Hello
Thanks for using Doctor Spring for posting your query.
I have gone through your question in detail and I can understand what you are going through.
The symptoms that you have mentioned suggest that you have a lot of distractibility, and as it is persisting for long, it There could be two main reasons for the low libido and erectile dysfunction. One could be the medication induced. You are on sertraline and sertraline can produce sexual dysfunction. From the medications that you have been put on it appears that your provisional diagnosis is bipolar depression and it has been proven often that use of antidepressants may not be required for bipolar depression treatment and hence it is advisable to come off sertraline. This may improve the sexual functioning.
Secondly the next possible cause if depression per se causing sexual dysfunction. Proper treatment of depression can by itself reduce the sexual dysfunction. You are on a good list of drugs. The other medications that can be tried are lithium, valproate, olanzapine etc These medications can also improve your resistant depression and then improve your sexual functioning.
Hope this helps,
In case if you have any further query, do let me know.
Kind regards
Dr. Srikanth Reddy
Patient replied :
Hello doctor
I had my consultation with doctor in regards to discontinuing serta but my doctor declined .moreover i had certain tests done the result of which are as below:
my prolactin level is 4.98 ng/ml HBa1c is 5.5 and testostorone level is 318.14 NG/Dl.
doctor otherwise i m working fine but the only thing at present that bothers me is low libido and low sexual drive (sexual weakness)....i would request you to suggest me a medicine which can cure my problem and in turn can be taken alongside my current medication...please doc i trust you to guide....me.....pls suggest a non generic medicine to cure my problem and help me in staying healthy...both mentally and physically for a longer duration of time
Hello,
In the cases like yours Tab Pramipexol 0.25 mg and then gradually increased to 0.5mg can increase the libido by acting on the dopamine in reward pathway. These need to be taken in divided doses. You may discuss these options with your traeting doctor and get them prescribed.
Doctor spring is an online portal for second opinion and it is an international community of doctors. The online prescription may not be valid in the country of residence. Moreover prescribing the medicines without physically examining you may not be safe for you.
You may discuss these medicine options with your doctor and get them prescribed.
Kind regards
Dr. Srikanth Reddy MD
Patient replied :
Hello Doctor
I had my appointment today with my doctor.I discussed my problem(libido and sexual weakness).He did raised an option of reducing serta then he himself said no and added another medicine adesam 200mg or sademet 200 mg....i do not know what is the purpose of this medication..So wanted to discuss with you about it ...
As far as your medication is concerned the tab pramipexol 0.25 mg....whether i s hould take it in the morning or at night...please advice....awaiting your reply...on what to do ?????
Regards..
Hello
Adesam or sedamet is containing S-adenosyl Metheonine and it works for depression by increasing the levels of serotonin. Probably your doctor wants to reduce the dose of sertraline after the adesam has started its effects. Regarding pramipex , among my patients I generally advise them to start the medicine in the mornings and then after the dose increase I advise them to take twice a day.
Its a good medicine. But as Doctor Spring is an online forum I wont be able to prescribe you the medicines online without physically examining you. I would suggest you to discuss about this medicine with your psychiatrist and get it prescribed.
Patient replied :
Hello Doctor
What other details you require to physically examine..me...ifyou want we can have a video chat ...or i m ready to share whatever details you require to examine me in detail...provided alll of it remains confidential....my only concern is to live a healthy life...
Hello,
I am sorry we are only allowed too have email consultations through DoctorSpring.com
We are legally not allowed to have video chat or phone consultations.
Regards.