Posted by h0dge on May 16, 2001, at 15:44:50
I think I'm dysthymic. I've always just had a negative mood, been low energy, and generally just been a misanthrope of sorts. :) I occasionally get to more severe depression, but nothing so bad as to contemplate suicide or anything really rash like that. Just lots of self-flagellation... I'm generally pretty anti-social, have trouble making decisions, things like that. I never have manic phases.
I've been on Zoloft and Wellbutrin before. Zoloft I tried for a while, and I think it had some beneficial effects. However, the delayed/non-existent orgasm made me stop - I didn't have reduced desire (more, actually), but it was just too frustrating. I can't precisely remember the dose I was on, but it was probably 150 mg or so. Wellbutrin I tried recently, at 300 mg or so for 10 weeks, and I don't think it had much effect at all.
So, getting to the AD bit - I'm going to start up medication again (waiting til insurance kicks in to be able to go to psychiatrist/therapy, but until then I have a good family doc who can get samples and is somewhat experienced in mental health issues). My main concern is that I find something that improves my mood/personality without significant long-term sexual side effects - I know, probably what lots of other people are looking for.
My thoughts so far:
-I believe a SSRI would work, based on my experience with Zoloft. I've been thinking that Prozac might be a good choice, since it sounds like it's energizing, and that might be good for me since I'm pretty low energy. I wouldn't mind some ejaculatory delay (it would be nice actually!) but not if it blocks orgasm altogether, reduces my libido, or otherwise wreaks sexual havoc. It sounds like Zoloft is the worst as far as that goes, so I'm hoping maybe Prozac won't be as bad. Some of my blood relatives are on Paxil or Prozac, and that seems to work for them.
-I've been contemplating Remeron, since it seems to have no sexual effect, from what I've read. The tendancy towards sedation is a bit worrisome - I don't need to be more tired! Possibly in concert with wellbutrin or effexor? I know Wellbutrin doesn't have sexual side effects for me, although it doesn't improve mood too much. Effexor sounds like it has a short-term effect on orgasm, which tends to subside after 2 months or so.
-I think I'd prefer to avoid MAO inhibitors since I really like a lot of the foods that are no-nos while taking a MAOI, like aged cheese, wine, coffee, etc.
Does anyone have advice on which course might be best to try first, or any alternatives that might prove fruitful? At this point I'm pondering either trying Prozac and seeing how the sexual effects go, or trying Remeron and seeing if the sedation is bad alone/with other things in the morning to energize. I have access to samples of Prozac (20mg), Remeron (30mg), and (probably) Effexor XR (75mg), along with a remaining bottle of Wellbutrin XR (100mg).
Any advice in followups/email would be greatly appreciated!
-jon
poster:h0dge
thread:63249
URL: http://www.dr-bob.org/babble/20010515/msgs/63249.html