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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 15 of 15. This is the beginning of the thread.
Posted by Jimmyboy on December 22, 2007, at 21:50:28
The good news is that my current medicine cocktail has almost completely gotten rid of my depression anxiety and panic, and my life is turning around at a fast pace and becoming great in a lot of ways. Unfortunately it has similar ffeeling of sexual side effects that SSRI's give ( although I am not taking an SSRI). That is loss of libido ( just don;t think about it much) and also loss of ability. Anyone have any advice on how to combat this?
Everything is going so well, I don;t want to stop what I am taking, but there has to be something that helps with this..
Any advice would be appreciated.
JB
Posted by Bob on December 23, 2007, at 1:17:01
In reply to Help med induced sex dysfunction, posted by Jimmyboy on December 22, 2007, at 21:50:28
I don't really have an answer for the sexual dysfunction, but I'm curious as to what the current drug cocktail you're taking is that's doing so well for you.
Posted by Mikez on December 23, 2007, at 3:03:39
In reply to Help med induced sex dysfunction, posted by Jimmyboy on December 22, 2007, at 21:50:28
You could try natural dopamine enhancement supplements such as NADH.
Or try asking for a low dose of mirapex, a dopamine agonist. This is known to reverse sexual dysfunction in many cases and also has a positive effect on mood .
Posted by Mikez on December 23, 2007, at 3:05:26
In reply to Re: Help med induced sex dysfunction, posted by Mikez on December 23, 2007, at 3:03:39
I should also add i've done a lot of research on this, and these are the steps that I am personally trying. I will let you know how it goes. If you have always had some kind of libido loss even before this current cocktail, you should get your hormones checked for peace of mind first.
Posted by bleauberry on December 23, 2007, at 5:32:32
In reply to Help med induced sex dysfunction, posted by Jimmyboy on December 22, 2007, at 21:50:28
What is your cocktail? What are the doses of each?
Posted by Jimmyboy on December 23, 2007, at 11:16:08
In reply to Re: Help med induced sex dysfunction » Jimmyboy, posted by bleauberry on December 23, 2007, at 5:32:32
After trying every med on the market for the last 12 years without success, I did finally find something that has worked well, although its rather unorthadox. It took me a long time to accept that supplements could work as well ( or in my case much better) than prescription meds.
First off I found out I had food allergies to gluten and corn, so I cut that out of my diet, which has definitely helped.
Next, I did some research on inflammation and depression, which led me to beleieve that if I could raise my prostaglandin E 1 levels that it would be very beneficial ( PGE 1 levels have been shown to reduce inflammation , and PGE 1 levels are low in depressed patients as well as too high in manic patients - it is known that having more can boost your mood). PGE 1 is made from GLA so I started Evening Primrose , which contains GLA --> which in turn can be converted to PGE 1 ( good) or PGE 2( bad). There is an enzyme called D5D that controlls which way the GLA goes , that is either to PGE 1 or PGE 2. If you disable the enzyme the GLA goes down the favorable pathway to become only PGE 1. I found some studies that said the compound "Sesamin" disables the D5D enzyme, so I started taking that. Well the combo of Borage Oil ( contains higher percentage of GLA that Primsorse) + Sesamin. Immediately cleared up my brain fog, made me much more active, optimistic, etc. Basically it wiped out the depression fast and has continued to work great for over 2 months. I also noticed, slowly the crippling anxiety I felt has disappeared and all panic attacks have ceased.
But the down side was also a slowly creeping up of less sex drive and functioning. Felt kind of like SSRI side effects. Well come to find out enhancing GLA can in a round about way raise serotonin in parts of the brain. This is what I attribute to the slow erasing of all of my anxiety. Which is great, but I am trying to deal with the sexual side effects.
Right now I am looking at small dose of 5ht2 antagonist lke Nefazodone, Mirtazapine, Trazodone or minasarin to add in. Hopefully it will be successful.
JB
Posted by Phillipa on December 23, 2007, at 12:30:06
In reply to My medicine, posted by Jimmyboy on December 23, 2007, at 11:16:08
So you've gone the natural way? Phillipa
Posted by cumulative on December 25, 2007, at 12:25:54
In reply to My medicine, posted by Jimmyboy on December 23, 2007, at 11:16:08
A few people elsewhere have mentioned a decrease in sexual desire after sesamin, which they link to an overall decrease in inflammation -- critical to the arousal response.
