Dysthymia, chronic anxiety neurosis (panic), chronic insomnia suffering from 21 years. 10 days back doctor prescribed me serta 50, bupran150 mg, arip10 mg, clonotril 0.5 mg, tryptomer25 mg. Now from 10 days no interest in sex, erectile dysfunction due to serta. I am afraid of bupran150 because I have monthly twice take 180 ml brandy. Is seizure, liver damage with bupran? Can skip the bupran? Is bupron taking take alcohol monthly twice? Even arip10 mg, clonotril, tryptomer, I have no very well sleep. Mirtaz is more sedation. escitalopram side effect me loose stool, stomach upset. venlafaxine, paroxetine no sexual feelings, I take duloxetine, olanzapine, divalproex 500. So now I am diabetes, grade 2 fatty liver. So duloxi discontinued. So doctor prescribe serta, bupran, arip, tryptomer. Sir/ madam can I take vortixitine instead of serta, bupran. Is it is very effective other than ssri, snri I mean serta, bupran. Can I take zyprosyn instead of arip. I have no very well sleep these medications.