Posted by SLS on November 20, 2015, at 23:55:05
In reply to Re: HELP sexual dysfunction, posted by Lamdage22 on November 20, 2015, at 11:16:52
> Is there a reason to believe Desipramine will not cause these sexual side effects?
Not really.
I'm going to think about this some more.
Desipramine is more selective for norepinephrine reuptake than is nortriptyline. I don't know how this relates to your case specifically, though. Anorgasmia is usually associated with serotonin reuptake inhibitors, including clomipramine and, to a lesser extent, imipramine. There is an interesting report of anorgasmia resolving once a patient was switched from imipramine to desipramine. The patient was female.
Perhaps NE reuptake inhibitors are problematic for you, though, so I won't make any guarantees. Before committing to making a switch to desipramine, you should wait for more opinions.
Are you totally incapable of achieving orgasm? If you can achieve orgasm at all, perhaps there is a chance that it will improve over time. This is what happened to me with Nardil. It took three months before orgasm approached normalcy.
If you were to switch to desipramine immediately, would you return to nortriptyline if it didn't work?
If it were me, I would continue to test nortriptyline at higher dosages, despite the presence of anorgasmia. I guess it depends upon how many options you have left. Of course, you can always stop taking it whenever you want. I would want the information, though. Most people with severe depression need a minimum of 75 mg/day of nortriptyline. You are almost there. It seems like a waste of the time you have already invested to quit now. I think it makes sense to find out whether or not nortriptyline improves your condition first before switching to another drug. If the anorgasmia begins to improve as nortriptyline begins to work, switching drugs would not be necessary.
It would be interesting to explore the capacity for Remeron to:
1. Reverse anorgasmia via 5-HT2a/c blockade
2. Enhance the antidepressant effects of Effexor or TCA.Good article:
http://www.medscape.com/viewarticle/430614_5
- 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/1084088.html