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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 12 to 36 of 36. Go back in thread:
Posted by Nezirov on June 24, 2005, at 19:09:47
In reply to Re: sex and ADs?!?! okay, honestly..., posted by Phillipa on June 24, 2005, at 19:07:40
Really? You're sex drive never came back? When was the last time you took an SSRI?
N
Posted by Nezirov on June 24, 2005, at 19:18:44
In reply to Re: sex and ADs?!?! okay, honestly..., posted by Phillipa on June 24, 2005, at 19:07:40
Hi again Philippa,
Didn't you say in an earlier post to linkadge that you believe once you're off SSRIs sexual functioning should return to normal? I guess you weren't refering to your own case? Not trying to put you on the spot, BTW.
Nezirov
Posted by ed_uk on June 24, 2005, at 19:50:52
In reply to Re: sex and ADs?!?! okay, honestly..., posted by Nezirov on June 24, 2005, at 18:41:52
Hi N,
>It appears that the celexa may have dirupted my hypothalamus-pituitary-testicular axis and given me low testosterone.
Have you had your testosterone level measured? If so, were you prescribed testosterone replacement therapy? Did it help?
>When you think about it, it's a miracle that some people seem to get almost no side effects from SSRIs.
I've taken various SSRIs.....
Celexa 60mg
Paxil 60mg
Prozac 20mg etc.They do reduce my anxiety and OCD which I why I continue to take them. My side effects......
Low libido, drowsiness, reduced motivation and profuse sweating.
So....what have you tried to increase your libido??
Wellbutrin?
Cabergoline?~Ed
Posted by Nezirov on June 24, 2005, at 20:11:42
In reply to Re: sex and ADs?!?! okay, honestly... » Nezirov, posted by ed_uk on June 24, 2005, at 19:50:52
I'm thinking about wellbutrin and cabergoline. More so cabergoline. Have you ever tried either of them? I'm wary of wellbutrin because my major complaint has always been anxiety, rather than depression, and I've heard that wellbutrin causes anxiety. Not sure it would be a good idea. I just wish I knew what the heck was going on. I'm furious that a so-called "antidepressant" could do this. Talk about having something to be depressed about...
I'm seeing a specialist in male TRT next month and hopefully we can restart my HPTA and get my T up to were it used to be. If T is the only thing causing my reduced libido, it must have been very high before, maybe around 1000 ng/dl. Right now its 375.
Posted by Nezirov on June 24, 2005, at 20:18:57
In reply to Re: sex and ADs?!?! okay, honestly... » Nezirov, posted by ed_uk on June 24, 2005, at 19:50:52
I'm also thinking about trying aurorix (moclobemide). I'd rather not try any more psch. drugs at this point. I think they do me *way* more harm than good. For a lot of people they are also very addictive. Once you've been on an SSRI for a while,, well, you know the rest.
Celexa was enough. But if this is the only way to get my sex drive back...I'll reluctantly try somenthing else.
Posted by Maximus on June 24, 2005, at 20:43:58
In reply to Re: sex and ADs?!?! okay, honestly..., posted by Nezirov on June 24, 2005, at 18:41:52
> It appears that the celexa may have dirupted my hypothalamus-pituitary-testicular axis and given me low testosterone.
You are absolutely right :-( *sigh* Long term SSRI's treatment lowers dramatically the testosterone level...
Posted by ed_uk on June 24, 2005, at 20:56:38
In reply to Re: sex and ADs?!?! okay, honestly..., posted by Nezirov on June 24, 2005, at 20:11:42
Hi N,
>More so cabergoline. Have you ever tried either of them?
No. Chairman_MAO currently takes cabergoline for sexual dysfunction associated with various medications: opioids and MAOIs. He has found it helpful. You might want to search from some of his posts.
>I've heard that wellbutrin causes anxiety.....
It often does...but not always.
~Ed
Posted by Chairman_MAO on June 25, 2005, at 12:41:47
In reply to Re: sex and ADs?!?! okay, honestly..., posted by Nezirov on June 24, 2005, at 14:44:29
You should get a doctor to prescribe you a DA agonist. The two most pro-sexual ones are Uprima (apomorphine, used as-needed) and cabergoline (as needed, but takes hours to work, or all the time). Others that have good track records are ropinirole, lisuride, bromocriptine, and probably pergolide and pramipexole (just dont remember). Oh yeah, and amantadine, but that makes some people feel downright strange and is not as strong as the rest of them.
