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    Suggest treatment for side effects of Zoloft and Paxil

Posted on Sat, 5 Aug 2017 in Relationship
Question: How to treat side effects of anti-anxiety drugs called Centreline (Zoloft) and Paxil? My side effect from Zoloft is a severely diminished libido / low sex drive causing severe ED issues. Testosterone level was recently tested to be ok.
Answered by Dr. Salah Saad Shoman 55 minutes later
Brief Answer:
Using an antidote

Detailed Answer:
Dear sir ,
I have gone through your question and I understand your concerns.

Zoloft and Paxil both are selective serotonin reuptake inhibitors which are well known to cause decreased lipids and erectile dysfunction in a high percentage of patients using them. As for Trintellix, it also acts by modulating serotonin and that is why your erectile dysfunction got worse while using these three drugs.

These Sexual side effects usually improve without treatment in approximately 20% of cases, although improvement is often incomplete. Moreover, several months may pass before symptoms diminish adequately, making this strategy impractical unless you are willing to wait.

Another option will be using an antidote as buspirone daily dosage of 15-60 mg or amantadine 200 mg daily which is reported to relive SSRI induced erectile dysfunction in about 60% of patients.

I hope I answered your question
Above answer was peer-reviewed by : Dr. Vaishalee Punj
Follow up: Dr. Salah Saad Shoman 15 minutes later
Hello, and thank you!
(1) How long before I see improvements if I use your proposed option - "an antidote as buspirone daily dosage of 15-60 mg or amantadine 200 mg daily"? Are we talking about 6 months or sooner?

(2) Who can prescribe these antidotes, my physician?

(3) which part of my brain is responsible to send signals to turn "on" my erection?...

I think there is something wrong with my brain - let me explain: I am not able to be sexually aroused, even if I really want sex... nothing helps me in the bedroom, not foreplay, not physical contact, not a stimulation of my penis either... I may get a weak erection for a few seconds, but then erection disappear and I am not able to have intercourse... that specific part of my brain (which is responsible to send signals to turn "on" my erection) - it does NOT work!!!

(4) how do I check / test Dopamine level? And if it is low, how can I boost it?

(5) what other brain messengers (beside Dopamine) are responsible for brain chemical messaging system to stimulate sexual desire?

(6) One time Last week for some unknown strange reason, I was able to have and sustain an erection long enough to have a two minute intercorse...

This was WOW!!!!.... and I can't explain it myself, but all of a sudden I felt again sensational penal blood flow (as if I was normal again), however the next day I had ED issues again, and still now I am having ED issues...
can you please explain what had happened to me that on time last week?

By the way, my recent Testosterone test results were ok...

(7) I am now taking male supplement pills called "Prosolution", which has all natural ingredients and herbs. I was told it may help me with my ED issues, but effects may take 6-8 weeks (I am only taking these pills for 5 days now)...
do you have any recommendations for male supplement pills?

Thank you very much!
Answered by Dr. Salah Saad Shoman 20 hours later
Brief Answer:
From one to eight months

Detailed Answer:
Dear sir, Amantadine and buspirone are perscribtion drugs but they can be bought online as an otc . As for amantadine it should be taken as 100 mg twice daily , improvement should start within a month, if not then the dose should be increased to 100 mg three times daily or 200mg twice daily. full improvement should be expected after from 4-8 months .
As for the way your medications induced sexual dysfunction is by inhibiting the reuptake of serotonin thus increasing its levels in blood.. Normally estrogen, testosterone, and progesterone promote sexual desire; dopamine promotes desire and arousal, and norepinephrine promotes arousal. Serotonin, in contrast ,appears to have a negative impact on the desire and arousal phases of the sexual response cycle, and this seems to occur through its inhibition of dopamine and norepinephrine. Serotonin also appears to exert peripheral effects on sexual functioning by decreasing sensation. so even if dopamine levels are within normal levels , increased serotonin will prevent dopamine from doing its action .
measuring dopamine level can be done through catecholamines blood test and if found to be low then its level can be increased by using dopamine reuptake inhibitors . I hope you find this helpful
Above answer was peer-reviewed by : Dr. Remy Koshy
Follow up: Dr. Salah Saad Shoman 1 hour later
Thank you very much!

1) What are the side effects of Buspirone 15-60 mg daily?

2) What are the side effects of Amantadine 200 mg daily?

3) i stopped taking Zoloft in September 2016, I stopped taking Paxil in February 2017, and I stopped taking Trintellix in May 2017.... Do I still have any of these drugs in my blood?

4) My doctor said my ED issues are cause by a high level of anxiety and my ED issues are not caused by Trintellix / Zoloft side effects... do you agree?

5) what blood test can be done to measure Serotonin level? Or I don't need to measure Serotonin? I only need to measure Dopamine level?

6) my doctor said, Monday next week I am going to do Catecholamines blood test... how do I prepare for this test? Doctor said test results may be incorrect if I feel anxiety or high level of stress.

Thank you very much!
Answered by Dr. Salah Saad Shoman 22 hours later
Brief Answer:
Generally well tolerated

Detailed Answer:
Dear sir, Amantadine is generally a well tolerated medication and adverse effects usually cease after one or two weeks , these side effects include decreased concentration , headache, naseau , loss of apetite and trouble sleeping. it is not a must that these side effects occur as susceptiblity differs from one patient to another .
as for buspirone , none, some or all of the following side effects may occur initially until your body is accustomed to it, dizziness, decreased concentration , headache, palpitation, naseau, dry mouth and nasal congestion .
The post SSRI effect may last for months to years after stopping the medications , these effects include the sexual dysfunction and anexity disorders.. so I disagree with your doctor as I believe that you are suffering from post SSRI effect..
It is better to measure serotonin level as well.. even if dopamine level is normal, you have to exclude high serotonin levels .. for catecholeamine blood test you need to fast 6-12 hours before the test but the serotonin blood test does not require any preparations.. I hope you find this helpful

Above answer was peer-reviewed by : Dr. Kampana
Follow up: Dr. Salah Saad Shoman 2 hours later
Thank you very much!

(1) I live in USA, and both Buspirone and Amatadine are not otc drugs here.
Is there another alternative drug for me?

(2) Which doctor specialist can better understand my post SSRI effect, Neurologist, Physician, Internal Medicine doctor, Psychiatrist?

(3) my physician doctor said that all I need to do is to calm down and all my ED problems will go away... but my question is - can Serotonin level be decreased naturally over time and without any drugs?

(4) What are Dopamine reuptake inhibitors?

Thank you very much!
Answered by Dr. Salah Saad Shoman 18 hours later
Brief Answer:
Buy them online

Detailed Answer:
Dear sir, buspirone and amantadine can be bought online without a perscribtion. Please also note that you should take either of them not both.
A psychiatric or a neurologist would have a better experience in that matter.
I agree with you doctor that calming down will help you get better faster.
yes serotonin level can go back to normal but this will take time which is variable from one patient to another which can range from months to years
dopamine reuptake inhibitors act by preventing reuptake of dopamine thus increasing its level but must be used with caution due to their nervous stimulatory effect such as bupropion 75mg to 150mg. Libido, arousal, and orgasmic difficulties can be effectively reversed by using it. I hope I answered your questions.
Above answer was peer-reviewed by : Dr. Yogesh D
Answered by
Dr. Salah Saad Shoman

Internal Medicine Specialist

Practicing since :2004

Answered : 2444 Questions


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