SSRIs for anxiety which do NOT significantly affect libido?
July 3, 2019 6:54 AM Subscribe
I used to be on Lexapro; the med was great for my social/generalized anxiety but killed my sex drive, so I ended up getting off it. I recently started taking it again due to an anxiety flare-up, and my libido is now almost nonexistent after only ~ 1 week. But SSRIs seem to be the only type of antidepressant which manages to effectively control my anxiety. For those who had libido issues on Lexapro (or Zoloft), did you manage to find an SSRI which combated the anxiety while leaving your libido relatively intact? If so, which one?
Prior to taking Lexapro, I was (and still am) on a cocktail of 150mg Lamictal and 150mg Wellbutrin. These meds kept me from falling into a more severe depression, but don't really seem to do anything to address my generalized/social anxiety, which I believe to be my primarily mental health issue. I was hoping to wean off the Lamictal if the Lexapro worked out since I feel that med sort of "deadens" my moods, but it looks like this won't be happening for the moment.
I must be really sensitive to the Lexapro medication since even the starter dose of 5mg is having a *significant* positive effect on my anxiety, to the point where I actually feel like socializing again (which is great!). But the libido thing is still a dealbreaker for me; my psych doc wanted me to move up to 10mg of Lexapro in a couple of days but I most definitely won't be doing that. I plan on staying on the med for the anxiety benefits in the meantime, but am looking to transition to an effective alternative ASAP.
Also, I've sent my psych doc messages in the past asking about making med changes and he invariably replies with some variation of "we'll discuss this during our next appointment," which is in... almost three months. I get he's overworked and that I have crappy insurance but still :/
So for those who had libido issues on Lexapro (or Zoloft which I also tried in the past and had issues with), did you manage to find an SSRI which combated the anxiety while leaving your libido relatively intact? And if so, which one?
PS: I would be open to trying anxiety meds which are unrelated to SSRIS, but am not interested in trying benzos like Xanax, Ativan, etc. due to various reasons which I won't get into here. Also, while I understand that Wellbutrin can raise anxiety in some people I haven't noticed much of an increase in anxiety compared to before I was on the med.
Prior to taking Lexapro, I was (and still am) on a cocktail of 150mg Lamictal and 150mg Wellbutrin. These meds kept me from falling into a more severe depression, but don't really seem to do anything to address my generalized/social anxiety, which I believe to be my primarily mental health issue. I was hoping to wean off the Lamictal if the Lexapro worked out since I feel that med sort of "deadens" my moods, but it looks like this won't be happening for the moment.
I must be really sensitive to the Lexapro medication since even the starter dose of 5mg is having a *significant* positive effect on my anxiety, to the point where I actually feel like socializing again (which is great!). But the libido thing is still a dealbreaker for me; my psych doc wanted me to move up to 10mg of Lexapro in a couple of days but I most definitely won't be doing that. I plan on staying on the med for the anxiety benefits in the meantime, but am looking to transition to an effective alternative ASAP.
Also, I've sent my psych doc messages in the past asking about making med changes and he invariably replies with some variation of "we'll discuss this during our next appointment," which is in... almost three months. I get he's overworked and that I have crappy insurance but still :/
So for those who had libido issues on Lexapro (or Zoloft which I also tried in the past and had issues with), did you manage to find an SSRI which combated the anxiety while leaving your libido relatively intact? And if so, which one?
PS: I would be open to trying anxiety meds which are unrelated to SSRIS, but am not interested in trying benzos like Xanax, Ativan, etc. due to various reasons which I won't get into here. Also, while I understand that Wellbutrin can raise anxiety in some people I haven't noticed much of an increase in anxiety compared to before I was on the med.
