Luvox (Fluvoxamine) SSRI and Sex...

[guptasa1]

Hey all,

 

I know this might be a stretch to ask this here, but I thought it might be worth a try to see if anyone has any input.

 

I've been dealing with depression/anxiety/OCD for quite some time, and was finally convinced (actually, in part due to a conversation with an escort I see in addition to some other conversations) to see a therapist/psychiatrist about the problemss. It's good and I think at the least it's healthy to talk things out, but I've just recently realized through it how severe these things have gotten and how much these things are interfering with my life - I hadn't even realized just how much...and it's a lot...

 

He feels it's severe enough to need to treat it aggressively and that medication is necessary. The last thing I wanted to do was go on medication, but I've agreed to give it a try.

 

He wants to try me on Luvox (Fluvoxamine) because he feels it's the best match for my conditions and the least likely to cause the side effects I most dread (namely decreased libido, inability to orgasm, and weight gain).

 

I was really hoping to try Wellbutrin, but apparently it only works well for depression - it doesn't work for anxiety or OCD and can even maybe make them worse.

 

Does anybody have any experience with Luvox? I know unfortunately these tend to affect everyone differently. The doc said roughly 10% of people experience the side effects I dread, so maybe I'll get lucky. I'm not particularly encouraged by what I've found on the web about the drug though... There just doesn't seem to be an easy answer to this... Maybe sexual function shouldn't be as important as it is to me, but at 23, the thought of losing it is...in a word...horrifying... (He did promise if I do have problems, we'd find a solution though.)

 

Still a week or so before I start on the medication. I'd love any input, and thanks...

[trilingual]

I'm glad to hear you're trying some meds. ALL of them can have side effects, but 10% is a pretty low number, so the odds are you won't have adverse effects. I haven't tried Luvox, but it undoubtedly works slowly, like most of the other similar drugs. That means that even if there are effects on your libido they'll probably come on slowly, too. When I was on Prozac, the libido thing didn't really kick in until a couple of years down the road. Even then, it didn't turn it off, it just turned it way down. In the right circumstances, I could function. However, at least for a while it was refreshing not to just spend my life being led around by my dick. I could actually get some other things done! But after a while I was getting tired of the low response, and I'm glad I switched to Wellbutrin, which doesn't suppress my libido.

 

Whatever, based on things you said earlier on, it's very much worth trying this med to see if it works for you. Just understand that it's not an exact science and sometimes there's trial and error involved in finding the right drug that works for you. When you find the right one, you will be SO glad!!! Because depression, anxiety and all the other charming relatives really do get in the way of having a full life. I envy you having figured out what was the matter at age 23 and having the chance to fix things now. I wasted a good 30 years of my life struggling against depression without medications, and a lot of it wasn't wonderful. You've got a much better chance to have a great life ahead of you, so don't waste it! Good luck! And let us know how things go using Luvox!

[jackhammer91406]

Guess I will weigh in here. It's no secret I have gone through much the same as you are experiencing, though thankfully I am now almost finished with the process. I started with Wellbutrin, then switched to a number of different meds , finally settling on Effexor. That worked the best for me. As Tri pointed out, it is not an exact science but you have taken the two most important steps already and with proper monitoring by your doctor, you can find the med that works the best. The only down side for me was not losing interest in sex, but actually having to be hard and stimulated much longer before climax. This symptom BTW is one that many guys wish they had, the ability to go for longer periods with an erection. So don't be apprehensive, the side effect may be a good one.

 

At 23, you have so much life ahead of you that you shouldn't be worried. Success rates will very with different meds and different people, but at least you have made the decision that you need some help and have taken the steps to get it. Good luck and feel free to message me anytime and I'll answer whatever I can.

 

[guptasa1]

Hey guys. Thanks for the great responses!

 

I'll admit I'm skill skeptical about them helping me and also worried about the side effects, but since the doctor's so patient and understanding about the symptoms I'm worried about, I figure I really can't lose. It just *feels* like this thing can't be broken with some pills...but maybe it can.

 

I hate the idea of trial and error, but I understand why it's necessary until they understand what makes these things work better.

