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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 jono_in_adelaide on February 10, 2014, at 23:08:19
Dont read this if you're squemist!
Nardil has quite literaly revolutionised my life, but its killed myy sex life - I can stil perform, and can satisfy my partner, but there isnt much in it for me any more
Wondering if anybody had had any help with Ropinirole for this sort of thing?
Posted by jono_in_adelaide on February 10, 2014, at 23:21:19
In reply to Ropinirole for AD sexual problems, posted by jono_in_adelaide on February 10, 2014, at 23:08:19
Current med regime
Nardil 30mg tds
Xanax 1mg tds
Nortriptyline 75mg qhs
Risperidone 1mg qhs
Posted by SLS on February 11, 2014, at 7:17:23
In reply to Re: Ropinirole for AD sexual problems, posted by jono_in_adelaide on February 10, 2014, at 23:21:19
> Current med regime
>
> Nardil 30mg tds
>
> Xanax 1mg tds
>
> Nortriptyline 75mg qhs
>
> Risperidone 1mg qhsHow long have you been taking Nardil for? A substantial number of people regain their ability to orgasm after 3 months, although it can still be somewhat difficult. You could try taking a small amount of cyproheptadine (Periactin) as long as you don't mind falling asleep afterwards. It is a serotonin 5-HT2a/b/c receptor antagonist. It is also a histamine H1 receptor antagonist, which explains the sedation. I think there is a window of opportunity where orgasm becomes possible and before sedation occurs. Buspirone (Buspar) is another drug used to help with orgasm due to its ability to stimulate serotonin 5-HT1a autoreceptors.
What do you take risperidone (Risperdal) for?
I don't know about ropinerole (Requip). It might be a perfect answer. I am not a big fan of DA receptor agonists, though. For depression, its therapeutic effects are usually fleeting. Personally, I have only tried bromocryptine (Parlodel) for depression. I was not experiencing anorgasmia at the time. I also worry that DA autoreceptor downregulation might persist after DA agonist discontinuation.
For depression and anorgasmia, you might be better off using aripiprazole (Abilify) in place of risperidone due to its DA D2/3 and 5-HT1a partial agonism. Risperdal increases prolactin secretion, which doesn't help matters. Aripiprazole has recently been reported to be a serotonin 5-HT7 antagonist, an action that may contribute to its antidepressant effect. Risperidone also acts to reduce 5-HT7 activity via irreversible binding to that receptor. Lurasidone (Latuda) is another antipsychotic with 5-HT7 receptor antagonism as well as 5-HT1a agonism.
Bupropion (Wellbutrin) seems to increase desire, but has no direct effect on orgasm. I don't know about methylphenidate.
- Scott
Posted by Phillipa on February 11, 2014, at 9:06:25
In reply to Re: Ropinirole for AD sexual problems, posted by SLS on February 11, 2014, at 7:17:23
Scott an old poster here that I stay in contact with is still using requip this was the med that got him out of his suicidal depression. He'd taken Maoi's also. Sorry to hijack but it works for MDD without severe mania. PJ
Posted by SLS on February 11, 2014, at 13:02:22
In reply to Re: Ropinirole for AD sexual problems » SLS, posted by Phillipa on February 11, 2014, at 9:06:25
> Scott an old poster here that I stay in contact with is still using requip this was the med that got him out of his suicidal depression. He'd taken Maoi's also. Sorry to hijack but it works for MDD without severe mania. PJ
That's interesting. Do you know what, if anything, else he is taking?
- Scott
Posted by phidippus on February 11, 2014, at 16:12:11
In reply to Ropinirole for AD sexual problems, posted by jono_in_adelaide on February 10, 2014, at 23:08:19
The only thing you can do is switch from the Nardil to something else. Ropinirole isn't going to provide you with much relief.
Eric
Posted by jono_in_adelaide on February 11, 2014, at 17:00:28
In reply to Re: Ropinirole for AD sexual problems » jono_in_adelaide, posted by phidippus on February 11, 2014, at 16:12:11
Scott, I take the risperidone because it helps with the anxiety and the depressive intrusive thoughts - I took 1mg at bedtime on hte fiorst night and work up feeling noticiably improved
I have tried Periactin (its OTC here) but it didnt produce any improvement,(perhaps because the risperidone and nortriptyline were already blocking the 5HT2 receptors?) but did cause a dry mouth, which wasnt a good thing for a gay guy having sex.
