Switch antidepressants to keep your love life alive
Q: I’ve been on fluoxetine for two years to treat depression. Now my sex drive is completely gone. I tried lowering my dose, but due to confusion, I had to return to the higher dose again.
This whole situation is killing me. I feel sexless. I’m in a beautiful relationship with a wonderful man I love very much. He is very understanding and patient, but I fear that I will lose him over the lack of sex.
I’ve even contemplated ending the relationship, but I don’t want to lose the love of my life just because I need an antidepressant. Do you have a solution to suggest?
A: Many antidepressants lower libido and interfere with sexual pleasure. There is even a medical name for this condition: treatment emergent sexual dysfunction (TESD).
The official prescribing information for drugs such as fluoxetine minimizes this problem. For example, the DailyMed data on Prozac (fluoxetine) suggests an incidence of 3% to 11%. Studies in healthy volunteers, on the other hand, indicate that between 50% and 80% of people report sexual dysfunction (Journal of Clinical Medicine, Oct. 7, 2019).
A few antidepressants may be less likely to flatten sex drive. Ask your doctor whether bupropion or mirtazapine would be an option for you. They act on different neurochemicals than the selective serotonin reuptake inhibitors such as fluoxetine.
Q: About 10 years ago, a child passed to me a bad case of insecticide-resistant lice. I tried using insecticide products three or four times, to no avail.
I then found on the internet a product that consisted of olive oil and a little rosemary oil. All the lice were killed in one application. It was easy to wash out the product, and my hair smelled great. I can no longer find this product on the internet, but I certainly recommend trying olive oil.
A: Oils may work against lice by smothering them. That is the basis for a number of home remedies, including Vaseline petroleum jelly.
Adding rosemary oil to olive oil sounds innovative. There is even some research to support such an approach. Scientists in Turkey found that rosemary oil is more effective for killing lice than other herbs traditionally used for this purpose (Turkiye Parazitolojii Dergisi, December 2017).
Q: I had a low vitamin D level back in December 2018, so my doctor put me on a course of 50,000 IU of vitamin D3 weekly for three months. By the end of the second month, I started to get severe diarrhea and bloating. This was worse after meals or when I slept.
I saw the doctor, and my vitamin D level was good. He diagnosed me with indigestion and prescribed pantoprazole. He also told me to take 50,000 IU of vitamin D every two weeks to keep my level good.
The pantoprazole never really helped, so I stopped taking it. I was still taking the vitamin D3 and got severe heartburn. I suspect that this vitamin was responsible, as I felt better when I stopped taking it.
A: Your doctor prescribed a whopping dose of vitamin D3. While it did the job of raising your blood level of 25-hydroxyvitamin D, we are somewhat surprised he wanted you to maintain such a high dose of this supplement.
A review of long-term vitamin D supplementation concluded that vitamin D alone does not cause gastrointestinal upset (Nutrition Reviews, Dec. 1, 2017). Nonetheless, many readers have reported heartburn or diarrhea while taking vitamin D.