I need to stop thinking about sex for the next week and a half. Yes, really.

May 21, 2011 9:08 AM

Short-term coping techniques for Wellbutrin-related hypersexuality? (likely NSFW)

My psychiatrist bumped my Wellbutrin dose up from 75mg to 150mg (and switched from standard to extended-release) about two weeks ago. There are eight days until my next appointment. Almost right away (say, three days in) I noticed a marked increase in my interest in sex. On a scale of 1 to 10, where 1 is a Care Bear and 10 is Larry Flynt, I'm usually a 3 or 4, and I was up to 5 or 6. On balance, this was a little unnerving but mostly OK; "interest in human relationships" is one of my therapy issues.

But over the last few days, my general interest in sex has been steadily increasing, to the point that (for the first time in my life) I've considered buying a vibrator, and spent three hours looking at vibrator models when I should have been working. I went from masturbating (at most) once or twice a day to, well, many many times - this is "walk in the door at 5:30, start right away, look up at 8pm and realize you've been doing it since you got home - eat half of what you usually do, then go back to it till midnight" level stuff. I'd say I'm at least an 8 on the Sunshine Bear/Hustler continuum, and I think I can probably see 10 from here.

The issue I have is that, quite frankly, I want to think about other things. I mean, I haven't even read MetaFilter much in the last two weeks (down from close to an hour a day.) I can't get through two stories at CNN without suddenly (more or less automatically) detouring to online erotica. I am uninterested, all of a sudden, in my entire reading list (which is quite broad, but distinctly unarousing in subject matter.) I am abandoning Churchill and Thomas Aquinas and Larry Niven in favor of badly written nonsense. I try to watch favorite shows on Netflix and end out ignoring them in favor of not-terribly-satisfying physical gratification. This is really irritating; I'm useless at work and home and beyond that I'm frankly scaring myself.

Obviously, this is going to be brought up at my next appointment.

Meanwhile, you can't just stop taking Wellbutrin right away, and moreover I can already guarantee this won't be a sufficient "emergency" to get me in to see my doctor early. "I slept three hours last night" got me a "bring a sleep diary in to your appointment two weeks from now."

SO: on the off chance that someone has some coping mechanisms, especially ones that you can do in a work environment where you can't install anything on your computer and reminder signs will attract more attention than shopping around for sex toys on your smartphone does... please share? Bearing in mind that only about 30% of me actually wants to stop, and it doesn't appear to be in charge at the moment. It's incredibly bizarre, because I'm actually finding the sexual thoughts rather boring and not that appealing on an aesthetic level; I just can't stop focusing on them. And yet I would like to get things done in May still. Help?

I don't know if it matters, but I'm currently diagnosed with bipolar II and ADHD; the Wellbutrin is for the ADHD. I don't have any non-psychiatric diseases to blame this on. Many therapists and psychiatrists agree I have strong obsessive tendencies.

posted by anonymous to Health & Fitness (21 answers total)

Hard, exhausting exercise or physical labor.

I'm sorry if any of the words in the previous sentence were triggering for you.
posted by telegraph at 9:18 AM on May 21, 2011 [12 favorites]

150mg is still a pretty small dose. It was my starting dose.

I'd just call the doctor ASAP and ask if it's OK to stop, or failing that, to cut the pills in half.
posted by Sys Rq at 9:22 AM on May 21, 2011

I have no advice, but it might help people if we knew your gender and approximate age.
posted by madcaptenor at 9:25 AM on May 21, 2011 [1 favorite]

I had exactly this experience during the late second and third trimester of my last pregnancy, with the added funsies that at the end, I couldn't DO anything about it because of preterm labor concerns. It sucked. I had to haul out the old CBT distracting-thoughts skillset that I ordinarily use for depression and anxiety. It took a lot of effort, and I won't say it conquered the problem, but it did let me get through my day while giant-pregnant and taking care of a 4 year old.

For me, the process went "This is a thought. It is only a thought. I am having this thought, it is not having me. I do not want to have this thought, and so I am going to breathe it away." (Ten deep breaths, each one visualizing "blowing" the feeling out of my body.)

I have never been so well-oxygenated in my life, I tell you. And again, it didn't "fix" it per se, but it did help me live my life and focus on the things I wanted to focus on.
posted by KathrynT at 9:29 AM on May 21, 2011 [11 favorites]

I'd just call the doctor ASAP and ask if it's OK to stop.

It is not okay to stop. (I mean, you'll live. But one doses down on these things on the way out.) However, you will not suffer if you dose yourself down, though of course our official line on these things is Take Medication As Directed and Do Not Make Changes Without Consulting a Doctor. Also? I would call. (Although it is now Saturday.)

Also, this will likely pass.

But really: why don't you have a vibrator??? Um, whether you're having [non-judgmental medical name of sex obsession stuff] or not, why wouldn't you have a vibrator? Just seems weird not to!
posted by RJ Reynolds at 9:33 AM on May 21, 2011 [7 favorites]

I think you need to call back and be crystal clear (if not explicit) about why you only got 3 hours of sleep. It's possible the person with whom you spoke is not quite understanding what's going on and was therefore sort of dismissive with the "bring the diary in later" thing.

