Posted by Maverick on September 6, 2002, at 0:30:16
In reply to Re: Effexor with Mirapex? » Maverick, posted by Rick on September 4, 2002, at 22:28:10
Thanks Rick, your feedback is much appreciated.I chose Mirapex because there have been some studies on its effectiveness in depression. My other choice would be Dostinex (cabergoline) as it is a D2 receptor agonist which can assist in libido and sexual function. It only needs to be taken twice per week as is cheaper.
I do think that my problems stem from high prolactin levels, which dopamine agonists can correct. The reason I say this is that I have noticed a female type fat distribution around my waist, chest area and buttocks, water retention, sore nipples, zero sex drive and erectile dysfunction. I feel that this has dampened by natural production of growth hormone and testosterone production as I fail to see the benefits of excercise like I used to, and no longer retain muscle gains.
I have tried added Wellbutrin to my Effexor regime in the past with no effect. The Effexor is a tried and trusted AD for me, as I have been on at least 10 others with minimal and diminishing effects. I have been on and off AD's for 6 years now.
What is your opinion?
Thanks
Merrick> Not positive, but my understanding was that Mirapex can cause some cognitive dulling, even if it *is* a dopamine agonist. While it might have more side effects (especially nausea and hypotension), bromocriptine/Parlodel might be a better choice. Bromocriptine is sometimes considered a "smart drug." Both Mirapex and bromocriptine have been shown to potentiate antidepressants, too, so you might be able to cut down your Effexor dose a bit, which could further help the sexual dysfunction.
>
> A few other "antidotes" to consider include a small dose of selegiline/deprenyl (although this dopaminergic agent is an MAOI, so strictly speaking it's contraindicated and there's a small possibility of serotonin syndrome...be careful); Buspar; Ginkgo Biloba; and Serzone (again, might allow you to cut the Effexor dose). There are lots of other antidotes to try -- though no guarantees, of course, and some can take awhile to kick in even if they do work.
>
> If none of the add-ons work, maybe you could "ease" into a trial of Serzone or Remeron monotherapy (or moclobemide if you're NOT in the U.S., although this would require a washout period, I believe). I know that's easier said than tried, especially if you've been on Effexor awhile and it works well for your depression.
>
> Good Luck,
> Rick
>
> >
> > I haven't started any form of dopamine agonist yet, but I will let you know when I decide on one.
> >
> > I have tried Wellbutrin SR in the past and don't find it to be of any benefit. It just increased my anxiety andthe Effexor side effects.
> >
> > What would your suggestions be to reclaim my sex life? I am unable to decrease my Effexor without the depression returning.
> >
> >
> >
> > In this scenario, the effexor is not
> > > causeing the sexual disfunction by means
> > > of dopamin down-regulation. It is more
> > > likely caused by an overstimulted seretonin
> > > receptor. Unlike SSRI's Effexor actually
> > > raises brain Dopamine to a certain extent.
> > > I personally found Effexor to be the best
> > > for cognition, (certainly better than some of the
> > > SSRI meds). I don't know of any interactions,
> > > but be careful of Seritonin Syndrome. Dopamine
> > > reputake inhibitors can tend to raise seritonin
> > > as well. It may also raise the insommnia.
> > >
> > > Let me know if you do - I am interested.
> > >
> > >
> > >
> > >
> >
> >
>
>
poster:Maverick
thread:118729
URL: http://www.dr-bob.org/babble/20020829/msgs/118973.html