antidepressants that do not cause sexual dysfunction and zombification - Page 2 - Social Anxiety Forum
View Poll Results: Which antidepressant class is least prone to cause zombification & sexual problems?
Selective serotonin reuptake inhibitors (SSRIs) 0 0%
Serotonin-norepinephrine reuptake inhibitors (SNRIs) 0 0%
Serotonin modulator and stimulators (SMSs) | e.g.: vortioxetine, vilazodone 0 0%
Serotonin antagonist and reuptake inhibitors (SARIs) | e.g.: Trazodone Nefazodone 3 37.50%
Norepinephrine [dopamine] reuptake inhibitors (NDRIs, NRIs or NERIs) | e.g.: Reboxetine, Bupropion 5 62.50%
Tricyclic antidepressants 0 0%
Tetracyclic antidepressants | NaSSAs | e.g.: Mirtazapine, Mianserin, Maprotiline 4 50.00%
Atypical TCAs | e.g.: Opipramol, Tianeptine 2 25.00%
Monoamine oxidase inhibitors (MAOI) 4 50.00%
Atypical antipsychotics | Buspirone etc. 2 25.00%
Others | e.g.: Agomelatine, Ketamine, Tryptophan, St. John's Wort, Lithium, T3/T4 etc. 4 50.00%
Multiple Choice Poll. Voters: 8. You may not vote on this poll

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post #21 of 62 (permalink) Old 05-18-2017, 09:03 AM
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The only drug didn't break my dick was Mirtazapine. In fact, it can increase pleasure and libido. However, you will gain a lot of weight and it will make you quit like me and then you're back to square one. I cannot stay on the drug because I gain too much wait.

I am 5'8" naturally about 155 lbs but on medication easily 175 within 2 months of mirtazapine. You will be HUNGRY (as hungry as consuming cannabis), and you WILL gain weight. At least on cannabis you don't gain wait. So I think there is also a receptor that is causing weight gain. It's not just the calories in calories out. But you will feel great.

I might get back on myself. I'm currently in really bad shape anxiety wise and Mirtazapine is good for that. However, a wedding in less than a year I don't want to show up like the Michelin man.
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post #22 of 62 (permalink) Old 05-18-2017, 09:22 AM
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We can't edit posts? Okay lol.

I will add that if you go on Mirtazapine you need to quit alcohol. It is a very very bad combination. If you're not prepared to quit alcohol don't bother.
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post #23 of 62 (permalink) Old 05-18-2017, 04:50 PM
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I was also on Wellbutrin when I took Mirtazepine and weight gain was not an issue at all. BUT the norm is definitely that people gain weight on it.

I can't speak to the alcohol part as I am now sober but that would make sense as well.
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post #24 of 62 (permalink) Old 05-22-2017, 01:12 PM Thread Starter
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I've had an appointment with my psychiatrist and we agreed on that I will take 50mg of Sertraline for another month or so and if the side effects (mainy insomnia and appetite loss) haven't subsided by then, we will try augmenting it with either Mirtazapine or Trazodone or alternatively try another standalone med...

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The only drug didn't break my dick was Mirtazapine.
Did it help you with your depression / SA? And how was it compared to other ADs?

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I will add that if you go on Mirtazapine you need to quit alcohol.
That's no problem for me. I am no alcohol-guy ^^

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post #25 of 62 (permalink) Old 05-22-2017, 03:26 PM
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I've had an appointment with my psychiatrist and we agreed on that I will take 50mg of Sertraline for another month or so and if the side effects (mainy insomnia and appetite loss) haven't subsided by then, we will try augmenting it with either Mirtazapine or Trazodone or alternatively try another standalone med...


Did it help you with your depression / SA? And how was it compared to other ADs?


That's no problem for me. I am no alcohol-guy ^^
It worked far better than any SSRI for anxiety - definitely. Although the happiest drug I've used was probably Paxil or one of those horrible drugs that makes your dick stop working. They are really good at pumping serotinin into your brain but bad at everything else.

It's been a while since I've used it. I think I mostly came off because of the weight gain and similar side effects. Then when I tried to get back on they didn't work as well. I might try again if this St. Johns Wort doesn't work.

