Well, here’s an amusing coincidence…

Last month, I was prescribed Bupropion 150mg a day for treating anxiety. Last week, my doctor upped the dosage to 300mg a day, split up into two 150mg doses  in the morning and evening. She picked this specific drug because it is not an SSRI, and therefore will not conflict with my migraine medication. I was looking up information about the drug on wikipedia, and discovered this:

Bupropion is one of few antidepressants that does not cause sexual dysfunction. According to a survey of psychiatrists, it is the drug of choice for the treatment of SSRI-induced sexual dysfunction, although this is not an FDA-approved indication. Thirty-six percent of psychiatrists preferred switching patients with SSRI-induced sexual dysfunction to bupropion, and 43% favored the augmentation of the current medication with bupropion. There are studies demonstrating the efficacy of both approaches; improvement of the desire and orgasm components of sexual function were the most often noted. For the augmentation approach, the addition of at least 200 mg/day of bupropion to the SSRI regimen may be necessary to achieve an improvement since the addition of 150 mg/day of bupropion did not produce a statistically significant difference from placebo.

Several studies have indicated that bupropion also relieves sexual dysfunction in people who do not have depression. In a mixed-gender double-blind study, 63% of subjects on a 12-week course of bupropion rated their condition as improved or much improved, versus 3% of subjects on placebo. Two studies, one of which was placebo-controlled, demonstrated the efficacy of bupropion for women with hypoactive sexual desire, resulting in significant improvement of arousal, orgasm and overall satisfaction. Bupropion also showed promise as a treatment for sexual dysfunction caused by chemotherapy for breast cancer and for orgasmic dysfunction. As with the treatment of SSRI-induced sexual disorder, a higher dose of bupropion (300 mg) may be necessary: a randomized study employing a lower dose (150 mg) failed to find a significant difference between bupropion, sexual therapy or combined treatment. Bupropion does not adversely affect any measures of sexual functioning in healthy men.

So basically, I am currently on a drug that is used to treat HSDD at the recommended dose for such a treatment. I doubt that it will have any effect on me, since according to this, the main effects are on arousal, orgasm, and overall enjoyment—none of which are things I have any problems with. (Why then, I wonder, is it prescribed for a desire disorder which may be renamed to Sexual Interest/Aversion disorder? The problem that this drug treats doesn’t seem to be with desire for or interest in having sex. It seems to be mainly with physiological function. Maybe someone can enlighten me?) But I’m open to seeing what the effects are, and whether they do indeed increase my general motivation to have sex or level of sexual attraction. So far, zilch. But it’s only been a week, and it takes time for this drug to take effect. I’ll report back on how it’s affecting me later.

I hypothesize that it won’t change my asexuality at all, because contrary to popular opinion, asexuality and HSDD are not the same thing. But I’m entertaining the possibility that it actually might. We’ll see.

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10 thoughts on “Well, here’s an amusing coincidence…

  1. One of the early pharmacological studies on HSDD “found” that Bupropion worked better than the control group–except that for some bizarre reason, the control group wasn’t a placebo, but some other drug. A latter study tried to replicate their findings, except using a placebo. Compared with that Bupropion was not more effective. I don’t know if there were studies since then that have attempted to try again.

    Decreased sexual interest is a commonly reported side-effect of a number of SSRI’s, whereas it isn’t for Bupropion, which is why it is often preferred for patients with sexual dysfunction (or “sexual dysfunction” depending on how you want to look at it.)

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    • Hmm, interesting. I hadn’t had time to actually check the references when I posted, because I was about to leave. I’ll have to look into it and see if I can actually find any placebo-controlled study with a positive result that’s suggested to exist in the article. Wouldn’t be the first time that Wikipedia is just plain wrong about something.

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  2. So if you did change significantly and stop being asexual, would that stop asexuality being an orientation? Is there a difference between an asexual taking a pill and developing sexual attraction and a heterosexual taking a pill and loosing it? (these are thinking aloud, not rhetorical questions)

    About the desire thing, HSDD/sexual interest/desire disorder is the only thing they have to throw at you when you have a generic sexual dysfunction, so they use it for all stages of the Masters-Johnson cycle.

    Also, in a more conspiracy-theory way, can I call heteronormativity on this? According to the standard masculine tropes, the important thing is that a woman can be bedded, not that she enjoys it. Hence, maybe, FSD’s focus on the initial stages?

