What's happened to my sexual response?

February 1, 2008 6:26 AM

My physical sexual response has suddenly vanished. I'm feeling the same emotionally, and "the captain stands at attention" in the morning, so I'm not entirely sure whats going on. This hit suddenly about a week ago. I've already made a Dr's appointment about this, but I won't be able to get in for a while. Is this likely something physical? Relevant details below.

I've been on Wellbutrin for about 6 months now. I recently (2-3 weeks ago) switched to the generic budeprion. Other than that, I take a generic claritin and the 150mg ranatadine. I've heard some scare stories about the generic budeprion, but I wasn't like this even before the wellbutrin - I've always been rather, well, "firm." There's never been a problem like this before.

As far as any other substances, I am not a heavy drinker, but I will have 1-2 drinks from time to time. I am otherwise substance free.

I'm male, and in my late 20's, so I find it hard to believe this could be an age related thing - and the idea of having to take another pill is not one I relish.

I'm in a very healthy relationship in which we have been very sexually active until this started happening. This is the most active sexual relationship I've ever had - 1-2 times a day was the norm until fairly recently. We haven't really had any issues that haven't been dealt with and resolved in a healthy fashion. Everything is just peachy there, aside from my "problem."

I'm on wellbutrin for "severe depressive disorder" but I think it's more of SAD, and I'm wondering if the weather might be affecting me... It's been pretty dreary here, but I think the GF has a hard time believing that the weather could impact me like so.

posted by MysticMCJ to health & fitness (32 comments total)

Oh, and I forgot to add, I can't even coax a response out of myself, which is something else that has never happened.
posted by MysticMCJ at 6:36 AM on February 1, 2008

My first advice would be to take a break for a few days, stop trying too hard, and stop thinking about this. Nothing prevents an erection more than being worried about an erection.. that is one very vicious cycle!

And, since the only medication change was the budeprion, you might want to consider a switch to see if that makes a difference..

IANAD, but I have a lot more years of experience, there's probably not a guy out there that hasn't experienced this once in a while....

I suspect all will be well...
posted by HuronBob at 6:37 AM on February 1, 2008

it's very likely psychological. Are you with someone new? Have you changed something recently? It happens to guys and can be depressing and kind of destroying, but it can be gotten over just as quickly. Don't stress too much about this.
posted by parmanparman at 7:08 AM on February 1, 2008

The same thing happened to me when I went on Prozac. It's common for anti-depressants to cause a serious change in sexual performance. Talk to you doctor. It may take awhile to find the right medicine for you.
posted by bryanzera at 7:15 AM on February 1, 2008

One of wellbutrin's most commonly reported side effects is sexual dysfunction. You can ask your doctor to switch you to one of the SSI's that don't have that as much. The fact that you've been on it for 6 months without any sexual problems doesn't mean it's not the wellbutrin (or the opposite, of course)
posted by bluejayk at 7:15 AM on February 1, 2008

I took wellbutrin to quit smoking and the same thing happened to me.

My very active and very happy relationship hit a major brick wall too.
posted by Pollomacho at 7:23 AM on February 1, 2008

I was under the impression that wellbutrin didn't have those same effects -- and it actually resolved another type of dysfunction, the one of delayed (as in not happening at all) orgasm...

Pollo - Was this recent?
posted by MysticMCJ at 8:41 AM on February 1, 2008

With all due respect to those above who have suggested otherwise, I sincerely doubt that this is psychological, although of course you should see a psychiatrist, and it's good that you're going to. The switch to Budeprion is very suspect, as you probably know. The odd thing, of course, is that Budeprion is supposed to have the opposite effect; in fact, it's generally used by doctors to replace Wellbutrin to treat sexual dysfunction; it's even used some for people who've never taken Wellbutrin to encourage the healing of sexual dysfunction.

You're a little unclear as to what your current medications are, though. You say "I've been on Wellbutrin for about 6 months now. I recently (2-3 weeks ago) switched to the generic budeprion." However, at the end, you say "I'm on wellbutrin for 'severe depressive disorder' but I think it's more of SAD;" are you still on Wellbutrin or not? I assumed your doctor replaced the Wellbutrin with the Budeprion. Did he? If so, why? Finally, if you aren't taking Wellbutrin anymore, and if you were just fine as far as sexual function when you were, well, talk to him about whether you perhaps should go back to taking it.

I take an SSRI (Zoloft) so I know that there are certainly some interesting sexual effects. My dose is low enough to not impact me too much, but I can tell when I've forgotten to take it. This is certainly something that a drug could do.
posted by koeselitz at 8:49 AM on February 1, 2008

The wellbutrin was provided by the ins/pharma as a generic for wellbutrin - It's all buproprion, so in theory, an extended release buproprion should work the same, generic or not, right? If it's not functionally the same as wellbutrin, I've been severely misled.

