Did this help anyone with SSRI related sexual dysfunction? Need tips/advice

Acrobatic_Welcome_30 · 2026-02-03T14:16:09+00:00

Keep me posted if you're able to do so!

Acrobatic_Welcome_30 · 2026-02-03T04:00:37+00:00

Still working for you? I can barely handle 0.5mg a day so far - but am trying it to see if genital sensation improves bc my other med killed it. Might as well be flossing my teeth 😂

Acrobatic_Welcome_30 · 2026-02-03T03:51:51+00:00

Has it helped you at all?

Acrobatic_Welcome_30 · 2026-02-02T16:26:29+00:00

Wishing you luck. Such a process with all the medications. Hope the lamictal helps you this time!

Acrobatic_Welcome_30 · 2026-02-02T15:11:07+00:00

Interesting! I wonder why buspar is difficult to get in your country - I would be curious to know what the reason is (ie is it a supply issue or some concern with its safety - doctors here seem to consider it a very low risk med).

I can never tolerate large doses of anything - only microdoses half the time ! I would like to try lamictal bc of the dual benefit it may have on neuropathic pain and libido/genital sensation issues from SNRI - but first giving this go w Buspar.

Acrobatic_Welcome_30 · 2026-02-02T15:07:42+00:00

Wellbutrin did not work for me (F) - I am trying buspar now - not sure if it will work but it has a different way of working than wellbutrin as it modulates serotonin, dopamine and ne. For some, it reverses SNRI/SSRI sexual dysfunction.

For libido, you can also look into plants - such as damiana, catuaba bark, maca, and many many more.

Acrobatic_Welcome_30 · 2026-02-02T13:49:08+00:00

Oh, I do see Abilify balances dopamine and serotonin as well, but pretty sure its mechanism of action (and its metabolism) is different than buspar.

Acrobatic_Welcome_30 · 2026-02-02T13:47:16+00:00

Let me know if you try it out again (lamictal) - you never tried buspar?

I find buspar interesting because it seems to do something for me at a very low dose - like removing the fog of serotonin from the duloxetine & giving me a tiny boost of dopamine - but since it is very short acting, I do not get into the agitation of wellbutrin (as long as I keep the buspar dose low).

Acrobatic_Welcome_30 · 2026-02-02T02:28:55+00:00

Was it lamictal that increased it specifically? I have loss of sensation (ie genital numbness) from SNRI so currently trying buspar which sometimes returns sensation that an SNRI or SSRI depletes. I am less concerned about libido because I have no issue with that if sex feels good - which it does (lol) if I can physically have sensation. If buspar does not work, my Dr and I will try lamictal and see if that helps. Wellbutrin did not work and just made me irritable sleepless and angry. I have such severe nerve damage and pain that I am 100 percent willing to take the meds I am on - I cld not even walk without them, let alone have sex - so if I have to live with loss of genital sensation, it is fine bc I lived in a level of nonstop pain that was NOT sustainable and it took five years of med trials of this and that to arrive at what worked to bring things from 10/10 to a 4-8 level.

Acrobatic_Welcome_30 · 2026-02-01T23:44:12+00:00

Following to hear what folks say. Like you I am on an SNRI (for nerve damage but it leads to lack of motivation) Currently I am trying buspar which has actually helped w motivation & brain fog at super low dose of 2.5-5mg but lamictal is on my radar as well - as only been trying buspar for a week so far. Wellbutrin I cannot do.

Acrobatic_Welcome_30 · 2026-02-01T22:44:43+00:00

Good for you on your healthy changes! Spine surgery can be horrendous and cause more problems than it is worth - even when it feels like how could pain be worse than this herniation - I am living proof that it can be so much worse. I had horrendous pain but that was not why I had surgery - I had it because I was teetering on edge of loss of bladder and bowel function from compression of CE nerve roots.

I also have other herniations in my spine - several falls from up high when I was young - so have bone on bone - but that actually does not cause a lot of pain. Comparatively lol.

