SSRI's work by increasing the neurotransmitter serotonin in your brain, this is what helps with depression and anxiety, but to much "serotonin" can also inhibit libido and make it 99% harder to orgasm. It's also 99% that when serotonin increases, dopamine is reduced!! Dopamine is a neurotransmitter that actually facilitates arousal (among other things), so if you're secreting less of it, you'll have a much harder time getting and staying turned on!!
SSRI's binds with' high' affinity to the serotonin reuptake site, but not to the norepinephrine or dopamine reuptake sites. SSRI's potently and selectively inhibits reuptake of serotonin. They also bind selectively with high affinity to 5-HT receptors and is a 5-HT receptor partial agonist.
It is a total disconnect between 'upstairs' and 'downstairs'!! Gimmick stuff ate going to do it!
I don't think the older 'tricyclic antidepressants have as much of an effect on libido as the newer based ones.. She could consider switching to a different one. And I don't think the tricyclics aren't as effective just b/c they're older. They have worked great in many women, in fact if anything it improved it, though I think that was more because they were feeling better generally than b/c of any side effects of the medicine. Basically, it's totally individual, the body sort of recalibrates and it doesn't affect it anymore.
Ask her doctor OR suggest adding on another medication like something that increases dopamine, or temporarily suppresses serotonin. Orgasm releases the hormone 'oxytocin'..
I think I told you about a couple thinks years ago. These are all compounded, and new a script.. I will add another that your need.. Sildenafil 3% - Nitroglycerin 0.2% and is hypoallergenic. Cream , also compounded. Its called Scream Cream or V Cream. Apply it the clitoris, it increases blood flow,and will help orgasm..
If her doctor isn't of this school', than go to any Hormone Replacement Clinic or Wellness Clinic/Center for women, they will know exactly what all these products are...
You can check out Dr. Randolph's site, he's a compound pharmacist I've know for years. Look at the Natural Balance Cream Progesterone Cream.... He has a lot of good stuff for both male/female..
www.agelessandwellness.com
I'm going to PM you brother with some info tomorrow ...…..Relax MA, this is very old school...…...AM