Let me just stress something again: for such an anhedonic state, you need a dopaminergic drug. Parnate would probably also work, as might wellbutrin or a psychostimulant.
Posted by Chairman_MAO on June 25, 2005, at 12:57:48
In reply to Calling Chairman_MAO » Nezirov, posted by ed_uk on June 24, 2005, at 20:56:38
Actually, cabergoline is not working as well in that department as it once did. There is a possibility, however, that the reason for this is that I started taking Nardil with bioperine, a bioavailability enhancer (to see if it would work better). I forgot the bioperine a few times in a row, and notice that I'm starting to feel the serotonergic-agent-withdrawal "brain zaps" every once and a while, so it most likely did increase plasma levels of it. Thus, it's possible that the increase was drastic enough that I was effectively taking too much for my body weight.
Also, opioids have an endocrinological effect (GnRH release inhibition) that also is detrimental to sexual functioning; that cabergoline would not address. Last weekend I found that if I took a LOT of it (6-8mg, I forget which) I was able to orgasm after an absurd amount of stimulation. I was astounded at how low a side effect profile cabergoline has, as with many other DA agonists there'd be a high probability that I'd get really nauseous, my sinuses would stuff up, I'd get really tired, hypotensive, etc. Instead I felt NO side effects.
As of now I am looking to add another agent to supplement the cabergoline, possibly something androgenic; I need to consult with my doctor. Another option is apomorphine, either by injection or sublingual tablet. That is a D1 and D2 agonist and very pro-sexual.
I also should add that if I weren't on 90mg of Nardil AND an opioid, the cabergoline might still be working. I will also talk to my doctor about slowly reducing the dosage of the Nardil perhaps to 75mg/day and the bupe to 8mg/day instead of 16 with the hope of things getting a lot better. That choice is DEAD LAST, as everything else besides the libido is great!
Posted by SLS on June 25, 2005, at 14:51:53
In reply to Re: Calling Chairman_MAO » ed_uk, posted by Chairman_MAO on June 25, 2005, at 12:57:48
Hi CM.
First of all, good luck with your treatment plan.
> Actually, cabergoline is not working as well in that department as it once did. There is a possibility, however, that the reason for this is that I started taking Nardil with bioperine
How does bioperine work?
If I need to go back on Nardil, I will simply titrate up clinically and not set target dosages based on the old preparation. So what if I would need 90mg this time and only 75mg last time? At least this way, there would be consistency without need of bioavailability enhancing strategies.
DA agonists increase the release of GH. Perhaps that contributes to an increase in libido. Do you think DHEA would be of any help?
- Scott
Posted by ed_uk on June 25, 2005, at 20:31:26
In reply to Re: Calling Chairman_MAO » ed_uk, posted by Chairman_MAO on June 25, 2005, at 12:57:48
Hi CM,
>I was astounded at how low a side effect profile cabergoline has.......
Have you tried any other D2 agonists?
>possibly something androgenic.......
I think testosterone injections are quite cheap.
>Another option is apomorphine, either by injection or sublingual tablet. That is a D1 and D2 agonist and very pro-sexual.....
We've got Uprima in the UK. Is it approved in the US yet? I don't think it is.
Kind regards
~Ed
Posted by Declan on June 25, 2005, at 23:27:36
In reply to Re: Calling Chairman_MAO » Chairman_MAO, posted by ed_uk on June 25, 2005, at 20:31:26
Hi Ed
This is rather off topic, but since you mentioned Uprima.....What do you think of the use of apomorphine for opioid addiction? Was it Dr Dent in the UK? He treated William Burroughs....Can you see any rationale for it?
Declan
Posted by ed_uk on June 26, 2005, at 7:53:27
In reply to Re: Calling Chairman_MAO, posted by Declan on June 25, 2005, at 23:27:36
Hi Declan,
Well.....AFAIK, dopamine release is reduced during opioid withdrawal. Since apomorphine stimulates certain dopamine receptors, it might be expected to reduce craving and/or the severity of the withdrawal syndrome. What do you think?
~Ed
Posted by Chairman_MAO on June 26, 2005, at 9:59:06
In reply to Re: Calling Chairman_MAO » Chairman_MAO, posted by SLS on June 25, 2005, at 14:51:53
AFAIK, bioperine has several different mechanisms. One of them is to inhibit p-glycoprotein in cells in the intestinal walls, thereby allowing more drugs and nutrients to make it into systemic circulation instead of being allowed to efflux back into the small intestine.
