How JustAnswer Works:

  • Ask an Expert
    Experts are full of valuable knowledge and are ready to help with any question. Credentials confirmed by a Fortune 500 verification firm.
  • Get a Professional Answer
    Via email, text message, or notification as you wait on our site.
    Ask follow up questions if you need to.
  • 100% Satisfaction Guarantee
    Rate the answer you receive.

Ask Selah R, M.S. LPC Your Own Question

Selah R, M.S. LPC
Selah R, M.S. LPC, Therapist
Category: Mental Health
Satisfied Customers: 582
Experience:  Licensed Professional Counselor; over 13+ yrs exp working with adults, teens, & families/couples.
3241695
Type Your Mental Health Question Here...
Selah R, M.S. LPC is online now
A new question is answered every 9 seconds

Re psych meds and anorgasmia. I have treatment-resistant

Resolved Question:

Re: psych meds and anorgasmia.

I have treatment-resistant depression, ADHD, OCD, and anorgasmia. I'm currently taking Neurontin (for anxiety), Effexor, and Wellbutrin. Several psychiatrists have wanted to add an atypical antipsychotic, but I've been afraid to do so because I already have orgasm difficulty and would hate to make it worse.

1) Which atypical antipsychotics are least likely, and which are most likely, to cause anorgasmia?

2) Based on my online research, should I ask my psychiatrist if I can discontinue Effexor, increase Wellbutrin, and add Zyprexa, Seroquel, or Clozapine?

Thank you. :)
Submitted: 4 years ago.
Category: Mental Health
Expert:  Selah R, M.S. LPC replied 4 years ago.
First of all, get your female hormones checked, they can affect your depression and your sex drive/functioning. You may need to try estrogen creams to help bring back your sexual functioning. There has also been research showing that woman with sexual difficulties on anti-depressants can have a benefit from taking Viagra. Talk to your gynecologist about these issues. The other thing to pay attention to is if your vaginal moisture had dropped (which can be a side-effect of many meds), because that can also cause less pleasure and less ability to orgasm.

After ruling out the hormonal side of things, then it's time to tackle the medications. You could try decreasing the Effexor to see if that makes a difference. I don't know if your going to do as well on only Wellbutrin (which acts mostly on norepinephrine) versus Wellbutrin plus Effexor (which works on both serotonin and norepinephrine). But it's worth a shot if the sexual side effects are that bothersome. Hopefully by adding an atypical antipsychotic to act as a mood stablizer will help you decrease the need of the Effexor too. Just know ahead of time that the sexual side effects can take time to correct itself after stopping a medication (partly because the medication still takes another 2 weeks or so just to finally totally leave your body).

Any of the three you mentioned have been shown to be in the "less sexual side-effects" category according to research. But, since every body is different, you may have to try them to really know if any work for you while still allowing you to have minimal sexual side-effects. Your best bet would probably be to try to find a combo of antidepressant and mood stabilizer/antipsychotic that allows you to get the best results on the lowest amount of the substance (rather than trying to find a way to move to a high dose of just one medicine).

Best wishes,
Selah
Selah R, M.S. LPC, Therapist
Category: Mental Health
Satisfied Customers: 582
Experience: Licensed Professional Counselor; over 13+ yrs exp working with adults, teens, & families/couples.
Selah R, M.S. LPC and other Mental Health Specialists are ready to help you

JustAnswer in the News:

 
 
 
Ask-a-doc Web sites: If you've got a quick question, you can try to get an answer from sites that say they have various specialists on hand to give quick answers... Justanswer.com.
JustAnswer.com...has seen a spike since October in legal questions from readers about layoffs, unemployment and severance.
Web sites like justanswer.com/legal
...leave nothing to chance.
Traffic on JustAnswer rose 14 percent...and had nearly 400,000 page views in 30 days...inquiries related to stress, high blood pressure, drinking and heart pain jumped 33 percent.
Tory Johnson, GMA Workplace Contributor, discusses work-from-home jobs, such as JustAnswer in which verified Experts answer people’s questions.
I will tell you that...the things you have to go through to be an Expert are quite rigorous.
 
