Posted by JohnL on October 25, 1999, at 5:14:26
In reply to So much for stability (next med suggestions), posted by Bob on October 25, 1999, at 0:27:30
Hi Bob. I can sure relate. I think I felt best (but not 100%) on Zoloft. But the same emotional numbness, apathy, and totally dead sex life. I would put my vote in that Zoloft is the problem. I also agree that Celexa is likely (though not definitely) a waste of time in your case.
I think Racer's suggestion of Effexor is a top choice. It can be harder than others to get used to early-on, often requiring smaller doses and slower titration to get used to it. But it is often more effective than SSRIs. I bet the Nortriptyline would go nicely with it. If you went with Effexor, just be aware that the undesirable effects of Zoloft will linger for up to a month after you're completely off it. That's how it was with me. So it could cloud the judgement of Effexor early-on. You'll have to give it some fair time to pass any judgements. It will take time for the sex to return and for the apathy to wear off.
Two more possibilities. There's been a lot of discussion on Selegiline. It would likely boost energy and sex and not have emotional numbness. It just doesn't have much of a track record in depression yet, so it probably wouldn't be viewed as a top choice by your doctor.
Finally, if you think you might want to take a more serious look at the TCAs, Vivactil (Protriptyline) is the black sheep of the family. It is activating, not sedating. It has been said that if Prozac hadn't been invented, Vivactil would be much more popular than it is. It is described as being "suitable for the apathetic withdrawn patient". And other sedating TCAs can be taken with it at night for sleep.
Just some thoughts to ponder.
poster:JohnL
thread:13823
URL: http://www.dr-bob.org/babble/19991028/msgs/13829.html