I'm just very sensitive about weight and health and the Mirtazapine was making me constantly hungry and fat so I came off. It also might have been pooping out. I can't remember. Been a few years and a bad memory. This drug does have a high poop out rate as well.
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post #26 of 62 (permalink) Old 05-23-2017, 01:57 PM Thread Starter
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It worked far better than any SSRI for anxiety - definitely.


At what dosage where you on it?

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This drug does have a high poop out rate as well.
That's the problem with Mirtazapine. I've read a lot about Mirtazapine pooping out...

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post #27 of 62 (permalink) Old 05-28-2017, 08:03 AM Thread Starter
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I am beginning to like that Setraline stuff
self-confidence is at an all time high, even been impulsive the last few days and positively aggressive.

nonetheless, lack of appetite and moderate insomnia is still a problem. (61kg @ 5'9'')
EDIT: And I am a little bit agitated, whipping up and down on my chair ^^

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post #28 of 62 (permalink) Old 05-29-2017, 01:55 PM Thread Starter
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Question

Is the "feverish" feeling a normal side effect under Sertraline? It coincides with my hot flashes... it makes me feel somewhat sick.

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post #29 of 62 (permalink) Old 05-30-2017, 01:17 PM Thread Starter
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Quote:
Originally Posted by Gillman fan View Post
Re: Nortriline and Maptroline - for the most part when I post here on the forums I am relying on reading I did months ago, studies, patient reviews etc. that basically just included meds in the US. I can read the Wikipedia pages for this two but it tends to not be very helpful. Also no receptor affinity data, which I consider very important.
I've been searching and searching and searching and finally have found something ...
https://www.researchgate.net/profile...l-Approach.pdf
https://dspace.library.uu.nl/bitstre...=1&isAllowed=y
http://dspace.library.uu.nl/bitstrea...54TOPHARMJ.pdf

PDF, Table 1, Page 57.

Quote:
You might have been asking Alchemist but I take Trazodone too. The big thing about Trazodone for me is that it does not build any tolerance, it does not cause withdrawals, it is non-addictive etc. And it can be a very potent sleep med. Almost all other sleep meds rely on antihistamine activity for a big part of their action, this tends to build tolerance over time.

Trazodone is a sleep med that moderately agonizes 5ht1a which I basically think of as the "MDMA" receptor, because agonizing it feels the most like MDMA /ecstasy. It is strongest at antagonizing 5ht2a which is anti-anxiety, sleep-inducing, and also feels good. Moderate antagonist at 5ht2c which may help with anhedonia. It it moderately antagonizes some adrenal receptors which helps your body to calm down. Moderately antagonizes histamine receptors which acts as a sedative. At higher doses it has some SSRI action, significantly higher doses than sleep aid dosage.

It isn't in your blood stream all day so it isn't going to do TOO much during the day. For me it is a sleep med but it also feels great. No effect on appetite or nausea. The weirdest thing about Trazodone is that it significantly boosts your erections! In extreme and unusual cases it can cause an erection that lasts 4+ hours which generally requires ER visit.
sounds pretty good
I will ask my psych-doc.

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post #30 of 62 (permalink) Old 06-06-2017, 03:16 PM Thread Starter
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Quote:
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Duckbruck: Agitation and restlessness is one symptom that is "supposed" to get better as 5ht2a downregulates.
Hasn't happened yet. Not sure what to think about it. Maybe a dose increase will mitigate this side effect? I've always been a motorically very over-active person: seesawing, moving my legs, feet, toes, lips biting, fingernails biting, bruxism and so on. I am not sure what this could be? Some form of hyperactivity disorder? I've been to a few doctors, but they were rather clueless to what this could be...

-----------------------

I was very interested in Nortriptyline and my plan was to augment the Sertraline with Nortriptyline according to the article from Gillman Blog, but Lundbeck has withdrawn it from the German (European?) market as of this year
http://www.lundbeck.com/de/service/nortrilen-truxal
Why the **** not withdraw everything from the market besides SSRIs, then it will be SSRI carousel forever and ever...

I've been also thinking about Mirtazapine + Bupropion, but I am uncertain if this combo is favorable to Mirtazapine + Sertraline.

