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citalopram + anorgasmia = try something else? update: now with bipolar II!
Caramel Genocide
Registered User regular
Registered User regular
I've been taking citalopram (celexa) for about half a year now (I'm currently on 30mg/day), and the only major side effect I've noticed is anorgasmia (I'm female) - and while the drug seems to be useful in helping my depression, this particular side effect is a bit of a dealbreaker for me.
Over the last few months as the citalopram has been helping me to think clearer, I've come to realize that it's incredibly likely that I've got adult ADD (and that my depression is one of the symptoms). I'm seeing my doctor again next month to discuss this.
Thanks to some information I've found here (and subsequently done research on), I'm going to ask to switch to buproprion (or add it to my current drug if the doctor thinks that's a good plan), since I've learned that it not only can it combat the anorgasmic effects of citalopram, it has also been found effective for adult ADD.
So my H/A question here is: does anyone have any experience with switching to/starting on buproprion - specifically for not only depression, but also anorgasmia and/or ADD? (I understand that situations may vary and I may not have the same reactions as anyone else, yadda yadda - however I'd still like to hear any experiences, positive or negative.)
Over the last few months as the citalopram has been helping me to think clearer, I've come to realize that it's incredibly likely that I've got adult ADD (and that my depression is one of the symptoms). I'm seeing my doctor again next month to discuss this.
Thanks to some information I've found here (and subsequently done research on), I'm going to ask to switch to buproprion (or add it to my current drug if the doctor thinks that's a good plan), since I've learned that it not only can it combat the anorgasmic effects of citalopram, it has also been found effective for adult ADD.
So my H/A question here is: does anyone have any experience with switching to/starting on buproprion - specifically for not only depression, but also anorgasmia and/or ADD? (I understand that situations may vary and I may not have the same reactions as anyone else, yadda yadda - however I'd still like to hear any experiences, positive or negative.)
Caramel Genocide on
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Not sure if that helps, though. I also (supposedly) have ADD though I don't take anything for it, ATM.
Steam Profile | Signature art by Alexandra 'Lexxy' Douglass
CUZ THERE'S SOMETHING IN THE MIDDLE AND IT'S GIVING ME A RASH
Situations may vary and you may not have the same reactions as anyone else.
That said, buproprion has fewer reported cases of sexual side effects in clinical trials than most other modern antidepressants. (Then again, so does Celexa.) If you can afford it & your insurance covers it, you might want to consider switching to Lexapro. It's chemically similar to Celexa: Celexa contains the same molecule in two different geometric configurations; this is called a "racemic mixture." One configuration has more of a therapeutic effect while the other configuration can cause side effects without actually helping your depression. Lexapro is the "good" configuration only. For all intents and purposes, you can think of Lexapro as a "purified" Celexa. Most people can take less Lexapro and have the same antidepressive effect but with fewer side effects. Talk to your doctor about it.
the "no true scotch man" fallacy.
Also, Bupropion has a good history of alleviating adult ADD symptoms as a side effect. It targets chemicals in a very similar way to Ritalin, which has a pretty good history with ADD sufferers. It has other side effects, some of which are not so bad at all. Naturally it can also affect sex drive. At risk of a bit of exposure, I've been using the drug for depression comorbid with ADHD. It makes me feel like I am the God-Emperor of Mankind. I am focused, energetic and frankly, my sex drive is up. Although the last part is hardly necessary, considering I am a man in my early 20s.
Lexapro is a marketing gimmick by the drug companies. It conveniently came to market about the same time Celexa was losing its patent and went generic. I'm not saying that a switch to Lexapro may not help, it still may. But the whole 'this isomer is better' crap is a load of bull.
Edit: Also Lexapro is still under patent and very expensive. Most insurance plans cover it with a $25-40 copay, if at all.
Yeah sorry, I was thinking of the XL variant, which is quite awesome but unfortunately not generic (at least last I checked). If I'm horribly wrong, hey, free money.
You're correct. The generic is cheap, but you have to take multiple pills over the course of the day. (For instance, some prescriptions might have you take one pill every four hours.) That can be inconvenient, which is why most people strongly prefer the extended release version which is more expensive.
And I don't really want to get into an argument over the benefits of Lexapro vs. Celexa, but I will say that clinical studies have shown Lexapro to be as effective as Celexa at lower dosages with fewer occurrences of side effects. I'm not a doctor, but I'm relatively confident that most doctors would agree with me. I just wanted to mention that, I'm no longer going to pursue this particular line of argument as I've said my piece.
the "no true scotch man" fallacy.
Let us agree to disagree on the Celexa vs Lexapro issue as it will derail the thread. Suffice it to say my faith in pharma funded studies has been thoroughly shaken after the Vioxx, Bextra, Avandia etc messes where critical data were withheld from the FDA.
