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Sexual Dysfunction.

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Please this question to Dr. Srikanth Reddy only .
Consultation ID: CS030520140095

Hello Dr. Srikanth,

I withdrew the Buspar completely as you told me gradually and everything now is ok .
I am now on Wellbutrin 150 mg morning along with Paxil 50 mg evening, Is it possible to reduce Paxil gradually until we reach to the constant does 30 mg daily ? Are you agree ? Is it need to elevate the wellbutrin to 300 mg daily during reducing Paxil ? I mean to reach to constant does (150 or 300 mg Wellbutrin daily + 30 mg does daily).
If you agree how can I reduse that correctly? Note that I will mention you below about the past plan until now : Wellbutrin 150 mg daily from 5 months until now continously (the entire periode 5 months) + Paxil 60 mg daily 3.5 months then 50 mg from 2 months until now continously (the entire periode 5.5 months) . Note that also my situation is very good now . But suffer from weight gain .Do you recommend other medication instead of Wellbutrin along with Paxil to encounter sexual side effects ?? Thanks a lot .

Best Regards

Category: Psychiatrist

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Dr. Srikanth Reddy
Category: Sexologist
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Expert:  Dr. Srikanth Reddy
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Hello welcome back to DoctorSpring
Thanks for the follow-up information and it was nice to know about the improvement that you have had. Your paxil explains the sexual dysfunction as well as weight gain and it can be gradually reduced and stopped. You can increase the Wellbutrin to 300mg and even reduce the paxil from 50 mg to 37.5mg (Paroxetine CR 25mg + Paroxetine CR 12.5 mg). This can be done over 2 weeks and then the Paxil has to be further decreased to 25mg.
I have used Cyproheptadine to counteract the sexual side-effects of paroxetine, but it would be advisable to come off paroxetine first and then if the symptoms perisist then you may take cyproheptadine further to improve the sexual functioning.
Further if possible try engaging in some physical activity like aerobic exercises at least 2-3 times a week.
Hope that helps,
If you have any further queries, I would be glad to help you.

Regards
Dr. Srikanth Reddy MD


Patient replied :

Dear Dr.Sirkanth,
Than you for the information. Firstly I have to tell you that I can not stop Paxil completely, what I can do decrease the dose from 50 mg to 20 or 30 mg as constant dose permanently because I can not do without Paxil.
Second we do not have Paxil CR we have only normal Paxil without CR, I prefer to reduce the Paxil to 20 or 30 mg (what does you recommend to fix) along with elevate the Wellbutrin to 300 mg, so can you give me a plan or determined steps to do that please ?
Best Regards


Expert:  Dr. Srikanth Reddy
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Hello
Thanks for the follow-up query.
You may reduce the doseage of paxil from 50mg to 40 mg first and after 7 days to 30 mg and then again after 7 days to 20mg.
Welbutrin can be increased from 150mg to 300 mg right away.
Hope you do good with these medicines. Even if you have slight discomfort with these medicines, do not panic.
I hope this has helped.
Thankyou


Patient replied :

Dear Dr.Sirkanth,

The last question I have : Is it possible to use 5 mg Cialis on demand ? Note that I do not have any heart or other diseases. Thank you very much and I hope to be in contact with you in future to more control .

Best Regards


Expert:  Dr. Srikanth Reddy
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Hello
Yes you may use cialis 5mg on demand. Ones taken the effects will persist for 72 hours.
In future if you have any issues, do let me know.

Regards
Dr. Srikanth Reddy MD

Dr. Srikanth Reddy
Category: Sexologist
Experience: 
Doctor of Medicine (MD), Psychiatry Residency Program,2001 – 2012
M.B.B.S,Mahatma Gandhi Institute Of Medical Sciences, Sevagram

Certificate Course in sex Therapy and Counselling, Sexology and Counselling, A
Sexology,Medikon Sexual Sciences, Mumbai

Training in Advanced Neurology at a leading corporate hospital (CARE hospital) in Hyderabad

Child Psychiatry Training in National Institute of Mental Health and Neuro-Sciences, Bangalore

Sex Therapy and Counsellingat MEDIKON Sexual Sciences, Mumbai.
Dr. Srikanth Reddy and 4 other Medical Specialists are ready to help you

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