 
 

What Customers are Saying:

 
 
 
  • I can go as far as to say it could have resulted in saving my sons life and our entire family now knows what bipolar is and how to assist and understand my most wonderful son, brother and friend to all who loves him dearly. Thank you very much Corrie Moll Pretoria, South Africa
< Last | Next >
  • I can go as far as to say it could have resulted in saving my sons life and our entire family now knows what bipolar is and how to assist and understand my most wonderful son, brother and friend to all who loves him dearly. Thank you very much Corrie Moll Pretoria, South Africa
  • I thank-you so much! It really helped to have this information and confirmation. We will watch her carefully and get her in for the examination and US right away if things do not improve. God bless you as well! Claudia Albuquerque, NM
  • Outstanding response time less than 6 minutes. Answered the question professionally and with a great deal of compassion. Kevin Beaverton, OR
  • Suggested diagnosis was what I hoped and will take this info to my doctor's appointment next week.
    I feel better already! Thank you.
    Elanor Tracy, CA
  • Thank you to the Physician who answered my question today. The answer was far more informative than what I got from the Physicians I saw in person for my problem. Julie Lockesburg, AR
  • You have been more help than you know. I seriously don't know what my sisters situation would be today if you had not gone above and beyond just answering my questions. John and Stefanie Tucson, AZ
  • I have been dealing with an extremely serious health crisis for over three years, and one your physicians asked me more questions, gave me more answers and encouragement than a dozen different doctors who have been treating me!! Janet V Phoenix, AZ
 
 
 

Meet The Experts:

 
 
 
  • Dr. Keane

    Therapist

    Satisfied Customers:

    1262
    Clinical Psychology PhD, Licensed Professional Counselor with experience in marriage/family, teens and child psychology.
< Last | Next >
  • http://ww2.justanswer.com/uploads/DR/Dr.Keane/2013-8-20_204325_drkeane.64x64.jpg Dr. Keane's Avatar

    Dr. Keane

    Therapist

    Satisfied Customers:

    1262
    Clinical Psychology PhD, Licensed Professional Counselor with experience in marriage/family, teens and child psychology.
  • http://ww2.justanswer.com/uploads/RE/resolutions66/2011-1-17_05728_IMG8202smilingeditedforJustAnswer.64x64.jpg Elliott, LPCC, NCC's Avatar

    Elliott, LPCC, NCC

    Psychotherapist

    Satisfied Customers:

    5024
    35 years of experience as a Licensed Professional Clinical Counselor, National Certified Counselor and a college professor.
  • http://ww2.justanswer.com/uploads/formybunch/2010-12-06_191055_img_0975.jpg Kate McCoy, M.Ed, NBCC, LPC's Avatar

    Kate McCoy, M.Ed, NBCC, LPC

    Therapist

    Satisfied Customers:

    3733
    Over 20 years experience specializing in anxiety, depression, drug and alcohol, and relationship issues.
  • http://ww2.justanswer.com/uploads/DR/DrAkiraOlsen/2012-2-20_746_AkiraADpicmain.64x64.jpg Dr. Olsen's Avatar

    Dr. Olsen

    Psychologist

    Satisfied Customers:

    2336
    PsyD Psychologist
  • http://ww2.justanswer.com/uploads/norriem/2009-5-27_134249_nm.jpg Norman M.'s Avatar

    Norman M.

    Psychotherapist

    Satisfied Customers:

    2193
    UK trained in hypnotherapy, counselling and psychotherapy and have been in private practice. ADHP(NC), DEHP(NC), UKCP Registered and ECP.
  • http://ww2.justanswer.com/uploads/PsychologyProf/2010-07-15_171248_logos060400409.jpg Dr. Michael's Avatar

    Dr. Michael

    Psychologist

    Satisfied Customers:

    2177
    Licensed Ph.D. Clinical Health Psychology with 30 years of experience in private practive and as a clinical psychology university professor.
  • http://ww2.justanswer.com/uploads/KURTEMMERLING/2010-07-23_215531_just_ask_picture1.jpg Steven Olsen's Avatar

    Steven Olsen

    Therapist

    Satisfied Customers:

    1727
    More than twenty years of expertise in counseling, psychological diagnosis and education