Posted by SLS on November 19, 2015, at 7:36:29
In reply to HELP sexual dysfunction, posted by Lamdage22 on November 19, 2015, at 5:24:38
I would consider switching from nortriptyline to desipramine if you want to continue with a TCA. Adding buspirone or Wellbutrin are possibilities. Periactin (cyproheptadine) can be very sedating due its antihistaminic effects. It wouldn't hurt to try it. Some people use if immediately before having sex so that the delayed sedation does not interfere.
If anorgasmia is your only concern, you might want to continue raising the dosage of nortriptyline just to see if it help you feel better. It is good information to have. You can then decide whether to continue with it and continue to treat the sexual side effects or make the switch to another TCA based upon this information. In other words, if full therapeutic dosages of nortriptyline produces a robust antidepressant effect, it would give you good reason to continue to work with TCAs. You might get lucky and see your ability to maintain erections and achieve orgasms if higher dosages of nortriptyline produce a full remission.
Frustration and fear. I know what it's like to want to trash a drug when sexual side effects appear. I don't think it makes sense to remain at 50 mg/day of nortriptyline. Either go up to at least 75 mg/day or discontinue it. I would go up. Seriously, what's the worst thing that can happen? I have never heard of a TCA producing residual sexual impairments the way SSRIs can. If you go up and it doesn't work, then it is an easy decision to make to discontinue it. If it does work, you can then choose to work on treating the sexual side effects. Alternatively, you could then try switching to desipramine given your positive response to nortriptyline.
Out of curiosity, what other drugs produced anorgasmia in you?
- ScottSome see things as they are and ask why.
I dream of things that never were and ask why not.- George Bernard Shaw
poster:SLS
thread:1083983
URL: http://www.dr-bob.org/babble/20151119/msgs/1084066.html