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Vakul Aren
Vakul Aren, Doctor
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Experience:  MBBS,DTM&H,30 years of experience
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Hello I have been taking the anti depressant Lexam 20mg for

Resolved Question:

Hello
I have been taking the anti depressant Lexam 20mg for a few years; it has had a devastating bad impact on my sexuality although it has suppressed by depression; I have been advised that Wellbutrin is very reliable as studies have shown it not impacting the sexuality area.
Can you suggest a reduction plan going off 20mg of Lexam to taking Wellbutrin say over a 3-4week period. What equivalent of Wellbutrin would that approx be to ? mg of Wellbutrin??
With Sincere Thanks
Hope you can help
John
Submitted: 9 months ago.
Category: Medical
Expert:  Vakul Aren replied 9 months ago.

Welcome to Just Answer.I am Dr Aren and I will help you with your query.SSRI drugs like Citalopram/Lexam do cause decrease in libido due to their effect on dopamine and norepinephrine receptors.There are certain steps which can be taken to correct the situation and reduce your depression and not your desire. You may discuss lowering the dose of your drug lexam gradually to the lowest effective dose,this may reduce the libido lowering effect. Taking a drug holiday once you are stable(as appears to be in your case) may help,this is especially effective in Sertaline and Paroxetine where taking 2 days off a week is possible. Addition of another drug like Bupropion/Wellbutrin,Buspirone,Cyproheptadine,Yohimbine,Pemoline may help reduce the loss of libido. Taking a drug like Viagra/Sidenafil in addition to the SSRI may solve the problem of erectile dysfunction which may be causing loss of libido. Lastly changing antidepressants to Nefazodone/Serzone or Bupropion/Wellbutrin under the supervision of your doctor may be needed.Since the drug Welbutrin is not a SSRI,it will need to be gradually introduced while the Lexam is gradually withdrawn.Wellbutrin may increase the libido ,thus may be more effective as far as sexual side effects go.

Vakul Aren, Doctor
Category: Medical
Satisfied Customers: 3367
Experience: MBBS,DTM&H,30 years of experience
Vakul Aren and 3 other Medical Specialists are ready to help you
Customer: replied 9 months ago.

Thanks can you give me an approximate schedule of reduction and introduction of Wellbutrin say over 3-4 weeks and approx mgs???


With appreciation


John

Expert:  Vakul Aren replied 9 months ago.
My apologies but as a policy matter of Just Answer,we do not prescribe or give exact doasage of medication as it is illegal to prescribe without examining the patient.This needs to be done by your doctor/Psychiatrist ,this changeover should only be performed under the guidance of a Physician/psychiatrist.
Customer: replied 9 months ago.

HI i don't want exact dosage or prescription exactness. All I'm simply asking what would be a generally acceptable transition period from 20mg Lexam to an equivalent dose of Wellbutrin. You have not addressed this and this is what I wish to know in a general way. Therefore, my question remains unanswered!!!!!!!


With Thanks anyway

Expert:  Vakul Aren replied 9 months ago.

You can try reducing your dose of Lexam to 15 mgms for about 10-14 days,then shift to the next lower dose of 10 mgms .Some doctors do this at 5-7 day intervals..Use of benzodiazepines like clonazepam may help any anxiety which may surface,addition of 150 mgms Wellbutrin/Bupropion may be considered by your doctor as an option insterad of benzodiazepines..Gradual further reduction of Lexam and increase of Wellbutrin may take place till you are controlled on the lowest possible dose of Wellbutrin.A drug taper and a cross switch may be put in place within a bout a month to two months.This may take place within a span of 4-8 weeks,the control of the dosages is to be made by your Physician depending on the situation.

Customer: replied 9 months ago.

Excellent! Thanks for this! I'm happy to have


your professional opinion that I can now show and


discuss with my GP


Once again thanks!!


Kind Wishes


John

Customer: replied 9 months ago.

Excellent! Thanks for this! I'm happy to have

your professional opinion that I can now show and

discuss with my GP

Once again thanks!!

Kind Wishes

John







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