How do SSNIs differ from SSRIs?

[Ahlstrom]

I've been taking Lexapro for around 6 years, even before my panic attack and never had any problem with sexual dysfunction. After I got my panic disorder I went off Lexapro for a new medicene and it was absolutely terrible, I was having suicidal and thoughts and constant panic attacks literally 24/7. I went back on 40mg daily Lexapro a few months ago and it greatly decreased my libido which had never happened. Months later I was unable to ejaculate no matter how hard I try, now it's progressed to the point where I can not get an erection to save my (sex) life.

I was really freaked out by me not being able to get an erection that it gave me a panic attack (if youre a guy and your dick stopped working I think that's a reasonable reaction, especially at 19). I went to my doctor and he prescribed my yohimbe, which is a sort of African bark sold in capsule form that is supposed to combat this symptom, yet even with taking this I'm still really freaked out that if I stay on this medicene it could get worse and worse, perhaps even last after I quit the Lexapro (although I heard that that occuring post-SSRI is astronomically low). I don't know what I am supposed to do, if I try to go off of it I will wind up with a constant heart rate of 150 and end up in the hospital/psych ward again.

Anyways more on point someone told me I should look into taking an SSNI as opposed to an SSRI, and that it may help the sexual dysfunction. Does anybody know the difference between the two? Thanks for any input.

[acetone]

SSRIs work by increasing the availability of neurotransmitter serotonin while SNRIs work by increasing the availability of both serotonin and norepinephrine in brain. I do not know whether SNRIs would be better for sexual dysfunction. I take zoloft(SSRI) and it does not cause any sexual dysfunction in my case. In fact, I suffer from high sex drive and wish Zoloft could do something about it.

[alankay]

SNRI"S work the same as SSRI's at lower dose but also act on norepinephrine higher doses. That's a very high dose of lexapro so I'm not surprised this has happened. Sorry.
You could (1)try another AD, (2)try a lower dose of lexapro and use a benzo for the toughest times as an add on, (3)try a lower dose of lexapro and add wellbutrin, (4)try a med holiday for sexual activity and also psychotherapy to see if you can find and address the source/root cause of anxiety if there is one.
The reason why I suggest a benzo is that at 19, no sex is a game changer..... for most anyone. What I mean is there must be a solution out there and it must be sought out for "quality of life" purposes.
If it were me I'd ask about lowering the lexapro and adding wellbutrin for a while and going from there. I mean, ....geeeez. Sex is a part of life you should experience for sure. :). You may have to be resourceful and/or compromise drug monotherapy though.
At 40 mg I doubt this will ever dissipate. PM me any time. Alankay

[Ahlstrom]

SNRI"S work the same as SSRI's at lower dose but also act on norepinephrine higher doses. That's a very high dose of lexapro so I'm not surprised this has happened. Sorry.
You could (1)try another AD, (2)try a lower dose of lexapro and use a benzo for the toughest times as an add on, (3)try a lower dose of lexapro and add wellbutrin, (4)try a med holiday for sexual activity and also psychotherapy to see if you can find and address the source/root cause of anxiety if there is one.
The reason why I suggest a benzo is that at 19, no sex is a game changer..... for most anyone. What I mean is there must be a solution out there and it must be sought out for "quality of life" purposes.
If it were me I'd ask about lowering the lexapro and adding wellbutrin for a while and going from there. I mean, ....geeeez. Sex is a part of life you should experience for sure. :). You may have to be resourceful and/or compromise drug monotherapy though.
At 40 mg I doubt this will ever dissipate. PM me any time. Alankay

I was on Wellbutin for about 14 days some time ago, it did fix my sexual dysfuction but made me have terrible depression so i quit. Luckily last night i was able to ejaculate so I dont think its nearly destroyed as i thought. Im planning on going off Lexapro ASAP, i recall doing it once before and my sex drive did return, hopefully im lucky this time. Im very scared about going off, when i went off it last time i wound up in the psych ward, however at that time i was switching over to a ssri called vibryd, i very much hope that vibryd is what caused such a bad reaction, now that i think about i was never actually off an AD. Hopefully it will dissapate like the other times, i have no clue how i would cope never being able to get erect again.