Anyway... moving on...
Wellbutrin XL is now generic. Also available is Wellbutrin SR, which is a twice a day formulation and I believe is on Target's $4 generic list.
I have never felt better on any drug than I have on Lexapro. I do not function particularly well on nothing (which is what I'm on right now), but on Lexapro I was so much more together. Celexa didn't do much of anything for me so I wasn't on it long, and Prozac dulled my cripplingly strong emotions but little else that helped me do better. Lexapro curbed the emotions *and* cleared the fog.
Bottom line: if you find the one that's right for you, it might be best not to mess with it. Talk to your prescribing doctor, but be very wary of drug interactions if you decide to go with more than one.
The doc switched me to Wellbutrin at my request a little while back (and tapered me off of celexa), and that didn't go as I had hoped (the only good thing about it was the appetite suppressant!).
In fact, the shitty side effects that I experienced indicated that I'm mostly likely bipolar (II), and so the docs have started me on a low dose of quetiapine (and taken me off the wellbutrin) to see if that helps. (Thank jebus I'm in Canada, so these things aren't costing me an arm and a leg.)
I start taking the quetiapine tonight. So if anyone knows of any must-read info for brand new bipolars and their significant others, I'd be much obliged if you could point me in that direction.
It's written by a young woman who, when diagnosed as bipolar, embarks upon a road trip to learn more about the disorder, and interview others with the disorder who were leading successful lives.
I read it right when it came out, which was in 2003, but I would certainly recommend it.
I don't have any reading material to recommend to you since everything I learned about it was through experience and doctors, but if you'd like to talk to me about it you can feel free to. Shoot me a PM if you'd like to talk through PM, email, or IM or something. I've lived with bipolar for ~6 or 7 years at this point so maybe I can answer some questions.
If you decide not to PM me, I wish you the best of luck dealing with this. It's an unfortunate disorder and can be hard to adjust to.
If you have a chronic depression problem and citalopram is effective, but are having problems with anorgasmia there is a full program to try.
1) take an over the counter allergy medication like Zyrtec or an equivalent for two weeks or longer, and stay on it. See what a difference that makes. If it does make a difference then get an allergy test and make sure you are not having a long term or lifelong allergic process that is affecting the histamine - dopamine pathway.
2) Get your sleep cycle monitored and your oxygen levels checked during the night. Especially if you have any chance of snoring. Even moderate nightly oxygen deprivation will have a dramatic effect on your chemistry.
3) Get outdoor aerobic exercise which increases your heartbeat and oxygen levels once per day.
4) reduce your citalopram dosage - you may be able to function on as little as 10MG if you can eliminate external factors affecting your chemistry.
5) combine citalopram with ritalin in controlled release form.
6) Take a 2-3 day holiday from citalopram, or try weekends without it, and plan for marathons on your weekends.
7) a one day citalopram holiday and a pot of coffee can usually counteract low dose effects as well as improve your enthusiasm.
If you want a better sex life, plan it for the weekends, and give yourself time to withdraw a bit, on the order of just one or two days. A stimulant like ritalin may also help, coffee otherwise, and have food around as well.
The research is emerging that while common depression is the result of simple mental chemical exhaustion, chronic depression is somehow related to immune system disorders. The most common of which appears to be the interaction of histamine and dopamine. This pathway also seems to impact serotonin but that relationship is not causally determined as yet. The very largest study to date has confirmed the genetic markers for allergies are .95 correlative to chronic depression. This also appears to confirm with the historical record for poets for some reason that will make a nice PhD study for some grad student.
Zyrtec, 10mg Citalopram, 1 hour of hard exercise a day (sex if you're athletic enough at it and can get the sex) plus running if possible. Allergy shots if you find out you have something that is chronic - do not underrate this. If it turns out it's something terribly common like wheat or eggs or dust, you will find out what it's like to feel normal after shots and your mood will improve dramatically with shots and avoiding those foods. A low dose of ritalin to be used on a discretionary basis. And a CPAP machine if you are running low on oxygen at night. Oxygen has a euphoric effect, which is just one of the reasons some athletes get depressed if they can't exercise from injury. Your brain may permanently require low doses of something because if cannot recover from a lifetime of deprivation or harm or simply training.
I have been working on this problem for twenty years. We are going to know a lot more in the next twenty. For me it's simple: exercise and low dose and allergy medicine and coffee mean no anorgasmia. If I feel a little decline in libido I take a vacation for a day or two. I would rather drop dosage and increase exercise and use coffee than take ritalin (or an equivalent), but the major issue was to control allergens, which it turns out was the causal problem. I have been trying to prove that relationship, but it's only been recently that there is supporting research.
Of course, a partner that you just want to have sex with all the time helps quite a bit. At least for me, that's not a problem.
the "no true scotch man" fallacy.