 

I still have issues with me not being able to "fix" this myself and it being an illness, but I'm starting to realize maybe I really am seriously ill and it's out of my control...

 

At any rate, I'll start on them a week from Monday (after a trip I have planned that I don't want anything to interfere with), and I guess we'll go from there...

 

Thanks for the great responses, and I'm sorry for anybody who's had to deal with depression, especially for large chunks of their life. It's certainly not a fun beast to deal with.

 

Any other responses are of course welcome. =o)

[jackhammer91406]

Just wanted to add...

The thing about depression is that it is often based on a chemical change in the body. It of course is also impacted by physical changes in environment and the ability to work through the responses of emotion. I never EVER figured myself as a person who would need therapy and most people who know me were very surprised that I fell into a severe clinical depression since they had been coming to me for years to get counseling.

 

It happens. As we grow, our body changes and despite the stigma of society on people in therapy, the fact is that without it and the meds, many people could never return to productivity.

 

There will be those , even on this site, who will ridicule anyone who opens up and expresses a need for help, but many, MANY more people need help than go to get help.

 

Stay the course and let the professionals help you work through the depression. You are no less of a man, no less a person of strong character, and certainly no less deserving of happiness than before.

 

I also want to reiterate how helpful this board can be. As melodramatic as it may sound, my participation here and the friends I made through this MC actually saved my life. No doubt I would have punched my ticket last year were it not for the great people (lovable and UN) from this MC.

 

Good luck

 

 

;-)

[OneFinger]

guptasa1,

 

Depression, anxiety, OCD and I are long-time friends. x( Over the years I've been on numerous drugs including some experimental drug tests for the FDA. I've been able to function very well without drugs since 2000 but anticipate that I *may* have to go back on the drugs in the future. But, in order to get me to a place where I didn't need drugs, my doc had me on the following combination of meds.

 

1. Luvox 50 mg @ bedtime.

2. Effexor 75 mg in the morning.

3. Methylphenidate 5 mg @ breakfast, lunch, and dinner.

4. Neurontin 100 mg @ breakfast, lunch, dinner, and 2 at bedtime.

 

I did experience some weight gain and delayed orgasm. But, it certainly didn't take away my sex drive, desire, or ability to perform. :7 In fact, the less depressed I felt the hornier I got. (Perhaps that was the OCD?!?!)

 

I'm sure many people will think I'm totally nuts but something that I found really helped was seeing a Chiropractor and a message therapist. During the first visit to the Chiropractor I found my mouth salivating and my nostrils opening. With continued visits I found my body responding better to the meds and I actually starting cutting back (with Dr. permission) on the dosage.

 

The massage therapist really helped with the anxiety. I found a Massage Therapy School where they offered supervised sessions for $20/hour. GREAT bargain!! They may have only been students doing the massage but it sure did the trick for me.

 

Good luck with things. Feel free to e-mail privately if you'd like to have further discussions outside the message board.

[guptasa1]

Thanks for the continued kind and helpful responses.

 

I tend to be pretty good at psychology, so I guess that's made it hard for me to accept that I need help all this time. But I think I'm finally there where I realize it... I still...I dunno...go back and forth on the medication idea. I'm very afraid that if I go on it, I won't be able to stop or that it might alter the way I think too much for my liking. I'm also worried about the side effect as mentioned. And it sounds like it can take years and years to get the right dosage of the right medication...if it even works for me at all.

 

This site has indeed been beneficial, and even moreso, I think seeing escorts occasionally has been great for me - it's gotten me out and given me some warmth and touching which has helped keep me going over the last several months (giving me experiences to look forward to and anticipate), whereas otherwise I just tend to seclude myself and try to be alone.

 

I was quite surprised by my therapist's response when I told him I see escorts - he even seemed to feel it was a good thing, which I wasn't expecting. (I should note I'm in a small, pretty conservative town where that might come as a shock to most people.)

 

I haven't experienced enough massage to really say whether it'd help me or not, but I'll keep that in mind.

