HealthCareMagic is now Ask A Doctor - 24x7 | https://www.askadoctor24x7.com

Suggest Treatment For Depression When Diagnosed With Bipolar Disorder

Posted on Fri, 30 Jan 2015

Question: I am suffering with bipolar disorder. Currently, I am going through a serious depressive phase. My sex drive has been seriously affected. Why am I not as attracted to women as I used to be? My libido used to be quite strong

Answered by Dr. Seikhoo Bishnoi (49 minutes later)

Brief Answer:
Reduced libido can be due to depression and side effects of drugs

Detailed Answer:
Hello thanks for asking from HCM

You are 45 years old and have Bipolar disorder. Now you are in depressive phase. You have tried Seroquel (Quetiapine) and Lithium Carbonate. You have complaints of decreased libido. You have depression and this could be a major cause of reduced libido. Reduced libido is common feature of depression. Seroquel or Quetiapine is known to increase prolactin levels and this can cause reduced libido. Both these are most likely reasons for your complaints. Before proceeding to proper detailed answer I would like to know a little detail about your problem-

- Whether you have any complaints of High Blood Pressure. If you have been diagnosed with Diabetes Mellitus?

- If you are currently on Seroquel and Lithium or any other medicine? If yes then at what doses?

- If you have taken any treatment of reduced libido?

Please provide details in follow up question so that I can comment with more details.

Thanks

Dr. Seikhoo Bishnoi
Consultant Psychiatrist

Above answer was peer-reviewed by : Dr. Vinay Bhardwaj

Follow up: Dr. Seikhoo Bishnoi (2 hours later)

I have no complaints of high blood pressure or Diabetes Mellitus. For medications, I currently take Seroquel 200mg and lithium 900mg. I also have an under-active thyroid for which I take synthroid 75 mcg. I also recently started to take a Vitamin D supplement 5000mg. I have never taken any medication to treat low libido per se.

I used to take lithium, lamotrigene, and epival at the same time in order to control my bipolar disorder. I stopped taking all of these at the same time several months ago. This of course was not met with my doctor's approval. At this point in my treatment, should I perhaps go back on these medications since they worked well in combination before? I realize that this might be a hard question to answer.

Thank You, XXXXXXX

Answered by Dr. Seikhoo Bishnoi (7 hours later)

Brief Answer:
Reduced libido is due to depression and side effects of drug Seroquel only

Detailed Answer:
Hello thanks for providing details in follow up question

As you are currently in depression so the treatment of depression should be priority. Improvement of symptoms of depression will result in improvement of libido. Low libido could occur as side effect of 200 mg Quetiapine. Quetiapine is known to result in reduced libido. So either you should be given some mood stabiliser that don't have any effect of libido or drug should be stopped.

Epival or Sodium Valproate is relatively safe drug if we consider libido. Secondly it is one of commonly used mood stabiliser. The drug will control your mood effectively without resulting in reduced libido. Lamotrigine is also a mood stabiliser and it have excellent roles in improving symptoms of depression. You can consult your doctor regarding start of these medicines again.

These medicines will not affect libido, and lamotrigine will also improve depression which ultimately result in improvement of libido. You never had high BP, or diabetes so most probable reason of the symptoms is side effects of medicines and depression only.

For some time medicines like Sildenafil, Tadalafil can be used on SOS basis for problems of erection only and this will improve libido also. Herbal medicines like Tantex Forte and Confido have excellent roles in improving libido. These medicines are safe to use and need no prescription. You can take these medicines for some time to improve libido.

Take your medicines in consultation of your psychiatrist only.

Thanks, hope this helps you. Please ask again for more doubts

Above answer was peer-reviewed by : Dr. Prasad

Follow up: Dr. Seikhoo Bishnoi (6 hours later)

Hi.
Does increasing libido also mean that a man's sexual desire/attraction will also increase?

Answered by Dr. Seikhoo Bishnoi (13 minutes later)

Brief Answer:
Yes, libido increase will result in increase in desire.

Detailed Answer:
Hello again,

Yes, increasing libido means increase in sexual desire and attraction towards opposite sex. Libido means sexual desire in broad sense.