I'm OK with that option, because I'm on a high-deductible plan that doesn't do much for my medication prices... I can get 3 months for $180 of the generic, and I just can't budget the name brand right now.
posted by MysticMCJ at 9:13 AM on February 1, 2008

err, i meant the budeprion was provided in place of the wellbutrin as a generic equiv.
posted by MysticMCJ at 9:14 AM on February 1, 2008

Sorry, I was getting some things confused. There have been some tests that have indicated that Budeprion and other generic Bupropions sometimes work differently from Wellbutrin, although the FDA says that it hasn't seen anything conclusive and that it's doing testing right now that it can't comment on yet. Also, there seems to be some confusion in the labelling of slow-release and extended-release generic forms; Wikipedia says:

Brand-name and generic bupropion tablets are available in three forms, each as the hydrochloride salt: immediate release (Wellbutrin), sustained release (Wellbutrin SR), and extended release (Wellbutrin XL or XR). "Sustained release" and "extended release" are generally interchangeable terms, but in this case Wellbutrin SR is intended for twice-daily dosing and Wellbutrin XL is intended for once-daily dosing. Not all generics have retained this naming scheme, and the United States Pharmacopeia requires all prolonged-release drug formulations (including generics for Wellbutrin SR) to be labeled "extended release", which has caused confusion and medication errors.

...so I don't know if there's some strangeness there.
posted by koeselitz at 9:23 AM on February 1, 2008

That terrifies me... Wellbutrin was strongly recommended because of family history and I cannot afford to take the non-generic form, since I have to pay for it in full.
posted by MysticMCJ at 9:28 AM on February 1, 2008

Yes, it should work the same, and sexual dysfunction is *not* a normal or commonly reported side effect of Wellbutrin or generic WB (don't know where bluejayk got that from). Other posters who are saying this is precisely not the case for Wellbutrin are right -- that's a major reason it's used in place of SSRIs. You might have developed a very unusual reaction but if so, it was very unlikely that it was the change to generic W (did you notice any effects 6 months ago when you started? Did you switch recently from standard to extended release formula or vice versa?).

And listen to the backstory a little. You have been diagnosed with "severe" depression, yet you think it's seasonal affective disorder, the symptoms of which do not usually approach "severe" at all. And presumably you were so diagnosed 6 months ago, when you started the Welbutrin, when it was not yet winter -- in fact, it was "August," so you reported depression symptoms to a clinician in the height of the summer. Has the Wellbutrin helped with that yet?

The odd coincidence of having just switched to a generic version of the drug is enticing, but as doctors do say, when you hear hoofbeats, think horses and not zebras. Depression is a very common cause of sexual dysfunction. Very. It's one of the most common symptoms, in fact. Your medication is not. You are depressed. The odds are that's what's going on here.

/ not a (medical) doctor and this is not medical advice etc.
posted by fourcheesemac at 9:32 AM on February 1, 2008

By the way, I wanted to add:

bryanzera: The same thing happened to me when I went on Prozac. It's common for anti-depressants to cause a serious change in sexual performance.

bluejayk: One of wellbutrin's most commonly reported side effects is sexual dysfunction. You can ask your doctor to switch you to one of the SSI's that don't have that as much.

Pollomacho: I took wellbutrin to quit smoking and the same thing happened to me. My very active and very happy relationship hit a major brick wall too.

First of all, bluejayk is precisely wrong. Bupropion, Wellbutrin, is not an SSRI. Furthermore, it's not generally found to inhibit sexual performance. See here:

These findings support that bupropion does not have subjective adverse sexual side effects and does not affect nocturnal erections in healthy men.

In fact, see here:

The purpose of this study was to examine prescribing practices regarding the management of SSRI-associated side effects in a sample of psychiatrists attending a psychopharmacology review course... As a treatment for SSRI-induced sexual dysfunction, 43% (143/330) chose adding bupropion...

In short, Wellbutrin is often used by psychiatrists to curb sexual dysfunction.

But that doesn't mean that Pollomacho didn't experience what he says he did, or that Wellbutrin or Budeprion isn't giving you this effect. This stuff has different effects for different people. It's very hard to know except by careful experimentation with the help of a psychiatrist.
posted by koeselitz at 9:39 AM on February 1, 2008

It helped almost immediately during the summer... I found my mood where it should be, and all sexual dysfunction went away. It's only been a really recent shift... I've been doing great until then, I've felt like "my old self" again.

I was hesitant to ever try wellbutrin -- It was the family history and use that ultimately convinced me, along with going to therapy for some time.


These negative effects do happen to coincide perfectly with the switch to the generic, which is enticing indeed. Hrm. I'm generally one to think that complaints of generics not working on the internet are a overly vocal minority, but this seems to have some legitimate press behind it.
posted by MysticMCJ at 9:42 AM on February 1, 2008

Hold on a moment . .. Mystic, when you say "all dysfunction went away" when you went on the WB in the first place, that suggests you were having problems *before* the WB, related perhaps to the depression (almost self evidently, given the statistical facts).