If your therapist/psych won't discuss this sooner, can you maybe try talking to your pharmacist?
posted by asciident at 9:39 AM on May 21, 2011 [1 favorite]

I don't know much about this stuff but it sure sounds like you've entered a manic phase, and if you phrase it that way in an emergency call the shrink should be responsive.
posted by mareli at 10:05 AM on May 21, 2011 [2 favorites]

RJ Reynolds: But really: why don't you have a vibrator???

I agree with this. In lieu of stopping, which may be too difficult right now, get a really good vibrator. Why? It's fast. It will take care of the problem much faster than 3 hours. And faster than erotica. It might help to get it out of your system efficiently!

Also, consider that if you're fairly young, this might actually just be your naturally occuring libido. Especially if you've recently gone off an SSRI. The Wellbutrin could be a red herring.
posted by Nixy at 10:10 AM on May 21, 2011 [7 favorites]

mareli, it's not a manic phase- just an (awesome, IMHO) side effect. I agree with this idea of keeping really busy and working out until you can go to your next appointment. Maybe go out for a hike or keep to public places where you won't be so easily distracted by the lures of the Internet and your own bed?
posted by Mouse Army at 10:15 AM on May 21, 2011

I can't answer most of your concerns, but for one point:

OMG, buy a vibrator. Honestly, it'll cut down your hours and hours of masturbation before dinner to...far, far less than that. And it'll cut down the time spent after dinner too. I promise you that you'll get more sleep. And well. Vibrators are pretty nice in general, really.

It might feel like a big step, like it needs 3+ hours of online browsing, like you need to find the perfect one, like it's a line you're crossing, but that's just because you haven't bought one before. It's the easiest thing in the world. So buy one. Now.

No, really. Right now. New tab, credit card, click OK, done.
posted by coffeepot at 11:05 AM on May 21, 2011 [4 favorites]

Try one of these. Maybe the intense mains electric power will satisfy you and allow you to focus on other things.
posted by East Manitoba Regional Junior Kabaddi Champion '94 at 11:35 AM on May 21, 2011 [1 favorite]

I agree with those who've suggested a vibrator... and you don't need the internet or an adult shop to get one! One of my favorites for many, many years has been a mains-powered "massager" like this one, available in the pharmacy section at Wal-Mart, Walgreens, Target, or anywhere else fine vibrators are sold without anyone having to admit what they are.

For less than $20 you can't go wrong, so try it and see what you think -- you can always go to a specialty store later, if you get into it (note: you will get into it!)
posted by vorfeed at 12:14 PM on May 21, 2011

I'm with mareli, call your doc. If you're bipolar and you've just upped an AD, and you're suddenly hypersexed that's a HUGE red flag. Hypersexuality, especially if it is to the point where you're masturbating from five p.m. to midnight (hello? seven hours?) for several days is a big sign of an impending manic episode or has been in my experience. As in, been there, done that, saw the movie, bought the t-shirt.

Call your doctor as soon as you can, I'm sure there is an emergency number you can call. I wouldn't take this lightly.

As for taking your mind off of it, I also recommend exercise. If nothing else, take some very long walk outside. It gets your body out of the privacy of your house and your mind off the sex (sometimes... ymmv).

As for vibrators. They really didn't help - I mean, sex is sex is sex and whether one is masturbating with a vibrator or elsewise. When hypersexed it's not about HOW it's about gimme gimme gimme more. I had a friend who, in hypomanic to manic episode became so obsessed with vibrators she spent over $1,000 on them in one week. So, there's that. That was my experience anyway - again, ymmv.

So, my suggestion? Call your doc right now. If you see any other signs manifest (impulsive spending, speeding thoughts, etc, you know the drill - hopefully) run, don't walk, to the nearest ER and get the help you need.
posted by patheral at 1:09 PM on May 21, 2011 [11 favorites]

Please, while all the sexy answers about getting a vibrator is fine I suppose, the issue here is not how to get you off. You need to let your doctor know what's going on ASAP. This appears, from here, to be a serious manic phase with very strong obsessions, compulsions, with great (and potentially harmful) impulsivity. In other words, the long question about how to control your sexual yearnings is a symptom itself. IANYD - this is my opinion.
posted by Gerard Sorme at 1:10 PM on May 21, 2011 [7 favorites]

Mod note: From the OP:

Thanks for the suggestions so far; I'm looking at CBT stuff now. I am in my early 30s and female. I am of the opinion that the vibrator issue is a problem because I went more than 20 years knowing about sex and never once even considered getting one, until I started obsessing about them right after taking a drug with known hypersexuality-related side effects. I asked family today if I seem to be hypomanic and the verdict was "kind of, but not nearly as bad as you are off of meds." And, just to be clear, the sleeping thing was about three months ago on a different set of medications altogether. I'm getting a consistent 5.5-6.5 hours a night. I have been overspending a little, but within budget - just more than I had been in recent weeks. Again, thanks all!

posted by jessamyn (staff) at 7:03 PM on May 21, 2011

My advice is still to talk to your doctor as soon as possible... I rationalized overspending when I was hypo as well. With a budget, without a budget, it's still a red flag. Add that to seven hours of masturbating, and being 'kinda' hypomanic... I'm sorry, you need to talk to the doc.

