Posted by Chairman_MAO on March 4, 2006, at 19:35:55
In reply to Re: Nardil versus Selegiline, posted by Ana-Anita on March 3, 2006, at 23:35:31
I believe Nardil has manifold effects on sexual function. Firstly, MAO-A inhibition causes a massive increase in synaptic concentration of serotonin; this (specifically 5ht2 stimulation) has an inhibitory effect on DA release. This is one substrate for anorgasmia (orgasm involves massive DA release). Nardil administered with paracholorphenylalanine (an SE synthesis inhibitor) was shown in an open trial in the 70s to INCREASE sexual desire in sexually hypoactive males. If you have excessive MAO inhibition, DA synthesis falls as well. Nardil can raise prolactin levels, which inhibits testosterone synthesis, resulting in impaired drive/libido. There are some differences here for men and women, but women need proper testosterone levels to get horny. If the ratio of testosterone:estradiol becomes too high in favor of estradiol, your sexual drive and function will go down the tubes.
Another hydrazine drug with (mild) MAO inhibitory properties, the TB drug isoniazid, has caused gynecomastia (feminine breast development) in men. This leads me to believe that there is something about hydrazine drugs that mucks with the endocrine system/hormone balance. Furthermore, one of Nardil's active metabolites is a potent GABA transaminase inhibitor (one of the enzymes that breaks down GABA). This results in increases GABA levels, which results in increased GABA-B receptor activation. This results in decreased DA release; this coupled with the decreased DA release possible from the rise in synaptic SE probably hurts things. Nardil also induces a rise in NE; this can harm sexual function as well, specificall on a physical level (erectile dysfunction in males, decreased vaginal lubrication in women).Testosterone PRN before sex is a great treatment. 1mg is a good dose for women, 5-10mg for men, though good luck getting a doctor to Rx this. Testosterone combined with a D2 agonist (cabergoline) helps. Cholinergic drugs (bethanechol is in the literature) can help. What specifically are your problems?
poster:Chairman_MAO
thread:615616
URL: http://www.dr-bob.org/babble/20060304/msgs/615986.html