Q. I have found that Luvox has been very helpful for the OCD (Obsessive Compulsive Disorder) component of the illness, but find the sexual dysfunction side effect (it prevents orgasm, even though arousal is intense) very disturbing in the long run. It would almost be better to be on other meds I've experienced which cancel out the sex drive--actually this kind of has the same effect since extreme frustration is always the end result. I know that side effects of this nature are being recognized now; it's still pretty hard to talk about though. I also know that it is SSRI's, or the tricyclic, anafranil, which are used to treat OCD--and all have this side effect. Is there anything else at all? I desperately don't want to interfere with the improvement I feel in the OCD, but really can't tolerate that side effect any longer.
I hope I don't sound like a sex addict--that's definitely not one of my problems, and it's taken quite awhile to get to where I can't tolerate this side effect anymore. Also concerned because I'm fighting another self-injuring phase ,and recently this rather extreme frustration triggered an episode of that.
A. There are a couple of things you might wish to try after talking them over with your doctor. First, you could add on BuSpar to the Luvox. There was a double-blind, placebo controlled trial published in The Journal of Clinical Psychopharmacology (I think 12/99 issue) which reviewed this treatment and it helps. BuSpar is also very good for OCD, but not self-injury.
Second, some folks add on Wellbutrin as 150 to 300 mg/day to help with sexual dysfunction. No controlled trials that I know of, but anecdotally it seems to help.
Third, I have also had good luck with orgasms in woman using Viagra. It does not help with libido but seems to help make them orgasm more easily. There seems to be a lot of headaches in woman, however, compared to men.
Fourth, some woman with your cluster of symptoms, good libido, no orgasm, do well on yohimbine (5.4 or 10.8 mg), too.
Fifth, you could also try EffexorXR. No controlled trials, but it seems to have less sexual dysfunction than the SRIs. Interestingly with Effexor, sexual dysfunction goes down as dose goes up. This is the exact opposite of SRIs.
