Shown: posts 1 to 10 of 10. This is the beginning of the thread.
Posted by JohnL on September 7, 2000, at 4:44:12
So, here's the scoop...
After not doing all that well with just about any antidepressant out there, I've found that Adrafinil, Amisulpride, or both together work wonderfully. But I seem to have a rare side effect with either of them...difficulty in the love-making department.I've heard scattered reports that Bromocriptine can reverse sexual side effects, including those caused by Adrafinil or Amisulpride.
So, my questions...
Does anyone know what the dose range should be?
Anyone else tried Bromocriptine?
Any stories to share?Mainly I'm interested in finding out about the dose range. I can't seem to find much information in literature about that.
Thanks,
John
Posted by Cam W. on September 7, 2000, at 6:49:09
In reply to Bromocriptine?, posted by JohnL on September 7, 2000, at 4:44:12
John - Bromocriptine (Parlodel™ & others) is a dopamine D2 agonist (stimulates D2 receptors - the opposite of traditional antipsychotics, like Haldol™). Originally it was mainly used to help new moms dry up their breast milk, but it was found only to delay the agony (no personal experience, just bitching from customers).
Bromocriptine is a D2 agonist it inhibits prolactin, suppresses growth hormone, and is sometimes used for the tremors of Parkinson's disease (although, it may actually worsen this disease) via the nigrostriatal pathway.
The way it probably only works for sexual dysfunction caused by hyperprolactinemia (too much prolactin, as is seen with some antipsychotics and in some menstrual disorders), although I have seen it tried in SSRI-induced sexual dysfunction (with not good results). The rationale here may be to reverse some of the dopamine suppression due to the increase in the body's serotonin levels (a big leap of faith and a little too reductionistic a view of the neurotransmitter system, for me).
One of bromocriptine's side effects is to produce those nasty free radicals that kill cells (and are mopped up by antioxidants, like vitamin C) as is seen in some cancers. Other side effects are the usual headache, nausea, vomiting, cramps, dizziness, etc. Some less likely ones are skin mottling, hair loss, changes in urinary frequency, confusion, hallucinations, fatigue, edema of feet, etc. Also, it is not to be used in people with heart problems.
Would I reverse drug-induced sexual side effects with this drug? Only if my breasts were leaking from galactorrhea. Bromocritpine has too many side effects and doesn't work that well. IMO, •don't bother•.
BTW - the usual dose is 1.25mg daily (with food) and titrate slowly (as needed) to 2.5mg three times daily.
Hope this helps - Cam
Posted by shellie on September 7, 2000, at 7:59:52
In reply to Bromocriptine?, posted by JohnL on September 7, 2000, at 4:44:12
> So, here's the scoop...
> After not doing all that well with just about any antidepressant out there, I've found that Adrafinil, Amisulpride, or both together work wonderfully. But I seem to have a rare side effect with either of them...difficulty in the love-making department.
>
John, I got this somewhere off Depression Central:
Five patients treated for DSM-IV diagnosis of Depression with an SSRI (fluoxetine or sertraline) developed sexual dysfunction during the course of their treatment. The three men in the study reported anorgasmia, decreased libido, and erectile failure. The two women had anorgasmia, delayed orgasm and decreased libido. Each patient was startedon a course of Ginko Biloba Extract 60 mg. (50:1 extract) twice a day.
There were no contraindications for the use of GBE, such as use of anticoagulants, coagulopathy,nor allergy to GBE.
Doses were titrated to 120 mg. twice a day over a 4 week period. Patients were assessed by clinical interview and subject reporting on the following parameters: change in libido, ability to achieve orgasm, and erectile competence.
Results
Sexual dysfunction was effectively reversed by GBE 240 mg. per day in each patient. Each patient chose to continue the treatment for an open ended period with clinical monitoring of symptoms.
Just something maybe to try (despite N = 5, response was 100%!). Shellie
Posted by AndrewB on September 7, 2000, at 11:10:49
In reply to Re: Bromocriptine?, posted by Cam W. on September 7, 2000, at 6:49:09
Cam, John,
Thank you Cam for the info on bromocriptine. I hope you are feeling better. I haven't noticed any side effects these first first days of mine on bromocriptine. No nausea or headaches for example. Thefree radical damage is troublesome. I wonder if the selegiline I'm taking should counter that along with the antioxidants I take.
BTW, Mirapex (pramipexole) I believe lowers prolactin much like bromo. but actually exerts a neuroprotective effect. Perhaps the best solution is that if someone finds bromcriptine effective, to then switch to pramipexole for long term use.
Any comments?
AndrewB
Posted by JohnL on September 9, 2000, at 6:00:35
In reply to Bromocriptine?, posted by JohnL on September 7, 2000, at 4:44:12
This is a darn frustrating situation. I think the only way to find out for sure is a trial. It's a darn shame, because I can be nearly 100% well with Adrafinil+Amisulpride, but sexual difficulties makes the whole deal stink.
I stopped Amisulpride a week ago, just to see if it was the one causing sexual probs. After four days, sexual function returned almost to normal. Adrafinil alone is somewhat guilty as well, though Amisulpride seems to be the main culprit. But depression is creeping back in. My wife says she can tell a big difference, because I walk different, talk very little, spend little time on hobbies that would othewise keep me very busy, and have a 'certain' expression on my face that advertises depression. Strange how others noticed before I did. Even my neighbor commented to my wife that I haven't been dabbling in my backyard garden. That's a dead giveaway. I normally spend hours in my fruit gardens and get a lot of pleasure out of it. Lately it seems so remote and I could care less about it. And at work I have no motivation. Everything is an effort. Even the simplest of tasks are starting to look overwhelming.
So, I know what works but I lose my sex life. What a cruel tradeoff. My options at this point are confusing. Do I try increasing Adrafinil alone? Do I stop it completely and just do Amisulpride? And then when the sexual probs kick in (about week 2), start Bromocriptine? Start Amisulpride and Bromocriptine at the same time? Damn damn damn. Decisions decisions. One thing for sure, I can feel the spiral down gathering strength, and I gotta do something. And I know from past experience my doctors have been rather fruitless at helping much.
I wish I could just forget it all, like a bad nightmare, and wish it away. I wish I could be like most of my doctor's patients, and take Prozac or Zoloft and be well. Of course, I've spent the last 10 years going those traditional routes with little success. Nothing has compared to the effectiveness of Adrafinil+Amisulpride combo. Geez.
Frustrated John
Posted by michael on September 9, 2000, at 7:51:41
In reply to Re: Bromocriptine?, posted by JohnL on September 9, 2000, at 6:00:35
John -
The place that I got the initial idea for trying bromocriptine was a msg in the tips section - the doc was specifically trying to address med-induced sexual dysfunction. Said he had good results, and if I remember correctly, also mentioned a "nice brightening"[my phrase-didn't bother to go look it up just now] (of mood, I guess) as well.Unfortunately, no details/specifics on dosage, or if it was "as needed" or a continual/daily dose, etc...
Anyway, it helped me when I experimented with it, and I was only taking 2.5mg (one tablet) per day - don't know how quickly I responded, but I know it was w/in a number of days...
Sorry I don't have better info for you - I've been experimenting w/my doses, trying to figure out what/how much is most beneficial for me w/my base meds (adrafinil/amisulpride, of course).
When I had the success w/the bromocriptine, I think I was only taking the adrafinil. The adrafinil had a definite negative impact for me, and the bromocriptine made a definite positive impact - nullified all the negatives.
However, I wasn't terribly scientific about it at the time - I know I was taking the 2.5mg/day (less than a week), but I thind I may have added an extra tablet - in anticipation.... anyway, I had definite, noticable, postive results. However, requires more experimenting. Sorry I don't have more to offer, but I'm very optimistic - I need to be more rigorous about it next time...
Fwiw, I'd be interested in any feedback from you too.... Good Luck! michael
> This is a darn frustrating situation. I think the only way to find out for sure is a trial. It's a darn shame, because I can be nearly 100% well with Adrafinil+Amisulpride, but sexual difficulties makes the whole deal stink.
>
> I stopped Amisulpride a week ago, just to see if it was the one causing sexual probs. After four days, sexual function returned almost to normal. Adrafinil alone is somewhat guilty as well, though Amisulpride seems to be the main culprit. But depression is creeping back in. My wife says she can tell a big difference, because I walk different, talk very little, spend little time on hobbies that would othewise keep me very busy, and have a 'certain' expression on my face that advertises depression. Strange how others noticed before I did. Even my neighbor commented to my wife that I haven't been dabbling in my backyard garden. That's a dead giveaway. I normally spend hours in my fruit gardens and get a lot of pleasure out of it. Lately it seems so remote and I could care less about it. And at work I have no motivation. Everything is an effort. Even the simplest of tasks are starting to look overwhelming.
>
> So, I know what works but I lose my sex life. What a cruel tradeoff. My options at this point are confusing. Do I try increasing Adrafinil alone? Do I stop it completely and just do Amisulpride? And then when the sexual probs kick in (about week 2), start Bromocriptine? Start Amisulpride and Bromocriptine at the same time? Damn damn damn. Decisions decisions. One thing for sure, I can feel the spiral down gathering strength, and I gotta do something. And I know from past experience my doctors have been rather fruitless at helping much.
>
> I wish I could just forget it all, like a bad nightmare, and wish it away. I wish I could be like most of my doctor's patients, and take Prozac or Zoloft and be well. Of course, I've spent the last 10 years going those traditional routes with little success. Nothing has compared to the effectiveness of Adrafinil+Amisulpride combo. Geez.
> Frustrated John
Posted by Seamus2 on September 9, 2000, at 11:32:36
In reply to Re: Bromocriptine?, posted by JohnL on September 9, 2000, at 6:00:35
> >but sexual difficulties makes the whole deal stink. < <
Out of curiosity, what specific sexual difficulties are you experiencing?
Lack of libido, erectile difficulties, anorgasmia?
I tried Bromocriptine many years ago while on Nardil to combat anorgasmia. Didn't help and made me light-headed.
I recently discontinued my Parnate of many years and am waiting for Amisulpride to get here to give it a trial.
Seamus
Posted by AndrewB on September 9, 2000, at 15:17:47
In reply to Re: Bromocriptine?, posted by Seamus2 on September 9, 2000, at 11:32:36
Just to correct some misinformation in an above post, bromocriptine is neuroprotective rather than neurotoxic. See the medical abstracts below for more information.
Bromo. can cause nausea, headaches, etc. in some individiuals. These side effects usually go away quickly. They can be minimized by taking bromo. with food and starting at a low dosage and moving up slowly.
Other rare but serious side effects can occur with bromo. that I don't know the specifics on.
Bromo. is effective in lowering prolactin. Raised prolactin can cause sexual dysfunction in men and swollen breasts, weight gain, and missed menses in women. If you experience these effects when taking amisulpride, it is safe to assume they are due to raised prolactin levels.
I am taking bromo now., 2.5mgs at twice a day, and will get a prolactin level test in 2 weeks to see if it is effective in lowering raised prolactin levels due to amisulpride. I do not know if I will continue taking bromo. though because I don't seem to be experiencing any effects due to my raised prolactin levels.
Perhaps the endocronologist I will see can tell me whether there is anything I should be concerned about.
AndrewB
---------------------------------------------------------------------------Title: Neuroprotection by bromocriptine against 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine-induced neurotoxicity in mice.
Source: FASEB J 1998 Jul;12(10):905-12
Authors: Muralikrishnan D; Mohanakumar KP
Address: Laboratory of Neurochemistry, Division of Pharmacology and Experimental Therapeutics, Indian Institute of Chemical Biology, Calcutta.Mice were treated with 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine (MPTP; 30 mg/kg i.p. twice, 16 h apart). This resulted in changes in motor performance and toxic insult of nigral neurons as evidenced by dopamine depletion in nucleus caudatus putamen. In vitro and in vivo treatment of MPTP caused the generation of hydroxyl radicals (.OH) as measured by a sensitive salicylate hydroxylation procedure. A dopamine agonist, bromocriptine (10 microM and 10 mg/kg i.p.), blocked .OH formation caused by MPTP in vitro (20 microM) and in vivo (30 mg/kg i.p.). An MPTP-induced increase in the activity of catalase and superoxide dismutase in substantia nigra on the seventh day was reduced by bromocriptine pretreatment. Bromocriptine blocked MPTP-induced behavioral dysfunction as well as glutathione and dopamine depletion, indicating its potent neuroprotective action. This study suggests that bromocriptine stimulates antioxidant mechanisms in the brain and acts as a free radical scavenger in addition to its action at dopamine receptors, thus indicating its strength as a valuable neuroprotectant.
------------------------------------------
Title: Bromocriptine protects dopaminergic neurons from levodopa-induced toxicity by stimulating D(2)receptors.Source: Exp Neurol 1999 Sep;159(1):98-104
Authores: Takashima H; Tsujihata M; Kishikawa M; Freed WJ
Address: Section of Neurology, Nagasaki Kita Hospital, Nagasaki, 852-8061, Japan.Neuroprotective properties of bromocriptine, a D(2) receptor agonist, were investigated using the in vitro neurotoxicity of levodopa for dopaminergic neurons from rat embryonic ventral mesencephalon. Levodopa, when added to the culture medium, showed toxicity which was specific for dopaminergic neurons. Bromocriptine was found to protect dopaminergic neurons from levodopa toxicity. Another D(2) agonist, 2-(N-phenethyl-N-propyl-amino-5-hydroxytetralin, showed similar protective effects. The neuroprotective effect of bromocriptine was inhibited by supplementation of the culture medium with sulpiride, a D(2) antagonist, or by D(2) receptor knockdown with an antisense oligonucleotide. Dopaminergic neurons treated with levodopa showed an increase in free radicals. These data suggest that neuroprotective properties of bromocriptine seen in this cellular model of neurotoxicity are dependent on dopamine D(2) autoreceptor binding and that levodopa toxicity may be related to increased free radical generation in dopaminergic neurons.
Posted by JohnB on September 10, 2000, at 14:25:53
In reply to Bromocriptine?, posted by JohnL on September 7, 2000, at 4:44:12
In past discussions of this subject, I often heard Viagra mentioned. Has anyone had any success with that?
Posted by JohnL on September 11, 2000, at 4:39:38
In reply to Re: Bromocriptine?, posted by JohnB on September 10, 2000, at 14:25:53
Michael,
Based on your experience and comments in Dr Bob's Tips as well as other websites, it would appear Bromocriptine is worth a try. In the PDR book I was reading about Zyprexa, and it stated that any D2 antagonist (most antipsychotics) will cause elevated prolactin, with impotence being a common result. Since Bromocriptine counters that, it's probably worth a look-see. I just wonder if it will in any way counter the good effects of Amisulpride or Adrafinil, or perhaps offer side effects of its own that are troublesome. We'll see. One thing for sure, I'm not in good shape at all without Adrafinil+Amisulpride. I need to get back to where I was and then try to treat the side effect.Seamus,
Erectile dysfunction is the problem. It's weird though, it isn't constant. I never know when it will be a problem and when it won't. When it is a problem, it's a good thing I have a patient wife. We can eventually make love if she works long enough to get me started. But it's unpredictable. Each trip to the bedroom is filled with mystery. Will it work this time or will it not? Decrease of libido is also a side effect, but it is not severe like with SSRIs. And it is not constant. At times during the day I'm fine. Other times I could care less. Like the erectile dysfunction, it is not constant. It comes and goes at it pleases without any predictable pattern. It's that unpredictability that is especially troubling.JohnB,
I have tried Viagra. I didn't like it. It made me feel somewhat dsyphoric and irritable, which carried over into the next morning a little bit. It definitely works, but only on erectile dysfunction. It does nothing for desire or sensation. It makes lovemaking almost mechanical, without any joy. It was even almost numbing or anorgasmic in a way.To all,
Thank you all very much for your comments and tips. If any other thoughts or results on Bromocriptine come up, please let me know.One final comment about Amisulpride and tinnitus. I never realized how bad my tinnitus was until I stopped Amisulpride. Amisulpride did a wonderful job of quieting tinnitus. I remember Zyprexa did too. Antipsychotics for treating tinnitus. I can see it now...a patient goes to the doctor because of ringing in the ear, and the doctor prescribes an antipsychotic! Yikes. But hey, they really work!
John
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