I have been on Nardil 7 months
I CAN orgasm by masturbating, but not through sex, the real issue is lack of desire (my guy has been away for 3 weeks and I havent had the desire to j*rk *ff even once)
Dropping Nardil isnt an option, its worked a miracle on my panic/anxiety
I think I'll buy some ropinirole and see if it helps - I have nothing to lose except a few dollars and potentialy a lot to gain
Scott, I am changing from risperidone to ziprasidone 20mg bd tomorrow, 1 because of weight gain, and 2 because of ziprasidones actions at the 5HT1 receptors, which *might* give me extra anxiolytic effect
Posted by Phillipa on February 11, 2014, at 19:38:13
In reply to Re: Ropinirole for AD sexual problems » Phillipa, posted by SLS on February 11, 2014, at 13:02:22
Desipramine,vyvanase, sometimes zyprexa,abilify at one time. He does worry about his weight gained quite a bit. Might be another can't recall. As mostly never discuss meds. PJ
Posted by SLS on February 12, 2014, at 6:57:47
In reply to Re: Ropinirole for AD sexual problems » SLS, posted by Phillipa on February 11, 2014, at 19:38:13
> Desipramine,vyvanase, sometimes zyprexa,abilify at one time. He does worry about his weight gained quite a bit. Might be another can't recall. As mostly never discuss meds. PJ
Thanks Phillipa. That might be meaningful.
- Scott
Posted by SLS on February 12, 2014, at 7:46:57
In reply to Re: Ropinirole for AD sexual problems, posted by jono_in_adelaide on February 11, 2014, at 17:00:28
Wellbutrin is supposed to help with reduced libido and anorgasmia. I would not overlook it. Orgasm is a complex phenomenon, and involves a delicate balance of neural pathways and neurotransmitters. It's too bad the cyproheptadine proved inadequate and problematic. Its blockade of 5-HT2c receptors can accelerate orgasm, but reduce erections. The opposite is true of 5-HT2a receptors. 5-HT1a agonism can delay orgasm, but promotes erections. Since Geodon is a partial agonist instead of a full agonist, I am very interested to see how it affects you.
Don't forget about buspirone.
Good luck.
- Scott
Posted by BrainDamage on February 14, 2014, at 6:18:54
In reply to Re: Ropinirole for AD sexual problems, posted by SLS on February 12, 2014, at 7:46:57
I'm slightly surprised people are so dismissive of Dopamine Agonists for sexual problems
Bromocriptine I found to be a horrible drug, blocked synuses & nothing else
Trivestal on the other hand was most definitely Pro-Sexual!
I know its a bit different from other DA Agonists because it affects Noradrenaline release
Unfortunately it made me Anxious & is contradicted with MAOIs
Still it worked
Is Trivestal just a Freak among DA Agonists?
Posted by SLS on February 14, 2014, at 8:50:09
In reply to Dopamine Agonists for AD sexual problems, posted by BrainDamage on February 14, 2014, at 6:18:54
> Trivestal on the other hand was most definitely Pro-Sexual!
How long had you been taking it for continuously? Why did you discontinue it? Would you recommend it for people with a SSRI-induced decrease in libido long-term?
- Scott
Posted by BrainDamage on February 15, 2014, at 9:09:13
In reply to Re: Dopamine Agonists for AD sexual problems » BrainDamage, posted by SLS on February 14, 2014, at 8:50:09
> > Trivestal on the other hand was most definitely Pro-Sexual!
>
> How long had you been taking it for continuously? Why did you discontinue it? Would you recommend it for people with a SSRI-induced decrease in libido long-term?
>
Ok you got me Scott!
I've only taken Trivastal/Piribedil a few days in a row, because I couldn't handle the Anxiety
I have bad GAD, so its not surprising I'm prone to Anxiety
Maybe if combined with a low dose Benzo?
I heard of someone who was similar to me, doing this
He loved it, but it made him anxious, he was less wary of Benzo's than meAnyway to get back on Topic, I have no idea if it would work Long-Term, for Sexual Dysfunction or as an Add on
Its a "Freak" among DA Agonists in that it causes Noradrenaline release
Can't remember exactly how, feeling very dozy at the moment
One final thought though:
I was struck by how completely different DA Agonists can feel
I hated Bromocriptine, felt toxic
Liked Trivistal
This makes me think that different DA Agonists might have quite different affects, despite being similar in Theory??
I thought there was a study where it successful as an AD, but can't find it now, this is the best I can do right now:
http://biopsychiatry.com/piribedil.html
Posted by SLS on February 15, 2014, at 9:43:33
In reply to Re: Dopamine Agonists for AD sexual problems, posted by BrainDamage on February 15, 2014, at 9:09:13
Thanks for the explanation and citation. Very interesting. According to the abstract you referred to, piribedil blocks NE alpha2 receptors. It is my observation that this can produce anxiety and a worsening of depression in some people. I would be curious to know if you had a similar reaction to Remeron at dosages of 45 mg/day and higher. What about Buspar?
- Scott
Posted by BrainDamage on February 15, 2014, at 13:35:49
In reply to Re: Dopamine Agonists for AD sexual problems » BrainDamage, posted by SLS on February 15, 2014, at 9:43:33
> According to the abstract you referred to, piribedil blocks NE alpha2 receptors. It is my observation that this can produce anxiety and a worsening of depression in some people. I would be curious to know if you had a similar reaction to Remeron at dosages of 45 mg/day and higher. What about Buspar?
>
I've never taken Buspar, unfortunately, wish I hadAs for Remeron it was the best AD I ever tried, when I first took it
Since then I've had transient response at 45mg which faded after a few weeks
Remeron never seemed to have a bad affect on me though, never noticed increased anxiety
This is the end of the thread.
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