Originally Posted by GQgeek
Please don't lecture me about poor man's science when you obviously haven't done the research yourself. Initial estimates were that a relatively small number of patients (i think it was around 15%) would be affected by the sexual side-effects of SSRIs. Once they got out on to the market, psychiatrists realized that the number of people affected was a lot higher than originally estimated. Here's an excerpt from the abstract of a study that was published in the Journal of Clinical Psychiatry.
"With regard to SSRIs, sexual dysfunction occurs in 50% or more of such patients, which is substantially higher than the rates reported in the Physicians' Desk Reference. The reason for this discrepancy is that patients will not spontaneously report sexual problems and must be questioned about such problems directly"
Hirschfeld, RM. Management of sexual side effects of antidepressant therapy. Journal of Clinical Psychiatry 1999;60(Suppl 14):27-30
SSRIs work very well for treating depression and my understanding is that most patients eventually find ways to deal with the effects, either by switching to a different SSRI, supplementing with various other drugs, decreasing dosage, etc. Some switch off them completely to something like Wellbutrin XR which is generally accepted to be less effective for treating depression but with less side effects. There's obviously no one solution for everybody because it's a complex problem.
As for dosages, I think that should be left to doctors, but you're right, often times docs start off with too high of a dosage because the pharmaceutical companies have a habit of suggesting starting doses which are too high.
Btw, if you agree that 10 minutes is longer than average, then why on earth would you suggest he take an SSRI?
- 1. 1999. What doesages were used, ah, they were the dosages to treat depression etc. not to prolong ejac. This is only one author's conclusion. Where's the data? Even then you can debate the the dosages the patient type etc. And even with your supposed conclusion by one author, it still doesn't deny the fact the drug 'DIDN'T' cause problems for 1/2. So why not try it. But in this case he should have a sex cons.
You stated, "I've been on them before and after 30-40 minutes of supreme effort I still wouldn't be any closer. In fact, it's estimated that 30-50% of men taking it experience anorgasmia, ED, or both, which is definitely not a good thing. Some docs supplement with Wellbutrin, which helps in some cases, but there really isn't a solution that works for everyone."
You stated because you had a problem someone else will too and you grouped '"anorgasmia,ED or both with 30-50% of men". Even by your own one study, one author line quoatation, the drugs were not a problem in 1/2 men.
- 2. Levitra has data by itself for ejac. let alone it can be used multi modal with SSRI on lower dosages. Ah, then where is the side effect profile with this combination?
- 3. Just so you know, Urologists prescribe Zoloft for this all the time, everyday, even as we are on this message board. And it can and is dose related. Where's your data again for dosing adjustments?
- 4. What data do have to support "pharmaceutical companies habit of suggesting starting doses which are too high"?
---- Pharamceutical companies use what dosage achieves the best outcome with the best side effect profile and it is approved by the FDA. They do not try to use a higher dose out of habit etc. Please cite the study that support this comment. Good luck on that one.
Also, in this case, a psych consultation would be in order as he's clearly within the norm.