[quote]Schwarzenegger wrote:
The antidepressants I’ve read that don’t have sexual side effects are bupropion, nefazodone, mirtazapine, and maprotiline. I’ve taken bupropion, though it didn’t work well for depression (it seems a lot of people report that).
The other three seem to have other odd side effects outside the realm of typical SNRI/SSRI meds, stuff like lethargy and hallucinations and stuff. Has anyone had experience with these drugs, and could possibly compare them with typical SNRI/SSRI drugs?[/quote]
Trazodone, Moclobemide, and Tianeptine also tend to lack sexual side effects and can be prosexual in some instances. I Believe Moclobemide and Tianeptine aren’t FDA approved in the USA.
I’ve taken Trazodone and Moclobemide. Both tend to be weaker antidepressants. Trazodone causes tiredness but is usually taken at bedtime, but without the hangover Mirtazapine has the next day at lower dosages.
Oddly enough, the higher in dose you get with Mirtazapine the less sedation there is. Around 45mg a day it starts to get stimulating. The adrenergic component tends to overpower the histamine blockade actions. At higher dosages both the weight gain and tiredness issues tend to be resolved. There’s less side effects the higher you get.
Unfortunately in North America Mirtazapine tends to be prescribed in lower dosages (15mg) which results in more discontinuation from patients. In Europe starting dosages tend to be around 60mg a day.
How high in dosage did you go with Wellbutrin? 300mg tends to be a low dose. Unfortunately Wellbutrin tends to be prescribed at too low of dosages due to the seizure scare when it first came out. The immediate release version had it’s problems unlike the SR, and XL versions of today. Wellbutrin SR/XL has the same seizure potential as the SSRI’s now.
If you’re looking for antidepressants that lack sexual sides, it’s best to look at drugs with the following characteristics. 5HT2a antagonists, D2 agonists, and alpha-2 adrenergic antagonists. For the most part these are the receptors that control sexual function.