I need advice

[Guest guest]

I have a long term problem of depression, I have tried many medications and talk

therapies with limited or temporary successes. I did well on a cocktail of

mirtazapine and sertraline but I discontinued it because of sexual and

non-sexual side effects. Duloxetine worked too but made me impotent, thankfully

that was reversed when I discontinued the medication.

I am fed up with medications and I am looking into transcranial magnetic

stimulation and even ECT, electroconvuslive therapy.

Nevertheless at the moment I really need medication and I am on agomelatine 50mg

but my psychiatrist wants me on nortriptyline too because I am just too unwell.

Nortryptiline is a tricyclic antidepressant, an old type, pre-ssri,

antidepressant.

I can already see already that diminishes my libido and makes harder for me to

achieve erections, my doc suggests me to keep using it saying that sexual side

effects could diminish with time, but I don't believe that, because in my

experience with previous ADs that never happened. In any case he suggests I

could use levitra or cialis.

I am in two minds, I really need to improve my depression because I am suicidal

but I don't want to have sexual problems. Also I fear that tricyclics too, like

SSRIs could cause long term sexual issues.

Do you have any advice? Thanks