BellaOnline Forums Health and Fitness Mental Health Finding the right meds for anxiety and depression

I have been on prozac daily, taking ativan as needed. I also have ambien for sleeping as needed.

Issue - my libido is a long ago distant memory. it's a huge issue in my marriage. I have heard Wellbutrin is better in that regard but also costs like $50 a month.

I have also heard zoloft lets you take 'drug vacations' for something like a special vacation.

My dr is thinking maybe to move me to paxil, even though that also deletes the libido. But she wonders if perhaps that side effect won't kick in.

I don't know how I feel about subjecting my system to all kinds of new drugs. And I worry things will get worse for my mental state. With prozac, I can at least function. What if paxil, or whatever, makes things more crazy for me?

Does anyone have any related issues or advice?

If your doctor is willing to work with you, often you can adjust your dosage in slight amounts by taking multiple pills (for instance 4x10mg or 2x10mg + 1x25mg instead of 1 50mg) or splitting pills. A lot of people find that they can get a dosage that works for their depression (or other health condition helped by antidepressants), while leaving you with a libido. Depending on your insurance and/or pharmacy it may cost more, less or the same to do this.

You might ask your doctor about taking trazodone instead of the ambien. It's an antidepressant (not one of the more effective ones) that is a very effective sleep aid. Sometimes you can decrease your antidepressant dosage by taking it. It doesn't seem to negatively affect the libido (at least in sleeping doses.) I take it even though I no longer have sleep problems because I found that it keeps me from gritting my teeth in my sleep if I'm stressed or in pain and thus prevents migraines.

Good luck!

Julie

hmmm, let me see my dosage. I don't even know what it is...brb...

Okay, it's 20 mg of prozac. Can't split them as they are capsules. But maybe i should see about taking 10 mg a day before trying a different drug?

I will research the trazadone and also ask my dr what she thinks. I am really happy with the ambien and only take it when needed.

I think they make 5mg prozac as well, so you could do 15 mg as well. 20mg of Prozac is usually considered a really low dose and doesn't usually affect the libido as much as you are describing (which isn't to say it can't, people who are sensitive enough to only need a low dose of something often are equally sensitive to the side effects.) You mentioned having a local naturopath friend in another thread, you might ask her about herbals that build you up in that way. I know several that can be useful, but don't know enough about potential drug interactions to know what might be safe for you.

Take care of yourself!

Julie

Thanks Julie, this is very good information for me. I didn't realize 20mg was a low dose. And I did not know that low dose people are more susceptible to side effects. I guess I have not been doing my research.

When I manage to get out of the house I will ask my friend what she thinks about herbals.

In any case I will see what my dr thinks about lowering my dose before trying other drugs.

I know I am coming in a little late to the conversation (lost username and password issues) but having psyiatric meds prescribed by a psychiatrist or psychiatric nurse practiioner is always better than having them prescribed your PCP. This is because these meds are constantly evolving and highly temperamental and general practioners don't have the time to spend on keeping up to date on them. In the clinic where I work, it is typical for us to see referrals from PCPS on very low doses because the PCPs weren't sure of themselves and so used a conserative and often non-therapeutic (which means exactly what it sounds like - not enough to work) dose.

M

Melissa -

I think it depends on the PCP and the support they have. When I had Kaiser, I was part of a pilot program where when your PCP diagnosed depression or anxiety (with the help of an adaptive computer information gathering tool designed by a Psychiatrist), you got telephone follow up from specially trained psychiatric nurses and pharmacists for the first 3 months to encourage you to also get counseling, get you to the right dose and help manage any side effects. (They worked with your PCP, of course.) They also had a lot of support for PCP's to diagnose and appropriately treat depression.

Sadly, not all PCP's have that kind of information and support available to them, but I think that PCP's are often in a position to notice that people are depressed and when you are feeling bad (physically or mentally), going to your familiar PCP is much easier than finding and going to a specialist (which might seem impossible.)

Julie

Hi, Jilly--

I hope you have resolved your libido problems, as they can wreak havoc on a marriage. You were considering Paxil--just wanted to warn you of my experience with Paxil. The reason I stopped taking it was because of the sexual side effects. Bye-bye orgasm!! Even if I wanted to, I couldn't! I wouldn't recommend it.

I do take Trazodone occasionally, and it is an awesome sleep aid. However, it knocks me out for a good 10 hours or so. If you try it, just don't take it when you have to get up early the next morning...or maybe take it early the evening before.

I wish I could suggest an antidepressant, but I can't take them. When I do, I can't sleep, and my anxiety goes through the roof.

Hope you get things worked out. Good luck!

Kitten

I know a few people who take zoloft with no sexual side effects and I didn't have any when I took lexapro.