10 replies to this topic

[giant]

Hi

 

I have ADHD and take dextoamphetamine tablets for that when needed. In a single dose I usually take between 2.5mg to 5mg roughly every 4 hours.

I am taking 30mg of Cymbalta now since April 2014 with the purpose to counteract the strong anxiety effects that dex produces. Other stimulant medications I have taken in the past for ADHD also gave me strong anxiety tension effects no matter how low the dose was, this appears to be no different with Dextroamphetamine. I tried Strattera for two years at one point but it was horrible.

Anyways! Upon starting Cymbalta in April, within day one to a week I realised that not only does it treat my anxiety both natural and anxiety exacerbated by stim, but it is also treating what must be long standing depression that I have had....or have...... Im not sure if this is clinical depression or depression caused by Strattera which I took for period of two years which ended in April 2014 where I started dex and then Cymbalta.

 

The depression treatment that Cymbalta has provided for me came into effect within one week of starting it.... life has been pretty good ever since. I get on much better with my family, I am a lot less irritable now, I feel happier and a little more motivated. The depression is.... GONE.

I'm a big believer in self healing so I also take two spoonfuls of liquid fish oil (high quantity) alongside Cymbalta. I also take 5000iu of Vitamin D during winter months. I am hoping that the Cymbalta + these natural approaches will help heal my brain from depression, so that if I do decide to stop Cymbalta, that (fingers crossed) the depression will not return. I'm hoping that the depression that I do/did have was just an episode caused by the long term negative social effects of the Strattera that I had taken previously - because if it is, then surely all I need/needed is lifted out of that through the help of Cymbalta and Omega-3. But if it isn't then the only cause for my depression is that its clinical which to me means, little or no recovery and can only be removed from my life with a lifetime of Cymbalta.

I take Cymbalta each evening before bed but I have been experiencing sexual side effects.

In my case, I can usually achieve errections, although never as often as I used to, I used to achieve errections whilst daydreaming not thinking about anything LOL, random errections? I got them like every 5 minutes LOL. Now, I never get random errections. But with a little arousal and manipulation I can achieve a mediocre errection. Next point, when I achieve an orgasm it is very much diminished to what it ever used to be and once the orgasm is over (7 seconds tops, I think?) I'm turned off completely, back to square one, all my interest in sex and anything to do with it is nil.

Another issue is, libido. I cant produce thoughts about anything sexual nor desire any sexual interaction whatsoever. Its sickening to think about it considering what I used to be....a horny bugger. Seriously. Now Im practically sexually dead.
 

Overall query

 

My question is this.... what augment into what I am currently taking (supplement wise) in order to combat these sexual side effects, there HAS to be something or a combination of stuff i.e. supplements, nootropics ANYTHING! There has to be something. I simply don't accept that there isn't anything. When I read about all the other stuff on this site to do with manipulating neurotransmitters and transporters etc... that's what I call REAL LIFE HACKING :D

There has to be something I can do with this guys, please help me out Im a little desperate because its a pain in the ass. I know Im not the only one though...

[Flex]

Well the sexual side effects that are caused by SRI/SNRI´s could afaik last for months or Years, but rather seldom.

If this happens, then there arent many or much solutions.

You could ask Your Doc for a additional med that blocks 5-ht2a receptors like trazodone, and see whether it works.

because afaik the primary causes of sexual side effects are caused by 5-ht2a activation.

 

On the other hand by taking more meds, You do also rise the posibillities of interactions ..So dunno

 

 

 

[giant]

Well the sexual side effects that are caused by SRI/SNRI´s could afaik last for months or Years, but rather seldom.

If this happens, then there arent many or much solutions.

You could ask Your Doc for a additional med that blocks 5-ht2a receptors like trazodone, and see whether it works.

because afaik the primary causes of sexual side effects are caused by 5-ht2a activation.