I'm not trying to stress you out, but even if you're not bouncing off of the walls manic, hypomania is something to be aware of (and talking yourself out of the fact that you *might* be hypomanic is something we're good at because, doesn't it feel great?).

Please, call your doctor. Tell your doctor what you've told us, including the hypersexuality, what your family said, and the spending - even if you think it's not important. One phone call won't hurt. The most your doctor will do is confirm or deny anything is wrong.
posted by patheral at 7:18 PM on May 21, 2011 [1 favorite]

Meanwhile, you can't just stop taking Wellbutrin right away,

Yes, you can. I mean, your doctor will probably tell you to go to a half-dose for a day or so and then stop, but when I stopped Wellbutrin I just stopped. No problems. I was on it for many years and took 300 mg a day split into two doses.
posted by Violet Hour at 7:20 PM on May 21, 2011

I'd advise against quitting any medication without consulting your doctor first. ESPECIALLY medications like Welbutrin which have withdrawal symptoms and ESPECIALLY if you are already going through a difficult time.

I'll repeat my former advice. Call your doctor and see what your doctor advises.
posted by patheral at 7:33 PM on May 21, 2011

This is a well known adverse side effect of Wellbutrin. Call the prescribing physician and let him or her know that this has happened. There is no reason you have to put up with this, any more than you would have to put up with an allergic rash from an antibiotic.
posted by Protocols of the Elders of Sockpuppetry at 10:55 PM on May 21, 2011 [3 favorites]

I'm a little late, but I really want to contribute to this because I have first-hand experience with Wellbutrin and hypersexual side effect symptoms. I'm posting because maybe it could offer you some perspective on your WB decision.

I am not a professional, but given what you're experiencing, it's kind of a big deal, and very reasonable grounds to stop WB in order to find a new medication. I wish I had stopped taking my medications before I had done a bunch of impulsive things.

I was on Paxil for 8 years and Wellbutrin for about 8 months, both of which caused hypersexual/hypomanic symptoms (and I'm not bipolar). My doctor said that Paxil induced hypersexuality was rare, as it usually has the opposite effect, and was generally dismissive of my concerns and symptoms. I continued the drug anyways. In hindsight, it may have been the worst idea to continue, but since its withdrawl effects were intense, I figured to keep going.

As I continued with Paxil, my hypersexual symptoms increased. And as time progressed the symptoms and my behavior escalated. Eventually I put my need for getting laid above other responsibilities, like school and even work. Then when I attempted to come off of Paxil, my doctor prescribed me Wellbutrin to aid in the weaning-off process. Within a week I had intense raging symptoms and knew it was due to the WB. I stopped it immediately and was put on Prozac to aid in the Paxil weaning. That worked with drastically better results. I'm now med-free.

For about 5 years I was in an increasingly hypersexual state, and as time progressed while on these drugs, so did the obsessive sexual compulsions. Those drugs made me act out beyond what I had ever imagined I'd do before. It began with spending hundreds on vibrators, and then progressed to serial dating/"sleeping around" after 3 years on the drug. I was really really lucky I didn't catch anything and insisted on playing safe. However I was slut-shamed by a friend and one guy whom I briefly dated (ironically he accused me of prior history between someone whom i never had any history with. that's the nature of a 'slutty' reputation, people will assume and believe anything they want about you). It's possible you may never have to deal with this since you are older than I and probably don't exist in a gossipy social group. Sleeping with a few people you aren't in a meaningful relationship with isn't the problem, it's the slut-shaming that really hurts because I feel like my peers 'know' about the old me, and it may still tint how they think of me now.

Coming off the drugs has made me realize how it was not really me. I am almost at 6 months without any anti-depressant and I feel 'normal' again. This isn't to say I am unsexual or asexual now, but that I have a healthy level of sexual desire, one that isn't obsessive or unbearable, and am able to act with conscience and without impulse. It is no longer my driving force in life. I feel a lot better in many ways.

So, in my opinion as a former anti-depressant user, I'd urge you to try another medication or quit all together! There are ways to combat ADHD without medication, like meditation. As for bipolar II, I am not an expert, but I did recently complete a 15 week group CBT therapy in which several members had bipolar II who seemed to benefit from the program (we all still meet once a month). Here is some other evidence.

PaxilProgress is a great resource for anti-depressant symptoms (of all kinds, not just Paxil) and withdrawl.
posted by GEB's fun world at 5:47 PM on May 29, 2011 [1 favorite]

*wellbutrin was for 8 days, not months
posted by GEB's fun world at 9:04 PM on May 29, 2011