 

I can honestly say my sex drive is the one thing that hasn't suffered adversely because of depression. I really doubt medication is going to lead to improvements instead of problems there, but there's no way to know without trying I guess.

 

Sounds like figuring out meds and dosages is quite an adventure in itself.

 

Anyways, thanks for all the supportive comments.

[londonbear]

Sorry but from long experience, all SSRI's have side effects and not just those you are aware of. During the entire time I was on Prozac for example, I had an anal fissure that refused to heal. When I stopped taking that SSRI, the fissure cleared up. I subsequently read a research paper that showed Prozac raised the temperature of the anal area in lab animals. There are also indications that this class of anti-depressant can increase violent and self-harming behaviour, particularly during adjustment phases of going on and off the medication and in the young.

 

If I sound anti, I am for the very good reason that I had 20 odd years of intermittant debilitating depression not helped by a melody of the latest products from the pharmacutical industry. Unfortunately I am not familiar with the American abbreviations you use but you should know that many clinical studies, in Europe particularly, recommend that for mild to moderate depression the treatment of first resort should be Hypericum AKA St. John's Wort, a herbal remedy. This is available on prescription certainly within the German health service. This is usually extremely well tolerated but does have some side effects that you should be aware of. The first is increased sensitivity to bright light (more on this later. The second is that it decreases the effect of some painkillers like Ibruprofen.

 

Hypericum appears to work by increasing the total amount of Seratonin in the brain. SSRIs on the other hand inhibit Seratonin being re-absorbed into the nerve cells once it has performed its function in neuro-transmission. Seratonin is also produced by the action of bright light on the body (hence the possible route that Hypericum uses, increasing sensitivity to light as I said being one of the side-effects) Light therapy also increases the amount of Seratonin and is particularly useful in bipolar or Seasonal Affectived Disorder. My depression was certainly triggered by reduced daylight in the Autumn/Winter but did not realise it until my therapist looked back over the records. It is not for nothing that we commonly use such terms as "a dark mood" or "feeling brighter".

 

Let's get one thing straight(!!), no medication cures depression, it only aleviates symptoms. I finally got rid of mine by a combination of several things. One was St John's Wort which both gave me the feeling of self-empowerment and stopped the very worse downs but otherwise did not significantly affect mental functions which I found the worse drawback of all other treatments. The most significant was that I was referred to a cognative/behavioural therapist. I now tend to use light therapy as an alternative to hypericum itself if I am feeling particularly low as I sometimes need to take Ibruprofen for a dodgy back. You can get special lights that are designed specially to give the correct level however I have improvised my own (knowing the lux levels needed and having a photographic light meter that measures the brightness in those units) using one of those 500 watt halogen lights that are commonly used for security purposes.

 

If all this sounds a bit way out, I should tell you that both my own primary-care physicians (or GP as they are called here) support this regimen and the therapist recommended the light therapy route to me. I intensely distrust the use of pharmacutical products to treat what are identified as mental illnesses. If you look at the statistics, huge numbers of patients are treated with these in the USA compared to elsewhere. This rather begs the question whether the illnesses are actually invented by the drugs companies to sell their product. This is particularly the case with such things as ADHD (Attention deficit hyperactivity disorder) in children.

 

One of the first things to do is accept that you are capable of a huge range of emotions and that these are natural but the conditions in which you live are not. To a large extent if you go the drugs route you are restricting the range of emotions you feel. While you may not have the lows, the highs are also going to be dulled. So you may also want to explore what you expect for yourself. If you expect to be permanantly happy, go ahead and take a cocktail of drugs to keep you that way but remember that you cannot know what sweet is properly until you know sour.

 

The second thing to consider is whether you are seeking treatment for yourself or to comply with some sort of "norm" expected of you. You have a right to be unhappy occasionally and sometimes intensely so in the case of berievement (sp??) for example. What you need to know is there are techniques other than powerful psychoactive drugs you can use to stop the descent into darkness and help you recover.

[londonbear]

A couple of UK sites that give fairly impartial information you might like to have a look at. The first site is closing in April due to lack of funding (I suspect their grant from our National Lottery has been withdrawn)

 

http://www.depression.org.uk/

 

The second is a major mental health charity here.