 

On the other hand by taking more meds, You do also rise the posibillities of interactions ..So dunno

 

Hi Flex, thank you for your reply to my thread. I noticed that you mentioned that the sexual side effects can last for months or years but rarely.. are you referring to irreversible sexual side effects as a result of SNRI/SSRIs? 
I have noticed talk about that on the web but I like to not think about that. 
My GP said that 99% of the time, the sexual side effects are reversible within a few weeks or so upon discontiuning SNRI/SSRI. 

I am interested on what you have talked about regarding 5-HT2A Activation... Thanks for the information. 

[Flex]

Youre welcome

 

Yes I´m reffering to that. The cause of this particular effect is not expalinable by 5-ht2a alterations.

As you´ve said, its nothing to worry about because its quiet rare.

 

If You ask me, I would rather be conservative with meds. The lesser the better.

But I guess You´ll be taking this for a while, so You could ask Your GP about this because of thoose annoying effects.

You can look into wiki for 5-ht2a antagonists.

Trazodone makes You quiety drowsy because of the alpha1 antagonism, but Your body get used to after 1-2 weeks, the down is that it may make you more anxious because of the stronger 5-ht2a than 5-ht2c inhibition.

Mirtazepine would be an alternative but its an alpha 2 antagonist and increases adrenaline via a negative feedback loop inhibition.

Although the combo of a SNRI + Mitrazepine is called californian rocketfuel ^^

but at least I wouldnt use this for everyday life. ^^

[magniloquentc0unt]

sildenafil or yohimbe should work

[giant]

sildenafil or yohimbe should work

What is Sildenagil and Yohimbe?

Are they pharmacutical or supplements? 

Where could I get them should I find them appropriate?

 

Thanks

[Flex]

I´m sceptic that those 2 would work.

The main function would be to induce an errection, but they wouldnt inhibit 5-ht2a which is the primary mechanism behind SSRI induced sexual dysfunction.

Furthermore Yohimbine could increase anxiety, but havent did that much in my case.

[giant]

I´m sceptic that those 2 would work.

The main function would be to induce an errection, but they wouldnt inhibit 5-ht2a which is the primary mechanism behind SSRI induced sexual dysfunction.

Furthermore Yohimbine could increase anxiety, but havent did that much in my case.

 

Are there anymore ideas or should I give the Yohimbe or Sildenagil a try??

I am desperate :(

 

[jaiho]

As the suggestions above. Or Wellbutrin augmentation.

[nowayout]

Wellbutrin or buspirone are the two main augmentation drugs sometimes useful  to treat sexual dysfunction.  Wellbutrin can cause anxiety so buspirone may be a better choice for you. 

 

Sildenafil/vardenafil/tadalafil can help with erections but won't give you libido.  Yohimbe may help with libido in some people but can cause anxiety and cardiovascular side effects, so not a good choice for chronic use IMO.  Trazodone can help with erections, but IME only sleep erections, not on-demand sexual erections, and IME does not help with libido.  Trazodone is also higly sedating to most people. 

 

There are other depression drugs besides cymbalta that don't have as high an incidence of sexual side effects, e.g., Viibryd (vilazodone), so you might also discuss changing your main depression medication with your doctor. 

Edited by nowayout, 24 January 2015 - 03:49 PM.

[giant]

Four years on the issue is starting to frustrate me a bit now. As a matter of fact I am going to the docs in the morning (UK time) and going to ask to reduce my 30 mg Cymbalta to 20mg

 

I will still need somthing for my anxiety and Cymbalta/Duloxetine at 30 mg for me has worked well to be fair and is very tolerable. Just the sexual side effects are an issue. I can't guarantee erections and I don't seem to finish, ever during sex. 

Logically thinking I think that dropping from 30 mg Dul to 20 mg is the logical first step in tackling this issue and see how I get on after that. 

I have noticed that sildenafil does help with erections so may discuss that with doc too. But ultimately I want to see an improvement in orgasms whilst still maintaining good control over my anxiety - which has been well managed at just 30 mg of Cymbalta (usually 60 mg is recommended for GAD with Cymbalta).