It would indeed be a most elegant explanation -- given that the WB XL can take a couple of weeks to kick in and I think as long to "wear off" -- if you were given a counterfeit or otherwise ineffective drug as a "generic." I would immediately take this up with your doctor and have her/him take it up with the pharmacist, who should immediately exchange the pills (though it might be best to get the non-generic again and see what that does, or to switch to another pharmacy for a generic). The facts line up neatly with the proposition that the pills you are now taking are inert or weak (have you checked their expiration date? Are you sure it's the same dosage? Check these things first).

It could also be that you have seasonal effects on top of a baseline no-seasonal depressive condition, and they are kicking in hard now that the weather is bad. Maybe adjusting the dose of WB up (from 150 to 300mg daily would be the normal jump, unless you are now at 300?) will work for you.
posted by fourcheesemac at 9:52 AM on February 1, 2008 [1 favorite]

I definitely think it is the switch to the generic. We've had another discussion recently about generic meds and the dangers that can come from them sometimes.

I have a question that may help you. You say your insurance will pay for the generic but not the Rx Wellbutrin, which is more expensive. Are you sure there aren't any exceptions? For example, is this the case if the doctor checks "no generic," or indicates you have an allergy or specific problem which excludes the generic? I have allergies to penicillin and sulfa, which make me a pain to diagnose for sometimes, and so the doctor HAS to prescribe something else. I think if you talk with your doctor and explain the physical problems you are having, he may be able to handle the situation with the insurance for you. It wouldn't hurt to ask.
posted by misha at 9:53 AM on February 1, 2008

no-seasonal=non-seasonal.
posted by fourcheesemac at 9:53 AM on February 1, 2008

To be blunt, the earlier dysfunction was not one of firmness, it was one of not being able to finish. I was amazed when that was resolved.

Anyways, the dosage is the same - I was at 300Mg XL of the brand, and the generic is 300Mg as well - XL, one a day for both.


I think I might push to get back on the brand, for at least a month, just to see what happens. If this has any legitimacy behind it - well, that's really scary.


The seasonal effects were one of my theories- I could be stepped up to 450MG, but I don't like the idea of pushing that much through my system. It may be the answer, though - I'll leave that one to discuss with the Psych.
posted by MysticMCJ at 9:58 AM on February 1, 2008

I'd be interested in reading that earlier discussion.

I have a high deductible plan... I pay full price for all meds until I hit $2000.
posted by MysticMCJ at 9:59 AM on February 1, 2008

MysticMJC: That terrifies me... Wellbutrin was strongly recommended because of family history and I cannot afford to take the non-generic form, since I have to pay for it in full.

Well, there are several different generic forms of Wellbutrin.

fourcheesemac: And listen to the backstory a little. You have been diagnosed with "severe" depression, yet you think it's seasonal affective disorder, the symptoms of which do not usually approach "severe" at all. And presumably you were so diagnosed 6 months ago, when you started the Welbutrin, when it was not yet winter -- in fact, it was "August," so you reported depression symptoms to a clinician in the height of the summer. Has the Wellbutrin helped with that yet?

The odd coincidence of having just switched to a generic version of the drug is enticing, but as doctors do say, when you hear hoofbeats, think horses and not zebras. Depression is a very common cause of sexual dysfunction. Very. It's one of the most common symptoms, in fact. Your medication is not. You are depressed. The odds are that's what's going on here.

fourcheesemac makes some very good points here. You should consider the depression as a possible cause, and I want to retract my earlier statement: this may well be psychological. Self-diagnosing as SAD seems odd, and fourcheesemac is right, it seems to me that it would be very, very hard to mistakenly diagnose someone as having SDD when they've got SAD.

Here's what I think: in a case of severe depressive disorder, you probably should be seeing a psychiatrist at least a bit. I'm no expert myself, and digging leads me to understand that, apparently, with milder or uncomplicated cases of depression, drugs alone are preferred. However, you say you were diagnosed as severe, and you don't seem to really believe that very much. What's more, I wouldn't want to stay on a particular drug without seeing my psychiatrist at least every two months. fourcheesemac is right: you have to ask yourself where you've gone with that, and whether the drug is helping.

I have a feeling you don't go to a psychiatrist as frequently precisely because it costs a lot. There are cheap ways to find psychiatric care; I think maybe you should pursue those a bit.
posted by koeselitz at 10:00 AM on February 1, 2008

Oh, I go to a psych on a regular basis - Monthly. I can pay for that, it's not so bad at all. I just recently started to question how severe the depression was, since the last visit...

