Prozac

[Tammy]

I have been on prozac or 1 month now. I feel so much better I was very tired all the time and had minor depression. I am on 20 mg. a day. I am 36 and feel 19 again except I can't have an orgasm. I cannot stand this my husband feels the same way. Will welbutrin help me the same way prozac does? I was reading it did not have the same sexual side effect is this true? Also would I quit prozac and start on welbutrin right away or do I wait a while between drugs? I am seeing my Dr. next week about it.

[Pat]

I have been taking Prozac for two years for OCD with good improvement in symptoms.I am also alcoholic but have been off
drink and attending meetings of AA(Alcoholics Anonymous) for 20
years.I  was diagnosed with OCD 2 years ago and although the Prozac has helped me a lot Ihave conflict with taking medication
long term and would like to consider going off medication by tapering the dose but am wary that symptoms might return. any comments /suggestions how best to go about it!

[Pat]

This is such a common thing.  I tried the switch to wellbutrin, but for me it was terrible.  Within the month, the Dr. switched me to serzone...not terrible...successful sex too (after a year).  Expect to feel some withdrawl from the previous med.  If you know to expect it, it won't come up and scare you too much.  The doctors will answer you with exactly what the drug company prints out for the drug; and almost all of them say there's no known withdrawl symtoms.  But I don't think those doctors are actual users of the medication.  There's something out there that will help you, you just have to find it by trial and error.

[HFHS MD - RG]

According to available literature, different strategies are available to counteract the sexual dysfunction due to SSRIs (prozac, zoloft, etc).

The addition of low dose Wellbutrin, not replacement have helped some individuals wih their sexual dysfunction.

Other medications include Buspar, Viagra, Ritalin, Gingko

You may want to re-consider totally changing your medications as there is always a chance that the next medication might not work as well as your present medication. But if you feel tha your current predicament is not tolerable, then this option should be explored.

other medications with no or low sexual dysfunction are Remeron, Serzone.

Tapering off (slowing coming off it) the Prozac and titrating (increasing slowly) Wellbutrin is recommended if you decide to change your antidepressants.

Talk to your psychiatrist and ask about these suggestive strategies.

[NRO-Sx]

Congratulations on getting over your depression!  I can understand your concern with not being able to orgasm.  This is very likely a result of your taking Prozac (sexual dysfunction is thought to be due to more serotonin binding to 5-HT2 receptors in the brain).  Sometimes the sexual side effects resolve spontaneously, and sometimes a reduction in dose or a "drug holiday" (where you stop taking it for a while then start again with the same dose) will work.  A switch to a different kind of antidepressant is another option.  It is true that Wellbutrin has a lower incidence of sexual side effects, but because it is different from Prozac (it increases levels of noradrenaline and dopamine instead of selectively increasing serotonin levels) there is a chance that it may not work as well as the Prozac for the depression.  Before switching medications from one that works, discuss with your doctor the possibility of changing your dosing schedule or taking a brief drug holiday.
Best of luck to you.