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Aswad -> RE: Mental Illness (7/30/2012 11:08:14 AM)
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quote:
ORIGINAL: LadyHibiscus
If that list has the LOWEST rate of sexual side effects, my heart goes out to folks on the others!
Yeah, it's a drug war thing, i.e. the war on poor people and depressives.
The most effective antidepressants are the mood brighteners, and those have this politically unfortunate property that their efficacy is directly correlated with dosage, including beyond neutral mood. Hence, a healthy person could use a therapeutic dose of those and become euphoric without the usual downsides, and in some cases without the risk of tolerance and addiction. This, of course, complicated the drug question significantly. Instead of tackling a more difficult question (i.e. one where the conservative answer is harder to arrive at), it was decided that they should go on the narcotics list. Ironically, the drugs which are best known for their addictive properties remained due to being firmly entrenched in medical practice as the go-to drugs for certain problems. Similarly, older drugs have been retained so long as they have enough side effects.
Used to be you could get drugs like tianeptine (Survector), whose side effects include heightened libido, shortened male refractory period, and in some cases spontaneous orgasms when previously aroused, documented in both genders. By contrast, the SSRIs tend to lead to a state wherein a guy might have four hot chicks lapping at his pole until their tongues fell out without ever getting anywhere, and simultaneously not really caring since he no longer has any interest in sex anyway. The ladies, by most accounts, are no better off. Of course, tianeptine was also dramatically effective and had an onset of action measured in hours to days, not weeks to months like the more common antidepressants (whose times to onset of action are comparable to the average time to spontaneous remission).
Sometimes, the addition of cabergoline or another antiparkinsonian may help, and Wellbutrin has been used for similar reasons, as has seligiline/deprenyl. It always struck me as somewhat odd that we're fine with this. Might as well get circumcised. The upshot, of course, being that it probably keeps the STD rate down. Not much incentive to go screwing around when sex is a chore you'd prefer not to do in the first place, is there?
There are neutral and prosexual alternatives, though, but they don't suit everyone, and many pdocs have little experience with them.
And, of course, celibacy is better than depression anyway.
IWYW,
— Aswad.
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