Ejaculatory dysfunction re. anti-depressant

[smilingjim]

Recently prescribed new anti-depressant, Effexor, for headaches.

In result, marked increase in libido; however, now cannot climax to orgasm or ejaculation, even making passionate love for hours.

Psychiatrist wrote for Wellbutrin, to "balance the neurotransmitters", but did not resolve.

Yesterday, doc added new script for Viagra. Wife guffawed, as achieving and maintaining erection not a problem. But, he said there was indication for Viagra for treatment of various sexual dysfunction due to anti-depressant use. No info though on my specific issue.

On initial dose Viagra, unable to assess effect on primary problem, but did determine insufficient half-life and length of activity. Taking prior, "as needed", seems also unsatisfactory. Several sessions sex per week; daily-type administration seems better than prn.

Cialis seems much better, with new daily regimen and longer-lasting. However, no recognized indication for Cialis for any kind of sexual dysfunction due to usage of anti-depressants -- let alone inability to reach orgasm -- just the approval for E.D.

Both meds are PDE5-blockers; will either help this issue, in particular Cialis? Neither are covered by insurance and are very costly, especially if ineffective.

Any other approaches that may help? Thanks!
.

[tic chick]

hey smilingjim!

glad you are still smiling and your wife can get a guffaw out of this situation!

from what i read, effexor is one of the antidepressants that has the greatest incidence of delayed or inability to orgasm probs. cymbalta is the other.

the two drugs that have the least incidence of this side effect are wellbutrin and serzone. so, i really don't think that giving you wellbutrin to "balance" things out with your effexor would work. i would think you'd have to take wellbutrin or serzone as your only antidepressant.

viagra, levitra and cialis all work about the same way. as you already know, viagra and levitra have short half-lifes and are meant to be taken an hour prior to having sex. therefore, you lose spontaneity. cialis does have the advantage of a longer half-life. all these ed meds are being tested for usage for people who are experiencing sexual probs due to antidepressant use; the viagra is being tested for your specific orgasm issue. you might also ask your doctor about a stronger strength of viagra.

i read that last year the european commission approved a low dose of cialis (2.5 to 5.0mg.) daily for the treatment of impotence from antidepressant use, although it didn't say if it helped the orgasm issues.

so, i guess there are a few choices:

-try the antidepressants that have a lower incidence of giving you orgasm probs.
-see if any other meds can be used just when needed for headaches. are you having migraines or cluster headaches? (if you don't mind my asking?)
-perhaps some stronger stimulation, such as with a vibrator, can be applied to certain areas during sex to heighten sensation.

glad you found our forums! i would also suggest you try the headache&migraine forum. perhaps someone there has had the same prob and found a solution.

best of luck, jim,
jeannie