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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 16 of 16. This is the beginning of the thread.
Posted by Chairman_MAO on June 12, 2005, at 9:51:14
A month later, cabergoline is still giving me a good dopaminergic effect in terms of AD augmentation, but isn't doing what it used to be doing for sexual dysfunction, despite taking 2mg/day. I think the problem is that I'm on buprenorphine in addition to phenelzine, which can cause sexual dysfunction also. I am going to try Tongkat Ali or some other thing to boost testosterone, as I believ the buprenorphine may be suppressing GnRH to some degree or doing something else endocrinological that a DA agonist cannot fix.
Given the results of DA agonists for SSRI sex dysfunction, I think cabergoline would be JUST FINE if you aren't also taking an opioid (I take 16mg/day sublingual, which I believe is like 0.6mg IV qid, the absolute highest dose possible, heh).
Posted by ed_uk on June 12, 2005, at 10:54:27
In reply to cabergoline update, posted by Chairman_MAO on June 12, 2005, at 9:51:14
Hi Chairman :-)
>I believ the buprenorphine may be suppressing GnRH........
Perhaps you could get your testosterone level measured. You could get a prescription for testosterone if necessary.
~Ed
Posted by Chairman_MAO on June 12, 2005, at 11:57:27
In reply to Re: cabergoline update » Chairman_MAO, posted by ed_uk on June 12, 2005, at 10:54:27
One study showed normal testosterone in bupe-treated men, but my pdoc said that simply because it has opioid activity, it necessarily must inhibit GnRH to some degree. I suspect that simply because it is equivalent to around 30mg of IV morphine per dose, it HAS to have some sort of negative effect.
I cannot afford to take any more Rx medication, as the cabergoline + everything else is already breaking the bank. Thankfully with a drug discount card and my parents helping me I can afford the Suboxone and Nardil. The cabergoline I pay for on my own, which is $100/mo now, at BEST $60/mo from a European source (that med in the USA from a pharmacy at the dose I take would cost $1000/mo+). And if I want to raise it, it will cost up to $120/mo, even at the best price I can find it at. I think I will try Tongkat Ali, which has a lot of glowing anecodotal evidence behind it as well as many animal studies showing up to a 400% increase in free testosterone when administered chronically.
Posted by ed_uk on June 12, 2005, at 15:10:16
In reply to Re: cabergoline update » ed_uk, posted by Chairman_MAO on June 12, 2005, at 11:57:27
Hi!
>One study showed normal testosterone in bupe-treated men........
Yes, I think I've seen that study.
>$1000/mo+
Whoa!
>Tongkat Ali...
Tell us how it goes :-)
Kind regards,
Ed.
Posted by Chairman_MAO on June 12, 2005, at 17:13:22
In reply to Re: cabergoline update » Chairman_MAO, posted by ed_uk on June 12, 2005, at 15:10:16
I found today that I was just a little late in taking my 3rd bupe dose, and because of that having an orgasm was no problem. I also felt the "nice" cabergoline effect again that I hadn't felt in a while. To know that with cabergoline I could have a dynamite sex life if I weren't on an opioid is painful! But I am so scared to even taper down on it because of how well I feel! ARgh! I guess I will try the tongkat ali and hope it works, even though I am tired of trying new meds.
Perhaps my doc will OK a taper down to 2mg qid, which could make things better. But perhaps I should wait until my life is more stable before attempting that. So confused!
Posted by ed_uk on June 12, 2005, at 17:57:48
In reply to Re: cabergoline update » ed_uk, posted by Chairman_MAO on June 12, 2005, at 17:13:22
Chairman, I'm so jealous of you!!!! Getting up so early and actually WANTING to go to the gym!! I got up at 12.30pm today. I had to restart Celexa not long ago, my OCD returned. I hate OCD, high-dose SSRIs are practically all that works. I suppose I could try an atypical AP but I think I'd rather take an SSRI to be honest.
>Perhaps my doc will OK a taper down to 2mg qid, which could make things better.
It could help :-)
Kind regards,
Ed.
Posted by Phillipa on June 12, 2005, at 18:35:42
In reply to Re: cabergoline update » Chairman_MAO, posted by ed_uk on June 12, 2005, at 17:57:48
Oh, so I'm not the only one sleeping late. I go to bed around l-2am and wake up around 8-9. Don't get out of bed until l0. Don't want to face the day. Fondly, Phillipa
Posted by Declan on June 12, 2005, at 23:27:55
In reply to Re: cabergoline update » ed_uk, posted by Phillipa on June 12, 2005, at 18:35:42
Hi CM
Interesting stuff. Even low doses of opioid, I found anti-sexual. Anything more than 10mg methadone/d or equivalent was almost impossible. Looking forward to cabergoline.
