Hello Ms. D!

I have a question for you as one who is likely quite familiar with both the benefits and drawbacks of various modern antidepressants.

Since 2005, I have suffered from an "idiopathic" small fiber neuropathy that was only finally correctly dignosed as being caused by Lyme Disease in 2012. Prior to that time, I was one of the countless millions of neuropathy patients who had fallen through the cracks with Lyme undignosed, due to the traditionally lousey Lyme antibody testing (ELISA, Western Blot) which kept missing me.

My breakthrough came in 2012, when my diligence in following legitimate Lyme research on-line finally brought me to the revolutionally new "Borrelia" (Lyme)blood culture test offered by "Advanced Labs" of Philadelphia ( www.advanced-lab.com ). My blood culture, in-turn, was positive for "Borrelia", and all of the pieces finally fell into place.

All that being said ...

I was one of the first to use Cymbalta when it became available in 2005 for my small-fiber pain, and have always had great success (75% overall pain relief) with it for my physical small-fiber discomfort.

As such, over the last eight years I have used it as needed, and then tapered-off when I did not.

However, I also noticed that my mood was significantly improved at the same time, leading me to conclude that I likely also suffered from mild to moderate depression (imagine that, after suffering undignosed with Lyme for years )

The only side effect of Cymbalta for me was extreme difficulity in having an orgasm and, as a relatively young guy who loves sex, that is a significant drawback to an otherwise wonderful drug! As a result, I was forced to only use it when I was going through a difficult period of small-fiber pain.

So here is my question ...

Having recognized that depression is present in my life, I would like to experment with a different anti-depressant that does NOT have sexual side effects. This anti-depressant does NOT need to treat pain; rather, just depression itself, as my pain issues are coming under control as I treat the Lyme.

What anti-depressants are available in 2013 that are regarded as relatively safe, mild and managable, do not have sexual side-effects, and might fit the bill of a 54-year old guy who only needs them for relatively mild depression?

As always, thank you for your remarkable insights, and I also welcome comments from other KNOWLEDGABLE contributors.

David