I recommend a D2 agonist.
Posted by Jimmyboy on December 25, 2007, at 12:57:30
In reply to Re: My medicine, posted by cumulative on December 25, 2007, at 12:25:54
What are some D2 agonists?
Thanks
JB
Posted by bleauberry on December 25, 2007, at 13:52:04
In reply to Help med induced sex dysfunction, posted by Jimmyboy on December 22, 2007, at 21:50:28
No way to tell where the dysfunction is coming from. Could be serotonin like you think, or could be elevated prolactin, or some other hormonal shift. GLA is used by women for hormonal stuff, so who knows what's going on there. Maybe it is just a temporary thing while bodily adjustments occur.
Even if you knew the precise cause, treating the problem is still a trial and error guessing game. Blocking serotonin receptors as you mentioned might work. A dopamine agonist might work. Herbal sexual enhancers might work.
Dopamine agonists include pramipexole, bromocriptine, ropinirole, carbergoline. In the natural arena Vitex has dopamine agonist action.
You might consider testing out the herbal sexual enhancers such horny goat weed, tribulus, damiana, maca.
A simple cheap test would be to try some tyrosine a couple hours before a desired sexual encounter. I found continued use of tyrosine worthless probably due to some feedback mechanism, but when taken on an as-needed basis it definitely boosts dopamine in a way you can feel, in terms of mood, sex, and energy. Doses vary widely. For me 250mg can be felt, while usual doses are in the 500mg to 2000mg range. Take it half hour before food or a couple hours after food. Whether it works or not it would be a good test to see if increasing dopamine helps, because if it does then your theory of serotonin may be correct.
Posted by Jimmyboy on December 25, 2007, at 19:43:17
In reply to Re: Help med induced sex dysfunction » Jimmyboy, posted by bleauberry on December 25, 2007, at 13:52:04
Hey Thanks for the valuable info, I think I will try the tyrosine option out and see if it works. Do you know of a drug that lowers prolactin levels?
JB
Posted by bleauberry on December 26, 2007, at 18:02:08
In reply to Re: Help med induced sex dysfunction » bleauberry, posted by Jimmyboy on December 25, 2007, at 19:43:17
> Hey Thanks for the valuable info, I think I will try the tyrosine option out and see if it works. Do you know of a drug that lowers prolactin levels?
>
>
> JBDrugs that lower prolactin levels are dopamine agonists. They include pramipexole, requip, bromocriptine, carbergoline.
St Johns Wort also lowers prolactin.
Posted by bleauberry on December 26, 2007, at 18:35:40
In reply to Re: Help med induced sex dysfunction, posted by bleauberry on December 26, 2007, at 18:02:08
Oops. I should add that the St Johns Wort studies at pubmed that showed lowered prolactin levels involved the Kira (LI160) brand and the Perika brand. Have no idea if other brands do or not. I get the hunch that it is the hyperforin content that does it, which most of the other hypericin standardized brands might or might not have adequate or stable amounts of.
Posted by Jimmyboy on December 28, 2007, at 19:32:27
In reply to Re: Help med induced sex dysfunction, posted by bleauberry on December 26, 2007, at 18:35:40
I have tried boosting dopamine , by means of selegiline ( 10 mg) for several days , Selegiline + L-Phenylalanine, and Vitex. And nada... no help whatsoever.
Also tried 5ht2-a antogonist , Nefazodone. No help either.
A few months back I took scopolamine IV and noticed an immediate reduction on what was previously a healthy libido. The problem has persisted, could the scopolamine somehow have screwed up or lowered my acetylcholine levels. I know having low levels of that could screw up your desire/functioning also.
What is the best way to boost acetylcholine and how loing would that take?
Any answers would be greatly appreciated.
JB
Posted by lois on December 30, 2007, at 16:09:12
In reply to Re: Help med induced sex dysfunction _ HELP! » bleauberry, posted by Jimmyboy on December 28, 2007, at 19:32:27
I have tried l-argine, steel libido for women - there's one for men, and 7-keto(precurser to DHEA precurser to testosterone.}
I am also low in estrogen and testosterone. So 'your' testosterone might be low.I hope my GYN will try the testosterone patch next time I see her.The same meds I have always been on for a long time.... and suddenly no libido. Hope it's the testosterone and not the meds. Can you get NADA OTC?
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