Any alternatives to drug holiday, bupropion, sildenafil, and yohimbine?
Answer from: at Community Practice
Serotonin-1 agonism will revert it in about 60% of cases. You have a choice of adding buspirone at about 30 mg bid or going to vilazodone which has already an SR1 agonism. Some bupropion, not clearly understood at about 300 mg can also do it. Or if possible, use vilazodone, bupropion, or mirtazapine...
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at Starting Point Behavioral Healthcare Very helpful because I have tried using buspirone ...
Our group has studied maca root as a natural treatment for antidepressant-induced sexual dysfunction. Maca is a perennial plant that grows in the Andes Mountains of South America and is traditionally used for nutritional and fertility enhancement. In two small studies, we found benefits from maca ro...
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at Private Practice, General Psychiatry Thank you, Dr. @Mischoulon. I'll recommend it to m...
at Centre For Behavioral Health I've never heard of it. Do you have experience wit...
at St. Clair Hospital Bupropion?
at Steven A. Fayer MD PC I have given Viagra and Cialis to women with some ...
at R Michael Prudent LLC I don't find bupropion to be particularly helpful ...
at Psychiatric Group Of Princeton I didn't have much success in treating this proble...
at Asheville Recovery And Psyhiatric Services Maca can cause insomnia as a side effect for some ...
This answer is not going to be "the end all be all" but please consider checking a patient's serum testosterone level (both male and female).
Try to check it in the morning as there is a diurnal curve. Order testosterone (Tot., Free, and SHBG). If ordering testosterone on a woman, be sure to order ...
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at Private Practice, General Psychiatry Very helpful!
I’ve found The Carlat Report outlines the most useful, non-biased, evidence-based strategies for managing this. Here is a link to a 2019 journal article on management: Strassberg, Carlat Publishing 2019.
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at Private Practice, General Psychiatry This is very helpful. Thank you so much.
I have recently had success in side-stepping this issue with the use of fluvoxamine, which is also an SSRI that for some reason we have relegated only for use with OCD.
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at Private Practice, General Psychiatry Very interesting. I use fluvoxamine a lot fo...
at Christianacare Wilmington Hospital Some patients respond to additional of Wellbutrin....
Decreased libido may not be what it seems. A female patient complained of sexual dysfunction from venlafaxine. We tried adding Wellbutrin and later Viagra and later switching to another antidepressant. But, after all that, her "sexual dysfunction" was cured when she left her husband and got a new pa...
Decreased libido may not be what it seems. A female patient complained of sexual dysfunction from venlafaxine. We tried adding Wellbutrin and later Viagra and later switching to another antidepressant. But, after all that, her "sexual dysfunction" was cured when she left her husband and got a new pa...
Comments
at Steven A. Fayer MD PC I like Wellbutrin
at Private Practice, General Psychiatry I love your example!
I have had some success in reducing SSRI-related sexual dysfunction with prn cyproheptadine, 4-8 mg, one to two hours before sexual activity. Not recommended if use will be so frequent that it would interfere with the antidepressant effects of SSRIs.
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at Steven A. Fayer MD PC I will give it a try.
at Inland Psychiatric Offices I have also had some success with cyproheptadine. ...
at Crandall Rebecca L Office In my experience, sedation is limiting its use in ...
Sexual activity is not equally important to everyone, and some would rather feel well. I always discuss patient values and ask them to choose (if they can). A surprising number of them prefer feeling well. I often ask myself whether libido reduction may be mechanistically related to improving depres...
I haven't had much success with augmenting strategies for this problem. Sometimes I'll just switch to Lamictal if it is a big problem. Sometimes Viagra helps but many patients don't like the idea. For a couple of female patients, it seemed like dryness and initiating sex were the major concerns. Adv...
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at Private Practice, General Psychiatry Thank you!
Very helpful because I have tried using buspirone ...