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Libido affected after taking pristiq and Remeron. Is this due to side effects?

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Addiction Medicine Specialist
Practicing since : 2002
Answered : 1486 Questions
Hello, I am on Pristiq 50 / day plus Remeron 15 mg at bedtime for axiety and panic disorder. It works, i feel much better. But my libido is not the same as before. I have friends they have had good success with some parkinson drug like requip or trivastal, i know it is an off label use but which one do you recommend? Thank you.
Posted Fri, 20 Dec 2013 in Mental Health
Answered by Dr. Preeti Parakh 3 hours later
Brief Answer: Trivastal Detailed Answer: Hi, Welcome back! In my opinion, you should try Trivastal because of two reasons: 1) Lesser risk of sedation as compared to Requip. 2) It also has some antidepressant action and may potentiate the action of Pristiq and Remeron. For Requip, there is one point in its favour. There has been some research on its effects in reducing antidepressant induced dysfunction and some benefit has been observed. However, no such research on Trivastal has been published. I feel that you should Trivastal first and if it doesn't help, then you can try Requip. Be careful that these medicines can cause hypersexuality or pathological gambling in some people. Please feel free to ask if you need any clarifications. Best wishes. Dr Preeti Parakh MD Psychiatry
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Follow-up: Libido affected after taking pristiq and Remeron. Is this due to side effects? 4 minutes later
Thanks for reply. Can be 50 mg in the morning enough once a day of Trivastal? Or Requip 2 mg slow realease at bedtime?
Answered by Dr. Preeti Parakh 22 minutes later
Brief Answer: Explained below. Detailed Answer: Hi, In my opinion, the lowest dose should be tried first. For Trivastal, try to see if 20 mg tablets are available in your country or not. If you cannot get that, then take the 50 mg tab. Take it once a day after a meal. Morning is preferred for people with Parkinson's as they need the drug to work in the day. For you, you can try different times and see what gives you the best effects. For Requip, an immediate release formulation is available in the dose of 0.25 mg. If you are going to have sex in the night, try taking this at night and see if it works. But if you want a whole day coverage, then the 2 mg extended release tablet should be fine. Best wishes. Dr Preeti Parakh MD Psychiatry
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