Declan
Posted by Chairman_MAO on June 14, 2005, at 20:02:45
In reply to Re: cabergoline update, posted by Declan on June 12, 2005, at 23:27:55
I am going to try taking the buprenorphine as one big dose at bedtime. I'm sure it won't give me the same level of effect, as bupe for pain is giving every 4-6 hours, despite it having a 37-92hr half-life. Buprenorphine is a really strange drug.
I'm hoping that I'll get acceptable results with this dosing scheme (which is the one normally used for Suboxone when used strictly for opioid addiction, although my doctor generally prescribes it at least twice per day). Since I am using it for depression/anxiety and drug craving in general--but not for anything related to opioids, really--I hope the once-a-day dosing scheme will still do what I want it to do. Then again, 90mg of phenelzine is nothing to sneeze at when it comes to anxiety, so perhaps this will work.
Hopefully using this once per day scheme will allow for easier orgasms.
Posted by Chairman_MAO on June 14, 2005, at 20:26:09
In reply to Re: cabergoline update, posted by Declan on June 12, 2005, at 23:27:55
In a non-tolerant person, 10mg of methadone packs quite a punch! With traditional full agonists, the problem is most definitely endocrinological. If you use some form of testosterone replacement or androgenic drug, I think you'd find the sex is fine.
Also, I once used bromocriptine while on a decent dose of heroin and had GREAT sex. Unfortunately, the immense pro-sexual effect of these DA agonists wane over time. They still maintain some efficacy, but my experience has been that it is not enough to counteract an opioid. It usually IS enough to fix antidepressant-induced sexual dysfunction, though.
Posted by Declan on June 14, 2005, at 21:54:56
In reply to Re: cabergoline update » Declan, posted by Chairman_MAO on June 14, 2005, at 20:26:09
Hey CM, when you used bromocriptine did you get blocked or stuffy nose or sinuses? Do you get that with cabergoline?
Bupe is often given 3 times a week in treatment of opiate addiction, here at least.
Of course, as you say, opiates go beautifully with sex, maybe it is the chronic use that is the problem.
Dunno about the hormone thing. I'm on testosterone replacement (I'm 52), so now my levels are OK, (not as good as you might hope), but I don't think it alone would make sex possible if I was on any amount of methadone.
You were saying, I think, that the cabergoline had some sort of good mental effect. I've had an excellent reponse to Hydergine and deprenyl, it's some kind of dopamine lack and, I think, an intolerance to noradrenaline.
Declan
Posted by Darwin on June 15, 2005, at 12:04:10
In reply to Re: cabergoline update » Declan, posted by Chairman_MAO on June 14, 2005, at 20:26:09
Can you tell us how cabergoline is better than the much cheaper bromocriptine?
Posted by Chairman_MAO on June 16, 2005, at 12:53:14
In reply to Re: cabergoline update » Chairman_MAO, posted by Darwin on June 15, 2005, at 12:04:10
No hyptotensive effect, taken twice per week to once daily (~72hr half-life, so steadier plasma level) D2 receptor selective (bromocriptine is a D1 antagonist, 5ht1a agonist, and has adrenergic properties that cause the aforementioned hypotensive effect). No constantly stuffy nose. Basically, The difference is one of [neuro]pharmacological profile and side effects.
Cabergoline also suppresss prolactin more completely, IIRC.
Posted by Peter Hirsh on June 25, 2005, at 6:52:43
In reply to cabergoline update, posted by Chairman_MAO on June 12, 2005, at 9:51:14
I am taking 200 mg Luvox / day against my OCD. That are killing my sexlife. I can`t stop Luvox or cut the dose so I have no option for that. CAN DOSTINEX help me?? I meen Dostinex as an antidot to the lack of sensitivity, libido, and anorgasmia!? Anyone who know what dose on Dostinex that I should take? If anyone kan help me plaese answer this or email me on eternety82@hotmail.com
Posted by ed_uk on June 25, 2005, at 16:04:39
In reply to Re: cabergoline update, posted by Peter Hirsh on June 25, 2005, at 6:52:43
Hi!
You need to speak to Chairman_MAO. I hope he replies soon :-)
Btw, I also take an SSRI for OCD.
~Ed
Posted by Peter Hirsh on June 26, 2005, at 5:42:22
In reply to Re: cabergoline update » Darwin, posted by Chairman_MAO on June 16, 2005, at 12:53:14
What is the best to do against Luvox - anorgasmia? Chairman Mao please email me as soon as you can. Eternety82@hotmail.com
Is Dostinex the best way?
This is the end of the thread.
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