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Elliott, LPCC, NCC
Elliott, LPCC, NCC, Psychotherapist
Category: Mental Health
Satisfied Customers: 7662
Experience:  35 years of experience as a Licensed Professional Clinical Counselor, National Certified Counselor and a college professor.
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I am a recovering sex addict. I have been sober for 3 years.

Customer Question

I am a recovering sex addict. I have been sober for 3 years. My Psychiatrist has me on 60 mg of Prozac and 150mg of Bupropion to offset the sexual disfunction of Prozac. However, I have found that the Bupropion does not totally offset the sexual disfunction effects of Prozac. When I am intimate with my wife I can only achieve an orgasm 50% of the time. And when I cannot achieve an orgasm I get into this viscious cycle of being "triggered."

Thus I am very frustrated and really on edge right now.
Submitted: 1 year ago.
Category: Mental Health
Expert:  Elliott, LPCC, NCC replied 1 year ago.

Elliott, LPCC, NCC :

Seeking expert counseling is a sign of strength. A personal relationship with a caring professional is proven clinically effective.

Elliott, LPCC, NCC :

Dear friend,

Elliott, LPCC, NCC :

I believe that I can help you.

Elliott, LPCC, NCC :

According to my professional sources, (pharmacy books), and www.drugs.com, Prozac and bupropion should not be used together.

Elliott, LPCC, NCC :

These two drugs in combination may increase the risk of seizures (which may occur rarely with either of these drugs, but combining them increases the risk).

Elliott, LPCC, NCC :

Furthermore,

Elliott, LPCC, NCC :

taking bupropion with Prozac can increase the blood levels of the Prozac, thereby enhancing the side effectsl.

Elliott, LPCC, NCC :

There is no need to take the Prozac as well.

Elliott, LPCC, NCC :

Ask your physician to wean you off of the Prozac. It is the easiest of all of the SSRIs to wean off of because it has a long half-life, among other reasons.

Elliott, LPCC, NCC :

Do not do this yourself.

Customer:

I have read where Prozac and Bupropion are the standard protocol for Sexual Addiction?

Elliott, LPCC, NCC :

This may very well end your side effects, perhaps after several weeks.

Elliott, LPCC, NCC :

They still have this potential reaction with each other and if it is causing negative side effects, then you should take this into consideration.

Elliott, LPCC, NCC :

Let me show you this website:

Elliott, LPCC, NCC :

Remember that the generic name for Prozac is fluoxetine.

Elliott, LPCC, NCC :

http://www.drugs.com/interactions-check.php?drug_list=440-0,1115-648

Elliott, LPCC, NCC :

A quick search did not show such a standard protocol for bupropion and Prozac (fluoxetine).

Elliott, LPCC, NCC :

I have now looked through four pages of search. It is certainly not a top priority search, meaning that it is not that commonl

Elliott, LPCC, NCC :

Hello. Are you still with me?

Customer:

Yes.

Customer:

I was trying quickly to find the link.

Customer:

But, you are saying to wean myself off of fluoxetine and stay on Bupropion under a doctors supervision.

Customer:

What about Viibrid as an alternative.

Elliott, LPCC, NCC :

I am NOT saying to wean yourself but to ask your doctor to wean you. I must use that language. There is no reason to stay on the two drugs when they interact negatively.

Elliott, LPCC, NCC :

As for the Viibryd:

Elliott, LPCC, NCC :

You will have the same problem: increased risk of seizures.

Elliott, LPCC, NCC :

Combining antidepressants are usually not indicated.

Customer:

Elliot, understood. I realize that any change in protocol needs to be done with a clinician's supervision.

Elliott, LPCC, NCC :

I know you do. I have to stay legal and not give you prescriptive advice.

Elliott, LPCC, NCC :

Taking bupropion with almost any other antidepressants will increase the risk of seizures.

Elliott, LPCC, NCC :

There is no reason to have more than one drug.

Elliott, LPCC, NCC :

Bupropion is one of the least innocuous antidepressants/antianxiety drugs on the market, and it very effective in most cases.

Elliott, LPCC, NCC :

The fact that you are getting sexual side effects is reason enough, as a first step, to cut out the Prozac, aside from the increased risks.

Customer:

My main goal is to achieve some relief from sexual compulsivity while at the same time having some semblance of normal sexual expression.

Elliott, LPCC, NCC :

How does your sexual compulsiveness manifest itself?

Customer:

Well, lately it is triggered by the inability to have an orgasm. So, I get into this obsessive loop of wanting to have an orgasm and that puts me on the trail of wanting to act out a la massage parlors and/or prostitutes

Elliott, LPCC, NCC :

Many treatment programs (such as sexaholics anonymous) use a 12-step program like AA, using cognitive therapy and total abstinence. I do not know enough about the effectiveness of these programs, but I wanted to comment on them.

Elliott, LPCC, NCC :

Have you tried ED medications such as Viagra, Cialis, and Levitra?

Customer:

I have been in SA for three years and have three years of sobriety.

Elliott, LPCC, NCC :

Are you currently undergoing any psychotherapy of any kind?

Customer:

Yes, My psychiratrist has prescribed Cialis and seems to help.

Elliott, LPCC, NCC :

Have you tried Exposure and Response Prevention?

Customer:

Yes, in addition to my shrink my wife and I see a counselor.

Elliott, LPCC, NCC :

That is good. You are doing as much as you can.

Elliott, LPCC, NCC :

The rest is up to you: exercising restraint, self control, and making the right choices.

Elliott, LPCC, NCC :

Perhaps getting off the Prozac and continuing to use the Cialis will be a benefit.

Customer:

We were intimate the other two nights ago, something very spontaneous and wonderful. But after an hour of bumping and grinding to no avail, she had a great time and I was left feeling uncompleted.

Elliott, LPCC, NCC :

You seem to be doing the right things

Customer:

Exposure and response prevention?

Elliott, LPCC, NCC :

That is frustrating, but it would be much worse in many ways if she was unfulfilled. We have to find the silver linings in the dark clouds.

Customer:

Elliot-

Elliott, LPCC, NCC :

Tempted by your obsessive thoughts but then prevented from carrying them out. A basic treatment for obsessive-Compulsive behavior.

Elliott, LPCC, NCC :

Yes sir?

Customer:

You are so right. I need to be greatful

Elliott, LPCC, NCC :

I am grateful to God that you said that.

Elliott, LPCC, NCC :

It sounded like a breakthrough in your thinking.

Customer:

Elliot-

Elliott, LPCC, NCC :

You will get back to normal and keep your wonderful marriage.

Customer:

Thank you, XXXXX XXXXX an intermediary for my Higher Power. He speaks to me quite often now that I am a believer again.

Customer:

I think we just had a God moment.

Elliott, LPCC, NCC :

You have just made my day too. We sure did ! ! ! !

Elliott, LPCC, NCC :

I will keep you in my prayers.

Customer:

Thanks!! You likewise.

Elliott, LPCC, NCC :

Thank YOU. :)

Elliott, LPCC, NCC, Psychotherapist
Category: Mental Health
Satisfied Customers: 7662
Experience: 35 years of experience as a Licensed Professional Clinical Counselor, National Certified Counselor and a college professor.
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