Dave made the following comment regarding his experience with two antidepressants:
I’m taking Welbutrin 300 mg.. And also on Paxil. The problem I have is I am unable to ejaculate.. I would think it was the paxil, but I was taking only 5 mg of paxil only and sometimes could ejaculate sometimes not.. I went back on the Wellbutrin and trying to stop the paxil. Went from 5mg to 2.5 mg.. Since I’m on the welbutrin, Can’t ejaculate at all.. Any Ideas? Any Medications I can add to help with this?? I don’t think Viagra will help.
As always, I’m obligated to say “Please consult with your doctor!” That said, here are a few things to consider when you do discuss this issue with a physician:
1. Side effect profiles of each drug.
Even though bupropion (brand name Wellbutrin) appears to have a lower incidence of sexual side effects in clinical studies, the prescribing information does list the following under, “Other Events Observed During the Clinical Development and Postmarketing Experience of Bupropion” (page 24 of 35 from the manufacturer website) – “Urogenital: Infrequent were impotence, polyuria, and prostate disorder. Also observed were abnormal ejaculation, cystitis, dyspareunia, dysuria, gynecomastia, menopause, painful erection, salpingitis, urinary incontinence, urinary retention, and vaginitis.” (italics were mine).
As for paroxetine (brand name Paxil), abnormal ejaculation were cited 12 times in its current prescribing information from the manufacturer website. Notably on page 27 of 45: “Table 3. Treatment-Emergent Adverse Events Occurring in ≥5% of Patients Treated With PAXIL CR in a Study of Elderly Patients With Major Depressive Disorder” the abnormal ejaculation was further described as, “4. Mostly anorgasmia or delayed ejaculation.” (on page 28)
2. Washout Period of Paxil
Even though you’ve stopped taking Paxil, the medication does not immediately “wash out” (completely eliminated from your body). Thus it will be important to look at how long it takes for each drug to completely leave your body in order to be sure that the side effects you’re experiencing are not due to the remaining traces of a drug you’ve stopped taking.
3. Treatment Options
I’m not familiar with the treatment options for anorgasmia or delayed ejaculation; you will definitely have to ask your doctor about what is currently acceptable for managing this side effect.