Q:  Would Wellbutrin Help ED?

My husband is on mood stabilizers for his bipolar disorder.  Unfortunately this has caused a problem with low libido and some E.D. issues.  He was on wellbutrin before, but it made him too manic.  I have read that when used with his mood stabilizers wellbutrin might help the E.D without causing mania.  Unfortunately we cannot afford the PDE5's like levitra or Cialis, because they are not covered by our insurance and cost upwards of $300 for a months supply.  What can we do?  Do you think Wellbutrin with mood stabilizers will help?  I'm having trouble finding information about this.

Thank you.


Dear Ms. E'-

You know, in medical school they really emphasize knowing what one is treating, and this is particularly important when treating erectile dysfunction (ED). As you can imagine, you would certainly want to know that the problem with your husband's libido and sexual performance was coming from the medications before you set out to use a "antidote" to that medication-induced problem.

You probably also understand that there are several other factors which can affect sexual performance. The reason for considering these other possibilities, probably first, is that antidepressants can have a destabilizing effect on bipolar disorder, even when a patient is taking a mood stabilizer. It is already clear that Wellbutrin has the potential to cause problems for him. Being on a mood stabilizer now is no guarantee against similar problems if he takes it again.

Some of the medications that we use as mood stabilizers can affect sexual function, but this is not a common major issue in their use (granted, it could be that this is because people simply do not raise complaints about it, not that the problem is not there). Here is one other explanation, besides looking at the quality of your relationship as a factor in libido: sometimes when people get good mood control their level of sexual activity plummets compared to their previous levels which were probably being driven by phases of hypomania, which is associated with a dramatic increase in sexual interest in many people. The frequency of intercourse might drop from daily to weekly, or even a few times a month. This is not "abnormal", but it is a huge change.

I emphasize looking for other potential explanations because in my opinion he would want to be very cautious about using Wellbutrin for any purpose; so if there is any other way to solve this problem, it is worth looking for.

Dr. Phelps