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Author Topic: Went to Psychiatrist for first time ever today  (Read 1174 times)

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Offline dh1972

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Re: Went to Psychiatrist for first time ever today
« Reply #10 on: March 10, 2014, 07:23:59 PM »
One other question, do SSRIs reduce your testosterone?
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Offline insights

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Re: Went to Psychiatrist for first time ever today
« Reply #11 on: March 10, 2014, 08:00:48 PM »
Any other options besides Trazodone?

The TCA doxepin, or Remeron (mirtazipine).

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Also, is the insomnia on Lexapro likely to pass?  I'm kind of a sensitive sleeper as it is.

Maybe. It all depends on your biology.

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do SSRIs reduce your testosterone?

No. What causes antidepressant induced sexual dysfunction is poorly understood, but it appears signal dampening in the anterior cingulate cortex and mid brain may have a role.

Ian



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NOTE: I'm not a doctor, and particularly not yours, so there may be factors I'm unaware of. Therefore all advice is of a general nature and you should consult your doctor before following any of it, especially before changing med doses.

Offline dh1972

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Re: Went to Psychiatrist for first time ever today
« Reply #12 on: March 10, 2014, 09:26:42 PM »
Thanks, Ian.

If I decide to stop the Lexapro, can I quit it immediately this early in the process or do I have to lower it gradually?
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Offline Potatoes

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Re: Went to Psychiatrist for first time ever today
« Reply #13 on: March 10, 2014, 09:36:03 PM »
I remind myself of one of those mental health patients that have escaped from the Looney Bin. (Please know that was a joke, so I hope whoever reads this doesn't get offended by that statement)

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Sometimes, when I'm home alone, I fill my bathtub with tomato sauce and pretend I'm a meatball.

Offline Potatoes

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Re: Went to Psychiatrist for first time ever today
« Reply #14 on: March 10, 2014, 09:38:36 PM »

No. What causes antidepressant induced sexual dysfunction is poorly understood, but it appears signal dampening in the anterior cingulate cortex and mid brain may have a role.

I heard it delays your orgasms. Why?
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Sometimes, when I'm home alone, I fill my bathtub with tomato sauce and pretend I'm a meatball.

Offline insights

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Re: Went to Psychiatrist for first time ever today
« Reply #15 on: March 10, 2014, 10:51:36 PM »
If I decide to stop the Lexapro, can I quit it immediately this early in the process or do I have to lower it gradually?

You should be able to just stop, but you could drop the dose in half for a couple of days if it would ease any concerns you may have.

Ian
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NOTE: I'm not a doctor, and particularly not yours, so there may be factors I'm unaware of. Therefore all advice is of a general nature and you should consult your doctor before following any of it, especially before changing med doses.

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Re: Went to Psychiatrist for first time ever today
« Reply #16 on: March 10, 2014, 11:23:23 PM »
I heard it delays your orgasms. Why?

A good question without any good answers atm. About the only thing really known is that drugs that bind with the serotonin transporters trigger sexual dysfunctions such as anorgasmia, but those which block serotonin 5-HTA2 receptors, e.g. trazodone, enhance it. It seems to be at least partially genetic as those with the 5-HT2A GG genotype are more likely to develop SSRI linked sexual dysfunction than those with the AA and GA variants.

Ian
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NOTE: I'm not a doctor, and particularly not yours, so there may be factors I'm unaware of. Therefore all advice is of a general nature and you should consult your doctor before following any of it, especially before changing med doses.

Offline dh1972

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Re: Went to Psychiatrist for first time ever today
« Reply #17 on: March 11, 2014, 12:30:36 AM »
Ian,

I've wondered about maybe suggesting to my Psych Dr. of trying Doxepin.

I tried it at very lose dose (up 30 mg for about a week) last summer from my sleep dr. but it did not get me drowsy at all - but that is a very low dose.  No side effects though, but that was low.

I think 75 mg is the starting dose?

Maybe a higher dose would help with sleep and anxiety.

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Re: Went to Psychiatrist for first time ever today
« Reply #18 on: March 11, 2014, 12:58:17 AM »
Maybe a higher dose would help with sleep and anxiety.

The usual dose range for insomnia is 20-50mg, so try 50mg first. It has relatively low potency at serotonin transporters so you should be able to go to 75mg without affecting Lexapro too much. It is a pretty good 5-HT2A receptor antagonist too which may also alleviate the anorgasmia to some extent.

Ian
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NOTE: I'm not a doctor, and particularly not yours, so there may be factors I'm unaware of. Therefore all advice is of a general nature and you should consult your doctor before following any of it, especially before changing med doses.

Offline dh1972

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Re: Went to Psychiatrist for first time ever today
« Reply #19 on: March 11, 2014, 12:58:51 PM »
Maybe a higher dose would help with sleep and anxiety.

The usual dose range for insomnia is 20-50mg, so try 50mg first. It has relatively low potency at serotonin transporters so you should be able to go to 75mg without affecting Lexapro too much. It is a pretty good 5-HT2A receptor antagonist too which may also alleviate the anorgasmia to some extent.

Ian

I decided to stop the Lexapro.  The insomnia and the sexual side effects are just not worth it and they are not easing up.

If I were to go on Doxepin from sleep and anxiety, 75mg typical while ramping up to that?
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