Tags
antidepressants, bupropion, depression, libido, meds, sertraline, sex, side effects, SSRI, Wellbutrin, Zoloft
I started sertraline (Zoloft) as a complement to bupropion (Wellbutrin XL) a while back, trying to reduce the PMDD-level depression that was arriving on a monthly cycle. It seems to have worked well for that issue, and had the temporary benefit/side effect of suppressing appetite (wish that had lasted longer than a few weeks, but no. Alas.)
Sertraline: Like being a eunuch, but not
But there’s something else it does that I hadn’t admitted to anyone, even Mr. Chickadee, until this week. It kills my libido. I just don’t care about sex anymore. It’s not that I don’t enjoy the intimacy, I just don’t have much interest. I imagine this is what asexuality is like – if it’s all the same to you, I’d rather have a grilled cheese sandwich and a glass of Marlborough Sauvignon Blanc. Or an extra hour of sleep.
As if that weren’t enough, the drugs also make it harder to get off. Poor Mr. Chickadee has to work his magic that much better/bigger/faster/more to produce the release that is indeed possible, but is now so challenging to generate that it seems a waste of time. I play along anyway but it feels dishonest to be (generally) disinterested, and that makes for all kinds of bad feelings.
So there you go: the dirty truth about sertraline and me. Sertraline is the only drug I take that’s known to have “sexual side effects” but I guess you only need one, right? It’s a pretty common side effect for SSRI’s, but damn disappointing. So the tradeoff is libido versus acute monthly depressive episodes. And sadly, losing my libido is better than crying all day and obsessing over self-injury.
I keep hoping that things will stabilize enough to reduce or eliminate some of the meds. The antidepressants are at the top of my list, as their side effects are most notable. But instead of decreasing dosages, I’m increasing sertraline this week, and trying out a switch from generic bupropion to brand-name Wellbutrin XL. ‘Tis the season, so to speak. I still try to hold out hope for “someday” but that’s rapidly fading. I’m always going to be a walking pillbox, it seems.
P.S. This is my 200th blog post! Woohoo!
Deedee, this is not good at all, and I don’t think you have to settle for it. Bipolar depression is notoriously resistant to treatment with antidepressants, and for good reason: it’s a different animal. Are you on/have you tried lamotrigine and/or lithium for the PMDD?
Hammering on the SSRIs when they’re not working and giving you SSEs might just make sad Chickadees :-/
I hope I’m not offending you by putting on my Doctor Hat. Sometimes I can’t help it….
Yep, I’m already on lamotrigine. It’s a miracle drug for me, but doesn’t do the whole trick.
My hope is that switching to brand-name Wellbutrin may make enough of a difference in efficacy to cut the sertraline back out. We’ve tried reducing the antidepressants several times but the results were such that I’m still on them.
I’ve also added in hormonal birth control – although primarily intended to reduce ovarian cysts, there’s also a possibility that it may also reduce PMDD symptoms. So far, so good on that one, more or less, but the jury is still out on exactly what is making things better. Hopefully over the next few months we can try subtracting some ingredients in the cocktail, since some of the other changes may make up the difference. It’s just a long and frustrating process, and heading into the winter season is the worst time to try to cut things back.
On the plus side, the most recent tweaks do seem to be having some effect – less anxious, much more clear-headed and alert. Good things in my book!
I can relate with the lack of libido. The only way I have an orgasm these days is to use my trusty little toy. I have worked through so many ‘it’s my fault, he doesn’t love me, I’m unlovable’ thoughts this past year that got in the way. I’ve tried, to get out of my head and go with the sensations. Unfortunately, I went from hypersexual to loving intimacy without sex to thoughts of just be done already because I won’t/can’t. I take Lamictal but that is not one of the side effects. I’m not sure if that has anything to do with it. I’m also in the midst of menopause, which may be a contributing factor. Plus grad school. It’s maddening. I get close at times with dear hubby, but after awhile I just say “go for it” so it can be done. He says, “you can always use your toy.” It happened twice this summer after a beverage or two, but I’ve given that up again because it messes with my head too much. I can count on one hand the times it’s happened in the last year. I’m hoping this is just for a season and not forever. I guess I’ll talk to my doc and discuss it again with my therapist next week.
Annoying, isn’t it? I’m still quite capable of orgasm, it’s just much less predictable and takes a lot longer.
My doc recommended DHEA to counteract low libido, but my DHEA levels are already on the high side. I may try it if things don’t improve, though.
I take the same combination. The wellbutrin is supposed to offset the sexual side effects of the sertraline, but obviously it doesn’t work as well on some as others. As a working mother, though, I’d say sex pretty far down on the list (not that it’s never done, but still). I am a walking pillbox too, but I guess it beats the alternative. Don’t get too down on yourself. Maybe there’s some way you can work this out, either switching meds or even just finding other ways to be intimate with your husband for a while. Sometimes it helps to not have the pressure of having to “go all the way”.
I hope it all works out for you. And congrats on the 200th post!
I keep holding out hope that I won’t be on this many meds forever, but that does set me up for constant disappointment.
My hubby and I are pretty good at intimacy without sex, and he’s the very soul of not pressuring. Nonetheless, I want to make sure we’re both getting what we need. Argh. Things will resolve at some point.
Good luck to you.
SSRI’s killed my libido too! Lithium AND lamictal didn’t fully kick my depression. So, my pdoc gave me a small dose of seroquel and i have noticed two things: 1) i am not depressed, and 2) my sex drive is BACK in a big way. And i am still on 20 mg of Prozac to boot! (although I will be lowering that to oblivion in the next month or so). Good luck to you!
It’s great that you’re doing well on your recent combo – I hope it lasts! I wouldn’t mind if these brief bits of relative stability stuck around longer myself…
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