His and Her Health

In the last year, I tapered of anti-depressants (an SSRI - selective seritonin reuptake inhibitor) because of delayed and blocked orgasms and started the Orgasmic Diet. Unfortunately, I relapsed and needed to go back on anti-depressants. I went on Wellbutrin, having read that it was the one anti-depressant that didn't cause sexual dysfunction. Unfortunately, I felt even more asexual on the Wellbutrin than I had on the SSRIs. I'm back on an SSRI and again feeling sexually-impaired. I'm wondering what my options are....I'm considering at least reducing my dose (with the help of my psychiatrist) and starting the fish oil again...

Does any one know of other options besides Wellbutrin? I have done extensive research but I keep finding the same information for avoiding sexual dysfunction with anti-depressants: take Wellbutrin, reduce your dose, go on drug holidays...And none of these are realistic in my situation.

Is there another drug out there in the making or that I haven't heard about? Or, is there a physician out there that specializes in the physiology of sexual function and the precise impacts of drugs on this? I feel like there must be some kind of doctor out there that understands this better than my psychiatrist or a pharmacist...

There are a few drugs on the horizon. LibiGel from BioSante is in clinical trials. Proctor & Gamble have a testosterone cream but it is only available in Europe. All I could imagine is trying to get some form of off label testosterone treatment from a doctor to impact the imbalance you are getting from the anti-depressants you are taking. However, I would think that the ADs are more important no? Have you asked your doctor about the problem?

You could try a testosterone cream but I don't think it would help much because of the way that anti-depressants work in the brain. Instead, consider talking to your doctor about treatment for hypogonadism, also called peri-menopause and menopause, as a contributor to depression. Depression, when caused by lower than normal levels of sex hormones, can be effectively treated. In men who seek treatment for depression, doctors are trained to look for and treat hypogonadism before using anti-depressants because treatment for hypogonadism can be so effective.

Also, it would be a good idea to get a full physical because other things like hypothyroidism can also cause depression.

If you begin to receive hormonal therapy, be it thyroid, or hypogonadism (estradiol, testosterone, progesterone and dhea) don't try to taper off your anti-depressant medication until you are on your hormonal therapy at least 3-4 weeks.