Q:  Husband's Insomnia & Libido

MY husband takes Celexa for depression and OCD. He has been on it for almost 2 years (40 MG) and it has been working great, he is like a new man that i like to be near However the last few months he has changed.There are some factors involved as well. He just bought a business(manufacturing) and it has been months of waiting, paperwork and mega stress. He also has trouble sleeping, as well as sexual desire decreased alot.

My question is this, aside from the added stress with the business he has been taking sleepease a sleep enhanser or he has a few (2) mixed drinks(vodka) to help him relax and fall asleep. I think this effects the way celexa works because now it as if I have the old guy back which was and is very difficult to live with.

Do you think there is a solution to the insommnia and sexual stuff as well as can alcohol change the effects of celexa?

Thank you Dr. for your help

Jean


Dear Jean -- 
There are a few simple answers in this rather complex situation.  First, stress can decrease sexual desire, no doubt there.  So can alcohol use (though I think perhaps a bit less so).  Of course, so can Celexa, but I gather it didn't for a year or so, so that's much less likely.  

Second, stress obviously is associated with insomnia.  So is alcohol, which when it wears off at about 4-6 hours after use, leaves people "rebounding" into alertness at 0200 or so and having difficulty getting back to sleep.  

Third, can stress or insomnia or alcohol "undo" what Celexa seemed to benefit before?  That's a little less clear, but possible, I would think, based on your info' here.  

You can see that one "solution" that kind of sticks out is to look at decreasing the stress.  Like, duh, of course you've probably tried six ways from Sunday to figure out how to do that.  But in the meantime as you're waiting to see how this business thing goes and whether it's worth what you're going through, there is the more practical and proximal solution: try substituting an exercise program for the alcohol: it works better for sleep, it's a heck of a lot better for your body, and it is a much better overall "treatment" for stress.  For a lot of people it's easier to make a big jump like that (alcohol to exercise) than it is to just try something smaller like backing off a bit on alcohol.  

I know, this is not an earthshaking or brand-new idea, this exercise thing.  Like your aunt Sally could have told you.  But, as solutions go, it really does stick out.  Good luck.  (If he's really drinking twice or three times that, stopping all of a sudden could cause withdrawal which can be medically dangerous, so be careful there). 

Dr. Phelps