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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 6 of 6. This is the beginning of the thread.
Posted by sip on December 29, 2003, at 16:00:57
Does anyone have links to published studies examining the results of adding Wellbutrin to an SSRI to help with sexual dysfunction? Or references? I have noticed some sexual s/e's (female in my 30s) in the four weeks I have been on Lexapro and I told my doctor about how I read on this board that some doctors prescribe Wellbutrin in addition to an SSRI or anti-d to offset the sexual s/e's. I realize that there have been mixed results with this, but my doctor dismissed Internet based accounts as "anecdotal" and said she had never heard of using Wellbutrin in addition to an SSRI for this at any conferences or from any reading/research.
Thanks.
Posted by zeugma on December 29, 2003, at 16:08:54
In reply to Scientific studies on adding Wellbutrin to an SSRI, posted by sip on December 29, 2003, at 16:00:57
> Does anyone have links to published studies examining the results of adding Wellbutrin to an SSRI to help with sexual dysfunction? Or references? I have noticed some sexual s/e's (female in my 30s) in the four weeks I have been on Lexapro and I told my doctor about how I read on this board that some doctors prescribe Wellbutrin in addition to an SSRI or anti-d to offset the sexual s/e's. I realize that there have been mixed results with this, but my doctor dismissed Internet based accounts as "anecdotal" and said she had never heard of using Wellbutrin in addition to an SSRI for this at any conferences or from any reading/research.
>
> Thanks.Sounds like your doctor hasn't gone to any psych conferences, and has done no reading or research.
Posted by m0nger on December 29, 2003, at 16:25:21
In reply to Scientific studies on adding Wellbutrin to an SSRI, posted by sip on December 29, 2003, at 16:00:57
These links have articles that refer to studies, but not the actual studies. Maybe with the names of the doctors you can find the actual studies somewhere?
-snip-
"In our study, Wellbutrin had a definite pro-sexual effect in people with sexual dysfunction," Alabama researcher Roberta May explains. "Our study -- and the others to date -- are not enough to establish Wellbutrin as a routine treatment for sex problems, but I see no reason not to try it. As medications go, it's a pretty benign drug."
...
According to May, patients on SSRIs who are suffering sex problems because of it can ask their doctors about using a low dose of Wellbutrin (75 milligrams) in addition to their SSRI two hours before sex to mitigate SSRI-induced sexual impairment. And if they switch to Wellbutrin, or add it to their treatment regimen, its side effects are likely to be similar to those caused by SSRIs. "But there's somewhat more likelihood of tremor," May explains. "The tremors usually go away after a while, but at first they can be scary."
Because Wellbutrin is already an approved antidepressant, doctors are free to prescribe it for sex problems without the FDA's specific approval. But approval would allow advertising and would certainly boost sales, especially to women, who have not shown benefit from Viagra, and to men with sex problems unrelated to erection, who also don't benefit from Viagra."
http://bupropion.com/wonderwell/index.html
-end snip-
And here is another link, its an abstract titled "A Prospective Trial of Bupropion SR Augmentation of Partial and Non-Responders to Serotonergic Antidepressants", although it doesn't discuss libido effects
Posted by Bill LL on December 29, 2003, at 16:28:30
In reply to Re: Scientific studies on adding Wellbutrin to an SSRI, posted by zeugma on December 29, 2003, at 16:08:54
I'm surprised that your doctor has not heard about adding Wellbutrin to an SSRI to help with sexual side effects. I have pasted 2 things below:
1) a question and answer from a health board, and
2) studies on WEllbutrinMy concern with your doctor is that if she does not know that Wellbutrin is used to try to offset sexual side effects from SSRI's, she may not be aware of other basic information on the use of antidepressants. This is general information that all internists and family practitioners should know.
Unless you really feel a strong attachment to your doctor, you might want to switch to a different doctor.
Question Posted By: KAG on Thursday, October 07, 1999
I work for a physician and have been hearing about treating sexual dysfunction on SSRI's with WEllbutrin. Just wondering if you knew the dosing and directions for use.