[Kevcules]

I hear ya loud and clear on the no sex drive issue. My drive has been zero for the last 6 months because of anxiety and depression continually getting worse.It bothers me a lot, in fact I know it causes more anxious feelings knowing that I can't get a real firm erection or sometimes not at all! You're right....it's scary!
I know that most of the drugs I have been on are serotonin inhibitors. I've recently been given Wellbutrin to try because the other drugs sexual side effects was the main reason I didn't take them. No sex is unacceptable for most men. I'm. 44 and far from done that business!! :) I've only been on them for 1 week. How long is it normal to get some results?
Good luck to you !

Which one of these anti depression, anti anxiety drugs actually boosts libido , while it helps your chemical imbalance???

[Ahlstrom]

I also must add that I've only recently began lexapro again in January. What makes you think it will never dissipate Alan? I appreciate your feedback, but man that line of text alone caused an actual panic attack. :(

@Kevcules. When I took it I found my sex drive returning to normal at around 14-17th day. After I quit immediately during those days my sex drive continued for around 20 days stopping the medication. I'd really recommend getting of an SSRI if you're on one. No one told me about the sexual dysfunction and they definitely didn't tell me that it could last for months, years, or maybe forever after I quit.

I'd rather have physical anxiety pain than have a useless dick.

[Kevcules]

I'd rather have physical anxiety pain than have a useless dick.[/QUOTE]

Hey Ahlstrom....thanks for the advice! I agree with your last statement! A useless dick is not an option! :)

I'll have to research the SSRI drugs. I'm taking wellbutrin which is an OK one (this is my 8th day) but I was also given something else for sleeping. It sure knocks me out. I don't really need it all the time so I'll ask the doc what it is and why I'm taking it with Wellbutrin!
That's news to me about the dysfunction lasting for years because of the drugs. I think once your body gets somewhat back to normal, the drive naturally returns..... who knows though? :)

[Ahlstrom]

I'll have to research the SSRI drugs. I'm taking wellbutrin which is an OK one (this is my 8th day) but I was also given something else for sleeping. It sure knocks me out. I don't really need it all the time so I'll ask the doc what it is and why I'm taking it with Wellbutrin!
That's news to me about the dysfunction lasting for years because of the drugs. I think once your body gets somewhat back to normal, the drive naturally returns..... who knows though? :)

Yeah, luckily it's around my 3rd day off and my sexual system is definitely getting better. Unfortunately I'm not supposed to just stop the Lexapro cold turkey, so I'm going to have to taper off of it. I've been taking Lexapro since I was 11, I'm 19 now but my panic disorder didn't come til I was around 18. Unfortunately at 11 you have no real choice nor idea what's going on with medicene, your parents say "here take this" and you follow.... messed up man.

[Kevcules]

Yeah, luckily it's around my 3rd day off and my sexual system is definitely getting better. Unfortunately I'm not supposed to just stop the Lexapro cold turkey, so I'm going to have to taper off of it. I've been taking Lexapro since I was 11, I'm 19 now but my panic disorder didn't come til I was around 18. Unfortunately at 11 you have no real choice nor idea what's going on with medicene, your parents say "here take this" and you follow.... messed up man.

I think you're right....it's all messed up! :) I didn't think you were so young, I was never on ,or needed this stuff till I was in my mid 30's. I'm 44 now and can't believe how my body has changed where I can't cope with society! Thank god for meds! Once you understand that the right ones do help your brain to get somewhat back to normal, then it does help. I never wanted to take these pills because I thought it was only for the weak minded. Well......I was wrong! Weak or strong minded, when you need help and we all do at some point in life, get it!!
I see my reg doctor today and I'll ask him about what drugs the psychiatrist recommended to me. I like to hear all opinions.

I do feel some progress after day 9....... :)

Take Care....