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Re: Any treatment for MAOI anorgasmia?

Posted by jamie on November 24, 1999, at 3:28:38

In reply to Any treatment for MAOI anorgasmia?, posted by Ron on November 23, 1999, at 22:56:08

> I've been taking Nardil 60 mg/day for three months now. My depression and anxiety have improved very remarkably. I've been waiting for the sexual side effects to subside. However, I've seen no relief in my complete inability to achieve orgasm. Is anyone aware of anything out there that has been successfully used to treat MAOI induced anorgasmia? Viagra doesn't help, nor does periactin, or ginkgo biloba. I understand Bupropion has been prescribed by experienced psychdocs (psychopharmacologists), even though its use in contraindicated. It seems that 5HT is the root of anorgasmia, and a very low lose of remeron (mirtazapine) might be helpful. Anyone know of this?
> Lastly, anything to help with a slight degree of apathy? I understand dopaminergic stimulants have been used, just can't find much on this.
> Thanks.
> Ron

I don't buy the theory that 5HT is the root of sex effects. Or else why would someone have trouble with some but not all SSRIs. It happens. I think there is something much more complex going on with molecular structure and hormones and who knows what else.

Most ADs raise prolactin levels. Raised prolactin levels are implicated in sexual problems. Prolactin levels are lowered by dopamine agonists like amantadine or bromocriptine. Maybe thats how they work. The dopamine stimulation would help with the apathy at the same time. Wellbutrin supposedly raises DHEA levels for better sexual function. All this seems complicated to me. And I think it's all a mystery to pdocs. But I think there are some unknown secondary mechanisms of dopamine agaonists that contribute to beneficial sexual function.




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