All of this craziness has happened over the past week or two.
posted by MysticMCJ at 10:15 AM on February 1, 2008

When I was in high school I quit taking meds after being prescribed three different antidepressants. Mostly because I stopped being able to sustain a normal erection, or sometimes even get it up.

And when I graduated and made some changes of direction with my life, I got happy.

Maybe consider that. I don't know how realistic it is for your situation, but it worked for me, and I can get boners.
posted by crunch buttsteak at 10:51 AM on February 1, 2008

I don't know how Wellbutrin works so I may be completely wrong, but maybe you just need to talk to your doctor about increasing your dosage? I've been on meds that I needed to increase after my body adjusted during the initial "settling-in" period.
posted by doubtful_guest at 11:36 AM on February 1, 2008

It's important to remember that the common advice around ALL of the anti-depressants is "keep trying until you find one that works".

While the drugs are relatively safe, they are absolutely notorious for having unpredictable side effect profiles. The side effects can be polar opposites even among direct blood relatives.

That said, the budeprion is the obvious culprit here, and you could quickly prove it by moving back to the brand name for a month. With that information behind you, you may very well be able to make a case to the insurance company that the generic doesn't work for you and that you'll need the brand.
posted by tkolar at 12:42 PM on February 1, 2008 [1 favorite]

Is it the Zantac you're taking? It seems to have a little of that effect on me, and 150 mg is a lot.

(Isn't it spelled bupropion?)
posted by gjc at 5:40 PM on February 1, 2008

tkolar, i think you overstate the unpredictability with respect to this side effect and this drug (and gjc is right about the spelling), which has been discussed at some length above. I think what's emerged is that there is no "obvious culprit" here. Anyway, here's the list of known significant side effects for bupropion. People don't usually experience side effects that have virtually never been reported in trials, and this drug has been around for a long while.

Flatulence, yeah. Sexual dysfunction secondary to flatulence, perhaps.

But if there is a relationship to the change to a generic, it is still likely to be mediated through the return of the depressive symptoms the Wellbutrin was successfully controlling, not directly caused by some different compound in the generic inducing a hitherto unknown side effect.


WELLBUTRIN (bupropion) is not for everyone. There is a risk of seizure with WELLBUTRIN which increases with higher doses. Taking more than 450 mg/day increases the chance of serious side effects. Don't use it if you've had a seizure or eating disorder, or if you abruptly stop using alcohol or sedatives. Don't take with MAOIs, or medicines that contain bupropion. When used with a nicotine patch or alone, there is a risk of increased blood pressure, sometimes severe. To reduce risk of serious side effects, tell your doctor if you have liver or kidney problems. Other side effects may include weight loss, dry mouth, nausea, difficulty sleeping, dizziness, sore throat, constipation, or flatulence.
posted by fourcheesemac at 7:06 PM on February 1, 2008

i'm on wellbutrin and I definitely have sexual side effects. They are not crippling, and I take Viagra to compensate. It's simply not true that sexual side effects don't happen with Welbutrin, they are just less common than with other Anti-Ds .

Its not necessarily the switch to generic. Psych meds sometimes work one way for a while and then suddenly switch.

Here's a study from http://depression.about.com/cs/sexualdysfunction/a/bedroomblues.htm



Wellbutrin, the brand name of bupropion, had the lowest overall rate of sexual dysfunction. It was associated with a rate of 22% of the overall population. The sustained release formulation fared almost as well with a rate of 25%. In contrast, the SSRIs (Prozac, Paxil, Zoloft and Celexa), venlafaxine (Effexor) and mirtazapine (Remeron) averaged about 40%. When subjects were removed who had other probable causes of sexual dysfunction, the results were even better. Wellbutrin's rate dropped to 7% with the other medications dropping to between 23-30%.

In other words, your odds are much better with Welbutrin than the SSRIs, but you've still got a reasonable chance of getting them.
posted by TigerCrane at 8:41 PM on February 1, 2008

7% (in a single study) is not a "reasonable chance," since there are "other probable causes" here. But it is pointless to debate something that is a question of fact and subject to empirical confirmation -- as the OP should certainly be seeking.

Because if you've been on a drug for six months without the side effect showing up, the odds that it will suddenly develop surely drop to negligible numbers, especially if they are starting at 7 percent probability.
posted by fourcheesemac at 8:47 PM on February 1, 2008

Crazy Meds is an excellent site to research anti-depressants: There's a thread on Budeprion 300 XL not working.

MSNBC looked into it.

As did NPR.
posted by Skygazer at 9:37 PM on February 1, 2008

Pollo - Was this recent?

Sorry for the late reply, it was actually about 10 years ago. I got better after coming off the meds.
posted by Pollomacho at 7:42 PM on February 2, 2008

Thanks for all of the answers.

I got off the meds, and all of my porblems went away, and ironically enough, I'm happier.
posted by MysticMCJ at 7:51 AM on February 13, 2008