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Originally Posted by Gillman fan View Post
Given this, you should try to get a Mirtazepine Rx and see how it does for your anhedonic symptoms. SSRIs tend to be more relaxing, feel good, and anxiolytic once they "kick in" over time but apathy is a side effect that usually remains. Re: the scholarly articles you linked, much of the praise regarding Mirtazepine applies equally to any med that is NOT an SSRI, e.g. most tricyclics are quite weak on serotonin. Anyway it is worth a shot. SSRI + Mirtazepine is usually better than just SSRI if you experience anhedonia. My view of Mirtazepine is overall not that great, but since most patients are forced on SSRIs, it can help to lessen the blow.
Yeahh, I guess this is the way to go. Sertraline on it's own isn't that bad. At least it is working to some extend, but augmenting it with Mirtazapine might lessen the side effects.

My appetite has come back

Current side effects that are stil bothersome:
# insomnia (unrestful sleep)
# zombification
# and sometimes I have those hot flashes | heat intolerance

Quote:
Originally Posted by Gillman fan View Post
However, if you want to start afresh - I had a look at the statistics re: German prescribing and I was surprised to see tricyclics doing so well. It looks like Amitryptiline is commonly prescribed in Germany. This med is interesting for several reasons, it offers several rather unconventional mechanisms for curing depression, and it metabolizes into Nortriptyline, which is a great 5ht2a and 5ht2c antagonist, just a great med period. It is rather like having 2 medications for the price of one. I don't think it would worsen anhedonia. Moderately strong on antihistamine, it should be a sedating combo which may help with your agitation. Anticholinergic side effects may bother you, or they may not, but at least it won't make your preexisting symptoms worse.
I will keep that in mind.
Thank you.

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post #31 of 62 (permalink) Old 06-13-2017, 05:26 PM Thread Starter
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time for an update:

it's been 8 weeks on 50mg of Sertraline.

on the pro side:
# helps with social anxiety and somewhat with depression
# some subtle psychosomatic symptoms have diminished
# diarrhea no longer an issue! Mr. Hankey is hard and cohesive.

cons:
# insomnia | ****ed up sleep cycle
# weight loss. My appetite is nearly back to normal, but I am still loosing weight or at least not gaining any. BMI 19 right now. That is bothering me. I don't want to become underweight.
# heat intolerance (my entire life I've been loving warmth and heat. I was the guy who could sit at the top row in the sauna for 20min @ 100C (212 F), but right now I cannot even stand the mild summer.
# exhaustion (walking 2km around the block makes me feel exhausted & breathless. I feel somewhat weak, without power)
# agitation /motoric restlessness seems to be worse than before taking Sertraline
# and the many times mentioned "zombification"
# mild heachache and "pressure" in my neck. Nothing bad, but very annoying in the mid and long term.

I am unsure about the further course of action: Staying on Sertraline as a standalone treatment is not an option, as the side effects are not bearable in the mid to long term. I've been thinking about the popular Sertraline + Nortriptyline combo, but Lundbeck has withdrawn Nortrilen from the German market, so this is no longer a viable option. I've been also thinking about Sertraline + Mirtazapine (heroic combo | Stephen Stahl), but I am not sure if Mirtazapine will counteract & attenuate the side effects of Sertraline!? Although it might be worth a try before discontinuing Sertraline forever...

What other options are there? Well, there are of course TCAs, which might be worth a try as standalone treatment, for example Amitriptyline, Clomipramine, Trimipramine etc.! Considering Gillmans TCA article & "When to consider avoiding SRIs as first choice" I seem to be a prototype for someone who shouldn't be treated with SSRIs but rather try a TCA as first line treatment *lol*

What are your thoughts?

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post #32 of 62 (permalink) Old 06-19-2017, 05:12 AM
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Just recently been prescribed Venlafaxine after trying Sertraline and Citalopram due to how they affect my libido, but so far they're causing the same problem. I'm also combining Zyban (Wellbutrin in the USA) with them as I've read they can counteract the side affects...? I've yet to see any difference. Zyban on its own doesn't help with my depression/anxiety much, but SSRIs do at the cost of my sex drive. It's frustrating as hell. >_<
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post #33 of 62 (permalink) Old 06-19-2017, 04:49 PM Thread Starter
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Just recently been prescribed Venlafaxine after trying Sertraline and Citalopram due to how they affect my libido, but so far they're causing the same problem.
Did you try augmenting it with Mirtazapine or Trazodone?

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post #34 of 62 (permalink) Old 06-19-2017, 06:16 PM
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It's funny, most doctor's don't have the balls to say "look kid, either you want to get out of depression and take a break with the "libido" and be a man about the problem for a few months or just keep jumping between ****". They're afraid to hurt their patient's feelings.

