new antidepressant drug of the reversible inhibitor of monoamine oxidase type A class
It has the food/drink restrictions listed.

Shalom!

I am not sure who inhouse pharmacy are, but I've got a link to the Australian Government PBS page regarding Moclobemide:

pbs.gov.au - Health Professional - Search results

All the PDF links titled "CMI" are the inserts that come in the package when you buy the medication. It warns against mixing with other Antidepressants but there's no food restrictions.

Here's a link from a US University too:
Moclobemide

Anyhow, I'm just suggesting it as an option as it doesn't have sexual side effects and is a very effective anti depressant. If you don't want to talk to your doctor about it that's fine I just wanted to highlight that the reason why you don't want to might not be valid.

I've been on it for years and eaten whatever I want with the blessing of my doctor.

Apart from that I think Trycyclic antidepressants may be another alternative. I believe doctors are pretty unlikely to prescribe them though (at least in Australia - they are a "last resort") - but you can ask.

Cheers!

[historyteach]

Wow, that's interesting.
Thanks for sharing.

Shalom!

[Thanks2HP]

Originally Posted by slimjim30

Anyhow, I'm just suggesting it as an option as it doesn't have sexual side effects and is a very effective anti depressant. If you don't want to talk to your doctor about it that's fine I just wanted to highlight that the reason why you don't want to might not be valid.

I've been on it for years and eaten whatever I want with the blessing of my doctor.

Apart from that I think Trycyclic antidepressants may be another alternative. I believe doctors are pretty unlikely to prescribe them though (at least in Australia - they are a "last resort") - but you can ask.Cheers!

Thank you for the information. It's nice to know there are more options out there to explore. I had the choice of going with bupropion/wellbutrin or nefazodone/serzone. It was a tough choice to make but obviously ended up choosing Wellbutrin. Moclobemide/Aurorix/Manerix isn't available in the United States yet but I'll bring it up the next time I see the doc, to get his opinion on it and whether he'd prescribe it to patients if it were available here.

I find the Tricyclic information interesting:
Tricyclic antidepressants (abbreviation TCAs) are a class of antidepressant drugs first used in the 1950s. They are named after the drugs' molecular structure, which contains three rings of atoms (compare tetracyclic antidepressant). They are used in the treatment of major depression and, in lower doses, for insomnia and pain relief in some chronic pain syndromes.

Antidepressants are often prescribed for a variety of maladies, even if the patient is not depressed. Often this is because the doctor feels that the issues are psychiatric or psychosomatic, but some antidepressants also have valid uses in non-depressed patients.
Tricyclic Antidepressants

Tricyclic antidepressants (TCAs) are an old class of antidepressive drugs, much older than Prozac and other SSRIs. The first TCA imipramine was discovered back in the 1950s, when psychopharmacology was still a new science. The name "tricyclic" comes from their molecular structure which contains three rings of atoms.

The TCAs are effective antidepressants, but because they tend to cause more side effects than newer drugs, they are rarely used to treat depression any more. They are, however, still commonly used in the treatment of chronic pain, sleep disorders and some other conditions, usually in doses much smaller than would be used for depression.

The SSRIs are fairly selective for serotonin, as their name, selective serotonin reuptake inhibitors, implies. TCAs on the other hand are far from selective. They increase brain levels of serotonin, but also norepinephrine (noradrenaline). In addition they block histamine receptors, muscarinic acetylcholine receptors and alpha adrenergic receptors and have some other actions.
Uses

The increased levels of serotonin and norepinephrine are responsible for the antidepressive effects of the TCAs. The sedative and pain relieving effects of the drugs, however, are thought to result mostly from other mechanisms of action.


Relieves depression, acts as a sedative and relieves pain...Reminds me of a sales pitch: "but wait, there's more".... "it slices, it dices, it makes julian fries".

I don't know, maybe the sedative effect would help reduce my anxiety. I struggle a lot with staying in the moment. Despite knowing better I catch myself worrying about "tomorrow". At least for today I am not depressed so I'm giving thanks for that and plan to enjoy it as much as possible. I took today off and the weather is beautiful. It's nice and sunny outside so I think I'll go out and enjoy it,--- "while it lasts" the "committee" tells me. Anyway I want to get my doc's opinion on this one too.
- Thanks again.

Regards, -R

[Thanks2HP]

I'd like to say thank you to everyone who's posted on this thread.

[slimjim30]

Originally Posted by Thanks2HP

Thank you for the information. It's nice to know there are more options out there to explore.

No problem. I'm sure your doctor will advise on what is best.

There may be other RIMA drugs apart from Moclobemide available in the USA. Your doctor could point you in the right direction if he thinks they are right for you.

Or perhaps even the tricyclics will help.

Good luck and happy bonking ;-)

[slimjim30]

One last post guys...I have a lot to say about this as when I started anti depressants (SSRIs at the time) the sexual side effects really ticked me off...I was told that Avanza had fewer side effects that others too. I believe you yankees call it Remeron!

Mirtazapine - Wikipedia, the free encyclopedia

That one IS available in the USA. I have no personal experience with it but it could be another good one to talk to the doc about.