Hello GrizzlyMantooth. Changing meds is always a tough decision for most of us. I dread changing meds. I haven't taken antidepressants for yrs, because they tend to make me go manic, however at one time or another I have tried a lot of them.
I can't say which med will work best for you as everybody is different. I can tell you a few things that I do know. First 40mg of ciparalex is a lot. Drugs.com or Health Cda's drug data base etc and others advise the usual dose is between 10 and 20 mg, although they do mention doses up to 40 mg so your doctor may have a perfectly valid reason for prescribing 40 mg . However it is known that the more you take of cipralex the higher the odds of running into side effects, especially sexual problems. Source Health Cda's drug data base
http://www.hc-sc.gc.ca/dhp-mps/prodpharma/databasdon/index-eng.php and others.
I also know that for many people, such as myself, that the amount of psych drugs that I have to take during my " get the damn thing under control " phase are much higher than the amount that I take as a maintenance amount. So you might ask your doc about taking a lesser dose .
In regards to Viagra etc, I find that it is expensive if you don't have a health plan (around $10 a pill) and it doesn't always work. There are several other brands out there and what works for one person may not work for another. Having said that Viagra is what works best for me, Cialis doesn't work at all.
Perhaps others have more or better info, but that's all I got for tonight. Good Luck, I know it's a difficult choice to make to change meds. Take Care.paul m