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    • I don’t think a single person changing from a drug would stop asexuality from being an orientation. There would have to be a significant amount of good evidence to support it, which means a large sample size in a double-blind placebo-controlled study with no problems with methodology, which would prove to be repeatable. There have been people who thought they were asexual and then discovered that they weren’t before, and the ones who concluded that that’s true for everyone I’ve always disagreed with because they have absolutely no evidence to back that up. For the second question, I have a sense that there’s a difference at least in cultural perspective, but can’t really articulate it now.

      I suppose that’s true, though if it’s generic, I wish they would rename it to sound more generic. The way they’re framing it vs. the way they’re treating it don’t really match up, and that’s pretty confusing. :/

      That sounds more like sexism than heteronormativity to me, although I suppose heteronormativity is pretty sexist in a lot of ways. But if Bupropion actually treats level of enjoyment, then doesn’t that mean that this takes more of a feminist, women-are-sexual-beings-too and enjoyment matters kind of perspective? Also, I don’t know if you can really separate desire/interest from enjoyment too much, but isn’t the fact that the women are seeking treatment (assuming they haven’t been coerced) proof that there is sexual interest/desire even if there is not really motivation to pursue it in real life? Although I suppose that since Bupropion is a dopamine reuptake inhibitor, and dopamine is associated with motivation as well, it might increase that in some patients, though I haven’t heard of any evidence that directly suggests that (not that I’ve looked too hard), and it might only work on a certain type of receptor… Btw, I’m guessing you meant HSDD, since FSD is more of a catch-all umbrella term?

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      • Sorry, I’ve realised I wasn’t very clear before. I know one person taking a pill and suddenly developing sexual attraction doesn’t mean anything for the rest of the asexual community. My point was, if there’s pills a straight person can take which will make them functionally asexual, we still consider them straight. So if there’s pills which any asexual could take which start making them feel sexual attraction, is that the same deal?

        I agree, the current system has a lot of emphasis on desire/arousal, which may or may not be the result of residual sexism. A system which places more emphasis on enjoyment, or just on every aspect, would be more feminist, less directly antagonistic to asexuality, and probably more helpful to women with FSD, who, as you say, often have desire, or they wouldn’t be pursuing treatment.

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        • Hmm, I think there might be a difference mainly because the sexual-asexual spectrum is different from the straight-gay spectrum (or spectrums, really). If you’re sexual, you’d tend to descibe yourself without actually saying that, and more in terms of the direction of sexual attraction… but since asexuals don’t have sexual attraction to begin with, maybe it doesn’t really work the same way? I’m just thinking aloud here, too. I guess the question is more about whether a person’s true self is the unmedicated version, or the medicated one. I’ve seen some posts about this with regard to schizophrenia and mood disorders before… I suppose it depends on perspective. I’m sure the default perspective from a non-asexual person would usually be that asexuality is some kind of dysfuntion/disorder/disability, so therefore the medicated version is truest. Asexuals themselves, not so much.

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  3. Keep us posted! I appreciate your investigative attitude :) I don’t know whether I’d be as game to find out how a drug affects libido. Why didn’t your doctor tell you about the possible side effects? Does she know you’re ace? I’d be a little weirded out that my doctor failed to mention anything my drug could do to me, let alone possibly affecting libido, up or down. I think I’m just paranoid. (cue Garbage song..)
    Best of luck!

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    • Oh no, she has no idea I’m ace. It didn’t seem really relevant to say it… She did tell me the drugs don’t have sexual side effects, but of course she didn’t mention the increase of desire/enjoyment/whatever because people never assume that’s a bad thing to anyone. It’s pretty much always viewed as an improvement by default, which is very sexual-normative. Of course I still doubt it will really do anything for me, so I’m not sure it’s worth it to ask… maybe I’ll decide that I want to by the time of my next appointment, which is in a month, though.

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      • I suspect the drug hasn’t been shown to increase enjoyment in people with normal sexual function; therefore unless your doctor had thought you suffered from a disorder, there would be no reason for her to mention that possible side-effect.
        I was on Budeprion (150mg) last year, to see if it would help with my mood/dysthymia. I don’t recall any sexual side-effects, but the other side-effects were bad enough that I quit taking it after a while. It seemed to make me more prone to bursts of rage, although that might have been coincidence.

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  4. I don’t know much about pharmaceuticals, but this makes me wonder if, assuming a pill could change your orientation, ones orientation would revert back to what it was after some time of concluding treatment. I’m not even sure that a sexual orientation could be changed through pills, but if it could would that change be pill-dependent, in other words. Hmmm. This kind of speculation might not even be relevant at this stage.

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