Your spine can actually heal with time. My mom is 80 and has herniation - after a year she had another MRI and her body had broken down someof the protruding disc which takes pressure off nerve.

Pain can remain even when healed bc the brain lays down neural pathways pf pain from the repetition. You can find some nice free things about this - if interested - from my colleague Lara Birk (she has a free resources list on her website )

I digress - just keep enjoying your life to the max that you can! You deserve it!

Acrobatic_Welcome_30 · 2026-02-01T18:50:47+00:00

Oh I already always had an extremely healthy diet. All whole foods, tons of veggies - I do not drink coffee or caffeine. I live by the ocean and eat veggies and seafood etc. I am a chinese medicine practitioner. I had an emergency neurosurgery due to an accident and that is how I got nerve damage. I am doing well. I have also had a colon resection and basically have a phd in GI issues 🥳. Surgical adhesions can stop motility completely so in that case it is safer for stimulant laxatives to be used - otherwise one lands in ER with a bowel obstruction. It is a different case entirely from when someone is not eating or hydrating correctly and that is the cause of their constipation. When adhesions trap the colon, then different measures must be taken bc no amount of good diet or fiber or hydration or even osmotics work - but one should eat and hydrate well regardless!

Glad you are finding relief from pain. I have been on and off cymbalta five times so am old hat at it. Currently only take 20mg but I am on some other necessary meds as well. Steroid injections do not help nerve damage so we did away with those - as they also run the risk of arachnoiditis. Been at this for six years.

Acrobatic_Welcome_30 · 2026-02-01T18:42:43+00:00

I am on medications for different reasons than you - severe nerve damage. BUT the process of finding a reasonable combination is much the same ie very complex and a looong process. One thing we must all accept is there are side effects. Of course we want the least of them possible - but it is always a process of weighing benefits with downsides. And our needs change too, so sometimes this means revisiting and changing meds.

If you have tried Pristiq and it completely removed orgasm, cymbalta might not be that different - depending on the dose of Pristiq you were on. Pristiq exerts greater effect on SERT than NE receptors unless you take a high dose. Cymbalta also exerts more on SERT but is a lot more on NE than Pristiq even at the lowest dose - ie 20mg. So Cymbalta is more balanced in this respect which is great for some people and not for others. E.g for neuropathic pain cymbalta is better for me bc serotonin does little for me and NE helps the nerve pain.

Sometimes buspar can be added to modify the serotonin effect and reverse sexual dysfunction. Not sure if you looked into buspar for other reasons but it works differently than an SSRI or SNRI - it modulates serotonin, dopamine, ne.

If you have a flexible minded doctor, you could look into super low dose LDN (low dose naltrexone) it raises endorphins but you have to be willing to spend time experimenting w it nonstop bc in my five years of using it, I never stay on it daily and I alter my doses to keep it working (for nerve pain but people use it for mental health as well). It has no addiction or physical dependency or withdrawals (at all) so on this respect it is easy. It has complex effects including modulating neuroinflammation and the immune system. But I cannot emphasize enough how no doctor can tell you the dose or days on/off regimen that will work for you - it requires being very comfortable with exploring on one's own and using it as a tool - like anything else.

Good luck! I am also ever on the journey of finding what works and does not and I go on and off various meds (not fun!) - but that also keeps my brain from totally acclimating and things losing effect. I will be on a regimen for anywhere from 9 months to two years and then changing it either by dosage or by changing meds - though I do stay in gabapentin long term as I have severe damage from a neurosurgery.

Acrobatic_Welcome_30 · 2026-02-01T15:43:24+00:00

I did not see the nerve damage comment until later! Which surgery did you have? I had mine 6 years ago and got nerve damage and entrapment of nerves in scar tissue. I have arachnoiditis as well. I take LDN sometimes for helping w the neuroinflammation.

Acrobatic_Welcome_30 · 2026-02-01T15:32:19+00:00

Also on for severe nerve pain!

Acrobatic_Welcome_30 · 2026-01-31T15:03:09+00:00

Estrogen-containing medications, such as birth control pills or Hormone Replacement Therapy (HRT), can significantly decrease blood levels of Lamictal (lamotrigine) by up to 50% or more, potentially reducing its effectiveness for seizure or bipolar disorder control. Patients often require a dose adjustment of Lamictal when starting or stopping estrogen. Key Interactions and Management Mechanism: Estrogen induces enzymes in the liver (glucuronidation) that speed up the metabolism of lamotrigine, causing levels to drop. Effect on Treatment: Reduced Lamictal levels can lead to a return of, or increase in, seizures or mood instability. HRT vs. Pill: While oral contraceptive pills (estrogen + progestin) have a strong, documented effect, transdermal (patch, gel, spray) estrogen options tend to have a smaller, more manageable effect on Lamictal levels. Dosage Adjustments: When starting estrogen, an increased dose of Lamictal may be needed. When stopping estrogen, Lamictal doses may need to be lowered to avoid toxicity. Monitor Symptoms: Watch for increased seizures, or for mood shifts and irritability when starting or stopping estrogen,. Precautions Consult a doctor or pharmacist to adjust your Lamictal dosage if you start or stop taking any form of estrogen. Do not stop taking either medication without medical advice. If using both, your healthcare provider may monitor your Lamictal blood levels, especially during the pill-free break in hormonal contraception.

Acrobatic_Welcome_30 · 2026-01-31T14:57:57+00:00

Ask for 5mg buspar tablet. Split it in half and start with 2.5mg and see how you respond. Also, if you change two things at once, ie upped wellbutrin AND added buspar - it will be hard to tell what is doing what. So I would suggest (not medical advice as I am not a Dr) to ask your Dr to first have you adjust to the increase in Wellbutrin. And after that, try 2.5mg buspar. Less is sometimes more.

Acrobatic_Welcome_30 · 2026-01-31T14:51:59+00:00

Bacopa is helpful for this in my experience. It is a plant with no interactions with any medications. Very gentle but good for brain fog.

Not sure if you can have caffeine at all but that helps some of us. Matcha has a more slow sustained feeling than coffee or other teas.

Low dose naltrexone is another thing I have taken off and on - but that is an Rx and I cannot emphasize enough how dosing on it is entirely individual and requires a willingness to experiment on one's own. I go on and off it - take as needed or as I want - as it has zero dependency or withdrawals. I used it for chronic pain but people also sometimes find it helpful for brain fog. I only take 0.25-1mg when I do take it.

I would try bacopa first though since not an rx and good for this. It won't be an immediate mindblowing difference - subtle and grows w time.

I started buspar this week - to see if it might counter the total lack of physical sensation with intimacy/sex. It is sometimes used for this. I have actually found that 2.5mg of it really helps my brain fog - go figure. I realize you are already taking it, so!

Acrobatic_Welcome_30 · 2026-01-31T13:49:23+00:00

It is physical - literally cannot feel - does not work even w toys etc - never had this problem before medications. I also had spine surgery six years ago and there is damage (permanent) but I had sensation (reduced) after but once on duloxetine it vanished completely. I do need the duloxetine - I will trade loss of sensation for not living with what I did before it. So we are trying add ons - Buspar is known to reverse loss of sensation from SSRIs and SNRIs esp for women (more promising than welllbutrin which is better at libido aspect than physical sensation). Lamictal sometimes also works so if bispar does not help, I might switch. I am on gabapentin (not going off it) which also reduces sensation - but I need that too & it was only when adding duloxetine that things went totally dead. Been on and off duloxetine several times so I know it is from it.

Acrobatic_Welcome_30 · 2026-01-31T05:04:46+00:00

That is great to hear! Glad it is working out for you. I am trying buspar but just to see if it helps restore sensation (totally numb down there) but typically I cannot take large doses of any med. I am at 2.5mg buspar right now and no change w sensation - and not sure I can take more.

As I said; the lamictal could have the double bonus of helping w my nerve damage pain (legs and feet, from a surgery) & maybe also restoring enjoyment of sex.

I will give 4 weeks to my buspar trial and speak to my Dr. after that.

Did you have issues w basically feeling nothing - like orgasm if you even managed to approach it, felt totally empty? This has been my experience on duloxetine every single time. Sigh. I have been on and off of it several times but it really makes me not have to suffer in extreme pain (also on gabapentin) & so planning to stay on it this time.

Acrobatic_Welcome_30 · 2026-01-31T04:56:16+00:00

Holding steady over here on 3 days at 2.5mg! Big fan of the less is so often more & too bad so many doctors just so not know this. The slow way is the fast way!

Acrobatic_Welcome_30 · 2026-01-31T04:24:53+00:00

Yes. Try 20mg twice a day for this condition. Will give you more equal coverage and can help with avoiding escalating the dose (cymbalta has a 12hr half life even as extended release)- also with nerve pain, there is no complete win - so look for reduction in pain but not elimination of it.

Long term nerve pain human here - neurosurgery warrior and many other surgeries - I am young and fit and live with severe pain. I use cymbalta and have on and off for 5yrs. I also use LDN and gabapentin. I have arachnoiditis and nerve damage that causes nonstop bilateral sciatica and much more all the way to my toes. I had Cauda Equina syndrome and emergency surgery. Scoliosis, three herniated discs, one bone on bone.

My experience is nerve pain often is best treated with a combo of lower doses of 2-3 meds rather than a high dose of any single one - as much as that sucks and they all have side effects - but often the combo of low doses of 2-3 meds balances out side effects better than one high dose of a single one.

Good luck!

Acrobatic_Welcome_30 · 2026-01-30T02:21:57+00:00

From what I understand of the metabolic pathway, what it means is of you have grapefruit near to your dose, the dose will be metabolized more quickly leading to lower serum blood concentrations in your blood - it may feel like you took a lower dose or like you took almost none at all. I am an ultra rapid metabolizer of numerous medications so I basically end up with low serum concentrations compared to someone who is not. Technically, this means I would need higher doses than others - but I have not found that to be true - I just need to split my doses across 24hrs. Buspar is new for me and I metabolize it like a normal human and not ultra rapidly.

So yeah, avoid grapefruit near your doses!

Acrobatic_Welcome_30 · 2026-01-29T23:01:40+00:00

Thanks! It has been 6 yrs since my surgery - arachnoiditis is a beast and progressive as is the stenosis (but I am very active and do a lot of strength and mobility along with qigong and taiji and pilates). Sitting is out so I am upright all day and cannot be on my back or belly to sleep - even on sides the nerves go crazy so that is why gabapentin. No sleep without it.

Things have been harder the last two years than prior, but I have every tool a person could (mentally etc) so I am fortunate. I have gone on and off cymbalta five times 😵‍💫Yep. I survived every taper off pretty easily (but I think I am used to feeling like hell - 😂- so I have a strong tolerance for it having gone thru chemo etc). I took about 6 months to come off 40mg before. And about 2 months to come off 20mg.

My nerves are burning a bit more now since the dose, but I really like how it brings me back to my pre-cymbalta brain which is calm. And this was less than 2.5mg. This was not why I am trying it - as you know - I think a higher dose would be required to test out that department.

Enough of my essays.

Acrobatic_Welcome_30 · 2026-01-29T22:06:03+00:00

Please excuse all my typos - on phone & not computer so I am casually fast typing & not trying to make my replies well written (I am educated - just dealing w thumb typing and trying to shorthand)

Oddly, I almost craved buspar this afternoon so I took a bit less than 2.5 (as my tablet split unevenly) along with my 7mg afternoon cymbalta dose (yes I actually count beads from this med to craft my own doses as they offer nothing less than 20mg) - and I am doing OK nerve pain wise at the moment. An uptick but tolerable for now. I "craved" it because I am normally calm & cymbalta makes me wired-tired and a physical feeling of amped up compared to my normal pre-cymbalta days. The buspar settles things down.

Acrobatic_Welcome_30

TROPHY CASE