Alicia Powell, M.D., is a psychiatrist in private practice in Jamaica Plain, Mass. Like many psychiatrists, she deals with sexual side effects of antidepressants on a daily basis.
“Most of the time the way I approach sexual side effects is to recommend a modified ‘Prozac holiday’. I fine-tune and tailor the procedure for each patient, depending on their schedule and which drug they are taking. For long half-life drugs like Prozac, I feel comfortable having patients stop it completely for two days and then resume it. For shorter half-life agents, like Celexa, Paxil CR or Effexor XR, I’ll more frequently have patients cut the dose in half for a day or two. But even with Effexor XR, which can cause severe discontinuation symptoms, I’ve had patients discontinue it completely for a day, or for a day and a half, and tolerate it fine and report a much improved sexual life.”
KarXT (Cobenfy) is the first antipsychotic that doesn’t block dopamine. We trace the origins of this new drug to a South Asian herb used for over 5,000 years, up to the three...