I'm on 20mg of Celexa / citalopram generic, and while steady-state libido is somewhat lower and it's a bit harder to achieve orgasm, my sex life is still fine. However it is fantastic for GAD & social anxiety and mild depression. A low dose of it (as noted by disaster77) might be just the ticket for you. I have extensive notes here from a previous ask.
posted by seanmpuckett at 7:31 AM on July 3, 2019
posted by seanmpuckett at 7:31 AM on July 3, 2019
I take .5 mg of Abilify for anxiety and it's a clean med for me - no real side effects. I will say that it doesn't make my anxiety GO AWAY - it gives me space from my anxiety, if that makes sense. So I'm still aware of anxiety and anxiety inducing situations, I just care less? it's been good for me. IIRC this is an off-label use for Abilify but it works for me.
posted by Medieval Maven at 7:37 AM on July 3, 2019
posted by Medieval Maven at 7:37 AM on July 3, 2019
Response by poster: Jj's mama: I am not sure why I am on the Lamictal in particular anymore now that I'm on the Wellbutrin/Lexapro, but it originally got me out of a severe depression and I had already tried the SSRIs. I was planning on dropping it assuming the Lexapro worked out (and my psychiatrist was on board with that plan). I started the Wellbutrin in the first place since I was sick of SSRIs and wanted to try something completely different. The Wellbutrin markedly improved my mood and helped with the depression side of things, so I'm thinking I want to stay on it for the time being (I think) even though it isn't really doing anything for my anxiety.
posted by CottonCandyCapers at 7:58 AM on July 3, 2019
posted by CottonCandyCapers at 7:58 AM on July 3, 2019
There is Buspar to treat anxiety. I don't have experience with it directly WRT libido. Here is a study that shows Buspar helps with SSRI induced sexual dysfunction.
posted by kathrynm at 8:33 AM on July 3, 2019 [4 favorites]
posted by kathrynm at 8:33 AM on July 3, 2019 [4 favorites]
TCAs ("tricyclics") can help treat anxiety and work via a different mechanism than SSRIs. This class of meds does not generally have libido-related side effects. In my own experience, they have not had effects on my sex drive. You might consider asking your psychiatrist about them at your next appointment.
posted by They sucked his brains out! at 8:55 AM on July 3, 2019
posted by They sucked his brains out! at 8:55 AM on July 3, 2019
I see you're aware that Wellbutrin can ramp up anxiety as a side-effect, but I think it is a good drug for me. It's one of the few ADs that doesn't affect sex drive.
I found a good CBD oil the most effective in managing anxiety.
posted by OnTheLastCastle at 9:35 AM on July 3, 2019 [1 favorite]
I found a good CBD oil the most effective in managing anxiety.
posted by OnTheLastCastle at 9:35 AM on July 3, 2019 [1 favorite]
I did not have this side effect on Celexa, but I honestly can't imagine feeling too great while dealing with the side effects of 3 different drugs. Unless your issues are very severe you might want to consider whether you are over-medicated. Personally, I found that SSRIs didn't do as much for my anxiety as CBT and regular exercise.
posted by noxperpetua at 10:49 AM on July 3, 2019
posted by noxperpetua at 10:49 AM on July 3, 2019
Hi there, how long were you on Lexapro for? It killed my libido at first and I also couldn't orgasm, but that only lasted about 6 months. Now everything is completely back to normal and I'm glad I persisted. I have no idea if this is something that often happens or for some reason it just happened to me!
posted by thereader at 12:57 PM on July 3, 2019
posted by thereader at 12:57 PM on July 3, 2019
Response by poster: noxperpetua - I may be getting hit with side effects which I'm unaware of but the libido issue is the only one I've actively noticed, so that's the only one I really care about at the moment. I agree that I am probably overmedicated - I'm planning on getting off the Lamictal once I can find a med which helps with the anxiety so the count will at least be down to two :)
thereader - I originally was on Lexapro for at least a few years; the sex drive issue persisted from the day I started until the day I took my last pill.
posted by CottonCandyCapers at 1:48 PM on July 3, 2019
thereader - I originally was on Lexapro for at least a few years; the sex drive issue persisted from the day I started until the day I took my last pill.
posted by CottonCandyCapers at 1:48 PM on July 3, 2019
I've had the same experience as thereader. All the side effects, especially the lack of libido, for about 6 months and then one day I was fine, which was such a novel experience.
posted by jenjenc at 5:29 PM on July 3, 2019
posted by jenjenc at 5:29 PM on July 3, 2019
If you’re a man, a friend who’s on Lexapro swears by tribulus terrestris as a libido restorer.
posted by sixswitch at 4:43 PM on July 4, 2019
posted by sixswitch at 4:43 PM on July 4, 2019
This thread is closed to new comments.
posted by disaster77 at 6:58 AM on July 3, 2019