You may do a very good job of keeping the patient from getting depressed again. I think we do a disservice when we ignore psychotherapy, but my opinion's not widely held, probably. That's a tough problem, the sexual side effects because that's going to really influence compliance. Actually, I had a patient today who was struggling with that. I like to add bupropion to the treatment.
Dopamine is the thing that gets released a lot when using cocaine.
It makes them hypersexual. It's an activating neurotransmitter. I think a dopaminergic agent like bupropion actually will help with the sexual side effects. It doesn't always work, but I've had good luck with that. I don't know if you all have tried that.