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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 7 of 7. This is the beginning of the thread.
Posted by John Michael on April 15, 2011, at 0:01:02
Hi, I'm a 27 year old man that has been suffering from anorgasmia, or the inability to feel orgasm, for the last several years. This is due to taking SSRIs I believe, and I took the drugs to help with depression, but mostly anxiety, specifically BDD.
Let me first state that I started drinking in college on the weekends, mostly the weekend, pretty heavy. I started smoking weed when I was about 21, and smoked pretty regularly up until the last few months, with a few 3-6 month breaks here and there. I now intend to stop smoking weed forever if that's what it takes for me to get better.
I took paxil when I was 21 for about a year, and during that time my orgasm was severely diminished if not gone. The first day I took the paxil, my penis felt numb. Once I weened off (after about a year of use), my orgasm and feel came back gradually to normal levels.
Took some time off, tried some Effexor around age 23, took paxil again when I was 24, tried throwing in some Wellbutrin to counteract the sexual sides and it didn't seem to work. The last time I was on something everyday was Zolof, last fall, about 6 months ago.
So the most recent thing I've taken is Seroquel 50mg to help sleep, and Xanax for certain social situations, 1-1.5mg, 1-2x/week. I saw my pdoc yesterday and she said to stop the seroquel for at least 2 weeks before we try some meds, and to see my primary care doctor and a urologist. So I'm going to stop the Seroquel and Xanax for as long as needed.
My sexual problem is really starting to affect me. It is horrible not being able to feel an orgasm at all, there is very, very little sensation on my penis during intercourse or oral sex, and if a condom is used, it's like why even bother. So after finally getting the courage to meet some women, and have sex with them, I found it's not worth it with the problem I have.
I've always ate halfway decent and exercised, but now I'm going to do more cardio, and eat even better, and try to get more sleep, which may be hard without a sleep aid.
Just wondering what I can do, what kind of drugs might help for orgasm/libido. I'm trying to get my doctor to prescribe Ritalin because I also believe I have ADD, and I've read that Ritalin can help with orgasm, so maybe kill two birds with one stone. I'd prefer something that works immediately and doesn't have to be taken everyday. But, I'm willing to go on the drug merry-go-round to cure this and will start anywhere. Just need some ideas to share with my doctors.
Thanks for anyone who can help.
Good day.
Posted by SLS on April 15, 2011, at 4:58:56
In reply to Anorgasmia, posted by John Michael on April 15, 2011, at 0:01:02
You might want to look into cyproheptadine (Periactin). It is used on an as-needed basis (PRN) to restore orgasmic function in SSRI anorgasmia. This works for both males and females. I'll be curious to see what you come up with. I believe it is the antagonism of serotonin 5-HT2c receptors that is responsible for this restorative effect. People often take cyprohaptadine 30-60 minutes before sex. It is sedating, so you will have to experiment to find the optimum timing. If that doesn't work, perhaps yohimbine would. It works via a different mechanism involving norepinephrine NE alpha-2 receptor antagonism in the spinal chord.
- Scott
Posted by John Michael on April 29, 2011, at 20:00:16
In reply to Re: Anorgasmia » John Michael, posted by SLS on April 15, 2011, at 4:58:56
So I saw my pdoc yesterday and had a good discussion with her, talked about this stuff and she was okay with cyproheptadine. Since I want to use something on an as needed basis, that's what we came up with to try.
So I just got the med today and am still a tad nervous to try it. Any last minute tips? I think my doctor said it might be a good idea to take it every 4 days, not everyday.
I hope to try it tomorrow or on Sunday.
Thanks Scott, and to anyone else who can help..
Posted by desolationrower on May 1, 2011, at 17:32:11
In reply to Re: Anorgasmia, posted by John Michael on April 29, 2011, at 20:00:16
Well hopefully that helps. I'm a bit unclear, does the problem only occur when you are on an sri?
if bupropion doesn't help at all, ritalin probably won't either (though it is a bit stronger)
-d/r
Posted by John Michael on May 1, 2011, at 20:28:27
In reply to Re: Anorgasmia, posted by desolationrower on May 1, 2011, at 17:32:11
So my first try with 4mg of cyproheptadine 60 minutes before sexual activity didn't do anything. I'll try increasing the dose and messing with timing a few times.
desolationrower, the problem is still here even though I discontinued all SSRIs and related drugs over 6 months ago.
Interesting that Ritalin may not help since Buproprion didn't work.
Thanks for the help.
Posted by desolationrower on May 3, 2011, at 23:50:23
In reply to Re: Anorgasmia, posted by John Michael on May 1, 2011, at 20:28:27
ritalin and bupropion both increase catecholamine levels.
You could also see about having your free testosterone and prolactin levels tested.
Anyway, try it multiple times, since there is a large mental influence on orgasm.
-d/r
Posted by Questionmark on May 14, 2011, at 11:27:23
In reply to Anorgasmia, posted by John Michael on April 15, 2011, at 0:01:02
It is very sad that many of us have to sacrifice a lot of enjoyment from one of the greatest pleasures in life, just to not be miserable. ... But, i suppose it is good to have any option at all, for those who would not otherwise have any.
Anyway. Additional possible helpful options for this side effect, in no order:
Dextroamphetamine
Amantadine
Dopamine Agonist
MAO-B inhibitors such as rasagiline or selegiline
Buspirone
Trazodone
NefazodoneGood luck.
This is the end of the thread.
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