 

http://www.mind.org.uk

[guptasa1]

Thank you for the very detailed response listing your concerns. They are very real concerns for me, and I'm glad to have a week before I'm supposed to start the medication to give it some more thought and research. In truth, I sitll don't know...

 

Regarding Hypericum (St. John's Wort as it's called here), it's actually available non-prescription. In fact, I have 3 time-release bottles in a drawer in my bedroom that I bought a few months ago to try.

 

Unfortunately, within a week of trying it, not only was I incredibly sensitive to brightness, I experienced some rather startling floaters and vision loss, which I now believe was inability to focus. I stopped the St. John's Wort immediately and saw an optometrist. I've seen him twice now (tried seeing an opthamologist for a second opinion but got him again instead) and he never was able to tell me what caused the problem. I'm not certain it was the St. John's, but it's the only thing I can think of that could have caused such a sudden change, so I'm reluctant to try taking it again as I think it was the most likely cause. My eyes still aren't where they were before that week. I'm not sensitive to brightness anymore, but the floaters are still there and they get very dry/irritated and are a bit harder to focus, but nothing as severe as that week. Still, it seems like whatever I did is permanent, though now minor, and I'd be very frightened of making it worse.

 

I wasn't certain about these SSRI drugs dulling your other senses, but I suspected as much. I don't WANT my other senses dulled. My mother's been on antidepressants for quite some time, and...well...she used to have terrible mood swings and it wasn't pleasant, but...now she seems almost silly most of the time, and her thinking doesn't seem as clear, and it worries me because, I can at least say my thinking is sharp, as are my good emotions when I do have them (which is rare, but it does happen). I don't want to lose either of those things.

 

I don't believe my depression has anything to do with brightness. (In fact, I like night better than any other time, and I sit in a dark room whenever possible - I don't particularly like bright places - lol.) So I don't know that light therapy would work for me, but it doesn't seem at all far out - I'm sure for those who have seasonal and other forms of depression it's a great technique. Who knows - might be worth investigating for me just in case.

 

You're also right in the "no light without darkness" argument. I almost wish I could find a way to USE this darkness instead of get rid of it as strange as that sounds. My emotions are intense, but I've always liked that...if I didn't feel so damned terrible all the time lately.

 

Finally, I'm aware these drugs can cause psychosis in a small number of patients. In fact, there's even a link to some of the school shootings here in the U.S. and those drugs, including Luvox. The percentage is supposedly very small, though, so I guess all I can do if I do try the drugs is hope I'm not one of the unlucky ones.

 

As far as why I'm doing this, well - even that's complicated. I do feel I'm not functioning correctly as I should in the world, but at the same time, I'd be lying if I said I'm not getting a lot of pressure from family members who are trying to enforce a norm and make me feel guilty about who I am. I honestly think if I were away from them (I don't particularly like to be around my "family" at all at this point), I would feel a little better than I do right now, but I still don't know that I could function well in the world. I'd probably just find a way to isolate myself even more - I really don't know.

 

I'd like to reiterate I don't like the idea of trying these drugs. At this point, though, it's one of those decisions where there isn't a good answer. I can choose to either try to keep going as is and hope it works out, or I can try these meds and hope they help me live a better life. Neither choice is what I consider a good one.

 

Thank you for the links also. I haven't checked 'em out yet, but I will.

[Guest bigTom]

guptasa1,

instead of thinking about all the possible bad things that can happen with medication, start by focussing on why medications were suggested and the problems that you are having. This may sound harsh, but your reluctance to consider drug treatment sounds to me like denial and rationalization. Depression, OCD, bipolar disorder, etc, are medical illnesses and not weaknesses in character. If you had a sore throat, a migraine headache, or diabetes, would you just blame yourself and not do anything about it? Depression is a potentially life-threatening illness, if not just life altering illness and not to be taken lightly. Yes, all medications have potential side effects and antidepressants are not exceptions. They have received a lot of media coverage, some good,and some worthless, but they are more effective and have less side effects than the older tricyclic antidepressants which had more problems with weight gain and impotence. The SSRI's have been associated more with weight loss (not always) and with delayed ejaculation.