--------------------------------------------------------------------------------
Answer Posted By: HFHS MD - RG on Monday, October 11, 1999Dear KAG,
There are different strategies to treat SSRI-induced sexual dysfunction according to different available literatures. This includes the use of Wellbutrin, Buspar, Viagra, among others.
The addition of a low dose of Wellbutrin SR with current use of an efficacious SSRI has so far shown good results with no concomitant adverse effects. Please be advised that each case should be considered individually and must not have any contraindications in this type of combination therapy.I advise a literature search in MEDLINE or other resources for a more scientific explanation.
Sincerely,
HFHS MD - RG
In a 1997 report, published in Clinical Pharmacological Therapies, researchers at the University of Alabama at Birmingham gave 107 depression sufferers one of four antidepressants: Wellbutrin or three SSRIs -- Prozac, Paxil or Zoloft. Among those taking the SSRIs, 73 percent complained of sex-impairing side effects. Only 14 percent of the Wellbutrin group reported sex problems, while 77 percent said the drug "heightened sexual function."
That same year, in a pilot study at the Medical University of South Carolina in Charleston, eight people who complained of sex-impairing SSRI side effects were told to take a low dose of Wellbutrin in addition. After one month, half reported "marked improvement" in their sex problems. The results were published in Annals of Clinical Psychiatry.In another 1997 study, reported in Journal of Clinical Psychopharmacology, researchers at Valparaiso University in Indiana gave Wellbutrin to 14 nondepressed diabetic men with erection problems caused by diabetes. After 10 weeks, they showed improved sexual functioning.
In a 1998 study, researchers at the State University of New York at Buffalo repeated the South Carolina study, but on a larger scale. They tested Wellbutrin as an antidote for SSRI-induced sexual impairment in 47 depressed individuals who were told to take the drug an hour or two before sex. Wellbutrin successfully reversed the sex problems in 66 percent of them. The only significant side effect was tremor (in 15 percent).
Wellbutrin watcher Joe Graedon found these studies tantalizing. "There was mounting evidence that Wellbrutrin has a significant pro-sexual effect for people with a variety of conditions. No other drug had ever done that."
But the studies also left him frustrated. "One key question remained unanswered: Is Wellbutrin truly sex enhancing? Or is its ability to improve sexual function simply a result of mood elevation in formerly depressed people taking a drug that didn't kill sexuality? No one had nailed that down."
This year, two studies have focused on this question by testing Wellbutrin as a treatment for sexual dysfunction in people not suffering from depression or any other serious medical condition. Both studies used placebos that looked identical to Wellbutrin pills so subjects could not tell the difference.
At Case Western Reserve University School of Medicine, a team led by R. Taylor Seagraves, M.D., a professor of psychiatry, gave Wellbutrin to 66 women, ages 23 to 65, who had experienced low or no libido for an average of six years. All 66 took a placebo for six weeks, then the drug for eight weeks. At the end of the placebo phase of the study, the group averaged 0.9 sexual encounters. But by the end of treatment with Wellbutrin, the figure had more than doubled to 2.3. Extent of sexual arousal also increased significantly, and number of sexual fantasies more than doubled (0.7 to 1.8). "Before starting treatment," Seagraves says, "100 percent of the women were dissatisfied with their level of sexual desire, but by the end of the [Wellbutrin] treatment phase, 40 percent reported feeling satisfied." The drug's only signficant side effects were insomnia (18 percent), tremor (6 percent) and rash (6 percent).
Posted by sip on December 29, 2003, at 17:43:06
In reply to Re: Scientific studies on adding Wellbutrin to an SSRI, posted by Bill LL on December 29, 2003, at 16:28:30
Thank you monger and Bill for your constructive and helpful posts.
Posted by paulk on December 29, 2003, at 20:22:50
In reply to Scientific studies on adding Wellbutrin to an SSRI, posted by sip on December 29, 2003, at 16:00:57
I would really think about finding a different prescriber - The use of Welbutin and others is well known for years now.
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