Thanks

Above answer was peer-reviewed by : Dr. Ashwin Bhandari

Follow up: Dr. Seikhoo Bishnoi (2 days later)

Hi Doctor
I am suffering from anxiety related to my low libido issue. Currently I am not strongly attracted to women like I used to be and that really bothers me. I just don't feel "normal". Will this change as my depression lifts? I really have a lot to look forward to in life and I want to enjoy it, I really do. At present, I have a great deal of anxiety every day. My last relationship was not a great one although I cared a lot about the woman. When will things get better for me? When will my "mo Jo" return? For the record, although I have lost my interest in women I am not interested in members of the same sex and have no inclinations in that direction. That is not me. Help me. Could u respond ASAP as I have an appointment later today? Thank you.
PS: I still like to watch straight porn in spite of all my difficulties. I still get aroused by watching the naked women

Answered by Dr. Seikhoo Bishnoi (20 minutes later)

Brief Answer:
Yes, improvement of depression will improve libido.

Detailed Answer:
Hello again and thanks for asking a follow up.

Yes, you will regain your libido with improvement of symptoms of depression. Anxiety and depression are the reasons behind your poor sexual desire. Improvement will result in better sexual desire.

Your "mo jo" will return back. Take proper treatment of depression and if needed take the medicines I have advised in my last answers for poor libido. Discuss about these medicines with your doctor.

As you are getting aroused by watching porn this also strengthens our diagnosis that psychological reasons are behind poor libido. Try to relax yourself and discuss with your doctor.

Thanks

Above answer was peer-reviewed by : Dr. Ashwin Bhandari

Follow up: Dr. Seikhoo Bishnoi (2 hours later)

Hi
Thank you for your help, Doctor. This is such an important issue for me. To me, it is about who I am as a man and as a person. In my current state, every aspect of my life is affected. I want to be well again.

Answered by Dr. Seikhoo Bishnoi (21 minutes later)

Brief Answer:
Improvement in anxiety will improve sexual desire

Detailed Answer:
Thanks its pleasure to answer you. Please don't think that you have some deficiency. Such type of problems are common in adult males at any phase of their life. Keep believing in yourself and keep one thing in mind that the problem of poor libido is only due to psychological reasons like anxiety. Try to come out of this anxiety. Improvement of anxiety will result in improvement of sexual desire.

Thanks, wish you a good health.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Seikhoo Bishnoi (1 hour later)

Hi. I would like to ask you another question as it relates to my anxiety. Several months ago, my girlfriend at the time made a very upsetting statement. I was very depressed and knew that I was suffering sexually. There was nothing there! She suggested that maybe I was discovering later in life that I was actually gay!! I couldn't believe it. Although I know I am not attracted to men, what she said has stuck in my mind ever since. It's not easy to get rid off. It all ads to the fact that my sex drive is so low. Overall, my life is a living hell! I can't forget what XXXXXXX said. I can tell myself a million times I'm not XXXXXXX but, I still feel terrible.
Please help me! I need some advice soon. I am going to see a therapist today
Thank you
PS: don't forget, I am aroused by straight porn. I also get excited by webcam girls. Overall, I am attracted to larger women.

Answered by Dr. Seikhoo Bishnoi (9 minutes later)

Brief Answer:
You are a normal heterosexual male and no doubt in that.

Detailed Answer:
Hello thanks for asking again

You have desire for women always and this is also reflected in your question so there is no question of you being homosexual. She has probably made the statement in anger to hurt you but you have started thinking about this thing again and again. This has resulted in obsessive thinking. You are not able to control these intruding thoughts and this is due to severe anxiety only. You are compelled to tell yourself that you are not XXXXXXX and this is also due to severe anxiety. This anxiety can also worsen your sexual power and desire. Try to reassure you and if possible tell about this thing in detail to your therapist. This could be due to obsessive thoughts.

Obsessions are repetitive intrusive dominating thoughts or ideas that are purposeless and individual is aware of that these are useless still fails to control them. To prevent these ideas they are compelled to follow a thought or behaviour like "telling yourself that your are not gay" in your case. These are called compulsions. These are disorders of anxiety. Try to explain your therapist in detail. I am sure by talking to your therapist about your thoughts you will feel relieved and relaxed.

Thanks, get back to me after visiting your therapist and if you have more doubts now you can ask again in follow up.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Seikhoo Bishnoi (8 minutes later)

Thank you so much for your help Dr. I will keep you posted.

Answered by Dr. Seikhoo Bishnoi (9 minutes later)

Brief Answer:
Wish you a good health

Detailed Answer:
Thanks and wish you a good health.

Take Care

Note: For further guidance on mental health, Click here.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar