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Dr. Bob is Robert Hsiung, MD,
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Posted by geno on March 13, 2002, at 17:27:10
I started paxil 2 weeks ago and i could tell my libido dropped. Im also on remeron.
Should i up the remeron to 45mg to kick in the alpha 2 nor receptors (libido) or stay at 30mg and add yohibine?
geno
Posted by TSA West on March 14, 2002, at 1:45:01
In reply to PAXIL Sexual dysfunction, posted by geno on March 13, 2002, at 17:27:10
Raise the Remeron and see what happens. Keep in mind that though the action on the Alpha-2 NE receptor occurs immediately after dosing, the clinical effect is still delayed until the brain has adapted some 2-4 weeks later.
Stay away from Yohimbe, as it can be seriously detrimental to your emotional wellness:
"When administered to humans, yohimbine causes a variety of symptoms, including anxiety, nervousness, palpitations, and restlessness, as well as signs such as elevated 3-methoxy-4-hydroxyphenylglycol and cortisol levels. In fact, yohimbine is one of the agents commonly used to provoke panic attacks and anxiety in studies of the pathophysiology, psychopharmacology, and treatment of anxiety disorders. Tricyclic antidepressants, medications with central alpha-adrenergic blocking properties, centrally acting sympathomimetics, MAO inhibitors, and antimuscarinic agents are all known to potentiate the action of yohimbine. Yohimbine also may contribute to psychotic symptoms, mania, and seizures, but these effects are not well documented.
Clearly, yohimbine-containing products have the potential to produce psychiatric symptoms, primarily anxiety or panic, especially in patients with preexisting panic disorder. While it is important to be aware of this in examining patients with anxiety who are also taking herbal remedies, many commercial products containing yohimbe bark actually have little or no yohimbine."
--Archives of General Psychiatry, November 1998. Herbal Remedies In Psychiatric Practice
+++++++++TSA WEST: Soldiers Without Swords******
Posted by geno on March 14, 2002, at 16:57:23
In reply to Re: PAXIL Sexual dysfunction » geno, posted by TSA West on March 14, 2002, at 1:45:01
thank you tcawest,
i will try upping my remeron to 45mg bid with 20mg of paxil. If the remeron increases causes me not to fall asleep, hopefully the paxil will counteract that, or i can take an ambien.geno
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