I still remember the day's when libido was a natural phenomenon that took two to get it to work, nowadays it seems like it is always on call. How unfortunate.
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post #35 of 62 (permalink) Old 06-20-2017, 03:28 PM
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It's funny, most doctor's don't have the balls to say "look kid, either you want to get out of depression and take a break with the "libido" and be a man about the problem for a few months or just keep jumping between ****". They're afraid to hurt their patient's feelings.

I still remember the day's when libido was a natural phenomenon that took two to get it to work, nowadays it seems like it is always on call. How unfortunate.
What is the NR.1 reason for patients to stop taking their medicine?

Libido while being depressed... Is this something that people usually have?

Now once again you are bashing people here...
"take it like a man"... Just whatta HELL kind of a comment is that.

Sexual side effects is a real problem that effects many people, this can be avoided or atleast helped with changing medicines, augments or such...

I find alot of your comments on this forum abit weird. Several of them to be just insulting.

Hello Darkness my old friend... I've come to talk with you again.

Take cover child! Now switch to Kryptonite!

What's Dr. Stahl say?
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post #36 of 62 (permalink) Old 06-20-2017, 03:33 PM
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What is the NR.1 reason for patients to stop taking their medicine?

Libido while being depressed... Is this something that people usually have?

Now once again you are bashing people here...
"take it like a man"... Just whatta HELL kind of a comment is that.

Sexual side effects is a real problem that effects many people, this can be avoided or atleast helped with changing medicines, augments or such...

I find alot of your comments on this forum abit weird. Several of them to be just insulting.
If you have a problem with my posts, Then be a man take care of it with me over PM. Maybe then we can reach some common ground and understand eachother a bit more equally.
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post #37 of 62 (permalink) Old 06-20-2017, 03:36 PM
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Quote:
Originally Posted by watertouch View Post
What is the NR.1 reason for patients to stop taking their medicine?

Libido while being depressed... Is this something that people usually have?

Now once again you are bashing people here...
"take it like a man"... Just whatta HELL kind of a comment is that.

Sexual side effects is a real problem that effects many people, this can be avoided or atleast helped with changing medicines, augments or such...

I find alot of your comments on this forum abit weird. Several of them to be just insulting.

GAD (not as bad now), Slight OCD, Panic disorder, extreme social phobia and paranoia. 18yrs and counting.
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post #38 of 62 (permalink) Old 06-20-2017, 03:37 PM
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Originally Posted by neonknight77 View Post
If you have a problem with my posts, Then be a man take care of it with me over PM. Maybe then we can reach some common ground and understand eachother a bit more equally.


I've heard what your like in PM, are you too much of a coward to do it in the open?
You keep saying sh11t like be a man, man up, man....but you sound like a little boy to me, a little boy that still hasn't learnt that it's not cool to be a bully. in the open or in PM where you seem to like to do it.

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post #39 of 62 (permalink) Old 06-20-2017, 03:47 PM Thread Starter
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+2

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post #40 of 62 (permalink) Old 06-20-2017, 03:51 PM
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Originally Posted by Duckbruck View Post
What are your thoughts?
My personal experience of using Zoloft two times. Second time combined with TCA Clomipramine, Sert 200mg Clomi 150mg... Is that the side effects you seem to have doesnt really get that much better with time...


Question here would be if you maybe should change the Zoloft to something else.

But otherwise, something like Mirtazapine 7.5 to 15mg towards night could help against the insomnia, hunger and the heat intolerance.

About.
# exhaustion
(this seems weird from an SSRI)
# agitation /motoric restlessness seems to be worse than before taking Sertraline
(probable caused by the increase of serotonin and how it "push" away dopamine, raising the Zoloft dose and hoping for some of that DAT action will probably NOT work)
# and the many times mentioned "zombification"
(this is really commen with Zoloft, actually from most SRI... But for some reason especially with Zoloft)
# mild heachache and "pressure" in my neck. Nothing bad, but very annoying in the mid and long term.
(i got this to specially some 2hours after taking the pills, i started to take the pills towards night when i was more "calm" it helped somewhat)

Hello Darkness my old friend... I've come to talk with you again.

Take cover child! Now switch to Kryptonite!

What's Dr. Stahl say?
https://www.youtube.com/watch?v=7tUE...ature=youtu.be

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