For some things the bioavailability increase is drastic, up to around 2000% (for curcumin(sp?)).
You know, I never thought about DHEA or other GH releasers. I'll have to look into that. THe biggest problem is anorgasmia, however, as when I am actually with my g/f, my libido usually does return to an acceptable level. Like I said, the cabergoline IS doing SOMETHING, it just doesn't seem able to push me "over the edge". Apomorphine might work because it is a D1 agonist as well.
I don't have that much money, though, and will go broke simply trying to get normal! argh!
Posted by Chairman_MAO on June 26, 2005, at 10:03:26
In reply to Re: Calling Chairman_MAO, posted by Declan on June 25, 2005, at 23:27:36
I'm not sure how one uses apomorphine to treat addiction, as its half-life is so short that in order for it to be used as a medication instead of a PRN (for emergency Parkinson's "freezing" or sexual issues), AFAIK you need to use an infusion pump!
I have heard the same thing, though, and so will look into it.
Posted by Sebastian on June 28, 2005, at 18:34:47
In reply to sex and ADs?!?! okay, honestly..., posted by iforgotmypassword on June 24, 2005, at 10:32:03
after 10 years of hardly any sex, the drugs start to make you wonder, how usefull are they. Then you think before all this I had a girlfrend everyday and every night, why not now since I started these drugs. This in itself is depressing.
Posted by Nezirov on June 29, 2005, at 23:13:58
In reply to Re: sex and ADs?!?! okay, honestly..., posted by Sebastian on June 28, 2005, at 18:34:47
> after 10 years of hardly any sex, the drugs start to make you wonder, how usefull are they. Then you think before all this I had a girlfrend everyday and every night, why not now since I started these drugs. This in itself is depressing.
Absolutely. I'm much more depressed now than before I took that reproductive toxin called celexa.Nezirov
Posted by Sebastian on June 30, 2005, at 11:41:27
In reply to Re: sex and ADs?!?! okay, honestly..., posted by Nezirov on June 29, 2005, at 23:13:58
The drugs make your life suck. But its even more sucky if you don't take them. Why me?
Posted by delna on July 3, 2005, at 7:32:07
In reply to Re: Calling Chairman_MAO » Chairman_MAO, posted by ed_uk on June 25, 2005, at 20:31:26
Sadly I have the opposite reaction to AD's...they make me oversexed. It's unbearable! Despite moodstabalisers this still happens....which AD kills sex drive the most?
Posted by Declan on July 3, 2005, at 15:35:11
In reply to sex AD's, posted by delna on July 3, 2005, at 7:32:07
Hi Delna
Which AD made you oversexed? I'm on a bit of Parnate which is prosexual.
What about Paxil for getting rid of it?
Declan
Posted by Maximus on July 3, 2005, at 17:42:17
In reply to sex AD's, posted by delna on July 3, 2005, at 7:32:07
>which AD kills sex drive the most?
SSRIs!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!But please enjoy first your libido.
Posted by iforgotmypassword on July 3, 2005, at 19:52:29
In reply to Re: sex AD's, posted by Maximus on July 3, 2005, at 17:42:17
but SSRIs can easily invoke manic (or mixed?) phases in people that are bipolar, so hypersexuality might be a symptom of manic/mixed/hypomanic states.
Posted by delna on July 6, 2005, at 5:36:50
In reply to Re: sex AD's, posted by iforgotmypassword on July 3, 2005, at 19:52:29
Actually it probably is just that...I'm bipolar II. But there seems to be no correct combination and its so frustrating..
but SSRIs can easily invoke manic (or mixed?) phases in people that are bipolar, so hypersexuality might be a symptom of manic/mixed/hypomanic states.
Posted by delna on July 6, 2005, at 5:38:40
In reply to Re: sex AD's, posted by Maximus on July 3, 2005, at 17:42:17
Tried them all...........I hate the excess libido!
>which AD kills sex drive the most?
>
> SSRIs!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!
>
> But please enjoy first your libido.
>
>
>
>
Posted by delna on July 6, 2005, at 5:40:29
In reply to Re: sex AD's, posted by Declan on July 3, 2005, at 15:35:11
Paxil didnt help...I'm beginning to think i'm beyond help..
This is the end of the thread.
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