Luvox was the first SSRI to be marketed for OCD, but is also effect for depression.

This is no simple way to prescribe antidepressants and trial and error, although crude, does work. Be honest with your psychiatrist and give the meds a chance. They may take up to six weeks.

St. John's Wort in used more in Europe than in the US. It is more refined and used in higher doses.

In summary, your choices are to try the meds or do what?

;-)

[guptasa1]

Thanks for your comments, bigTom.

 

I can't really help but think of the negative consequences with medication. There are some major drawbacks to this, and it's hard for me NOT to worry about. So this is a pretty big decision for me.

 

For one, I have a family member (my mother) who's on a related med (Paxil), and I honestly can't say I'm thrilled with how it's changed her from a 3rd party standpoint (though she at least says she's happier in herself). She just seems...a little too artifically happy sometimes and silly most of the time without as much clear thought.

 

The only denial I've faced is in the fact that I can't win against this myself, and I'm still struggling with that. I know I'm depressed, anxious, and have OCD. I do rationalize, and I feel like I *should* be able to control it without meds. Maybe that isn't correct, and I acknowledge that, but I'm still wishing I could handle it.

 

The trouble with these meds is at this point, they're highly unpredictable. Heck, just doing some research, I realized Luvox happens to be a drug associated with both the Columbine and Littleton tragedies...so it's one that can cause psychosis in a very, very small percentage of the people who try it...but even so, that's scary to think about. At least without medication, I know what to expect and am not a real danger to myself or more importantly others. (And if I ever decided to take my own life, it would be well thought out and not simply an act of a drug-induced overwhelming urge that couldn't be controlled.)

 

Even without huge concerns like that, there are enough other possible side effects from nausea to insomnia to sexual ones that can't yet be accurately predicted. Additionally, everything I'm reading says that for some people, antidepressants are absolutely hell to get off of (though to be fair, Luvox is supposedly better than most in this regard). I don't like a feeling of being trapped at all.

 

Even without side effects, I'll feel a little limited by the medications. I won't be able to drink much anymore, etc. (not that I drink a huge amount, but I do occasionally and enjoy it). Little things, but unpleasant nonetheless.

 

Please don't get me wrong. I probably will be giving Luvox a try, mainly because I feel like I've exhausted most of my other options. But all of this stuff really does concern and scare me. I know most of it's unlikely...but the possibility of some of these things is still troubling.

 

Just being completely honest here. Your argument is very valid. I'm just struggling with this stuff within myself.

[cuddler]

Just a short note. Give it a try and don't stop until you have tried for at least 4 weeks. I have had OCD for most of my life but did not know what it was till 12 years ago. I have tried with and without the medicines. There is no comparison with the quality of life when the meds work. They do not have to be permanent...in fact the OCD is like a hiccough/hiccup...thst when the meds are used stops the hiccough and gives you a chance to try behavior therapy.

I have seen many people in support groups for OCD who absolutely refused medication....but when they tried it stated why did they wait so long. There life seemed to be given back to them.

I believe part of the OCD can be the resistance to take meds. If a person can work on it without meds fine...but there is nothing wrong with capturing your life back.Side effects can be temporary or dealt with.

I do not want to go into more discussion...however if you would like me to email you or call...let me know with a reply and I will figure out a email address to give you unless you post yours.

What city are you in? Seattle has a good support group as well as other cities in the states.

OCD foundation has a website and there are many boards with help on the internet for OCD.

You can feel better ...just stick with it. It is better in the long run to try 1 med and if it does not work after 4-5 weeks try another. Do not stop in the middle or you will never know if the med would work for you.

Take Care

Cuddler

[guptasa1]

You're correct in that my stubborness may be a bit of the OCD - I'm honestly not sure.

 

I likely will be trying it, and I will give it time if I do. If these drugs did help, it would be worth it. I guess I just feel skeptical, but as long as I know I *can* get off them after a month or two if they don't work, I can deal with it.