Posted by Sad Panda on March 14, 2004, at 11:47:25
In reply to Re: Mirapex for SSRI SD, posted by King Vultan on March 14, 2004, at 11:04:45
> > > Will this work to reverse the sexual side effects? Or do ssri's have a dopamine antagonist effect that make it not work?
> >
> > It is supposedly able to help a good deal. And no, SSRIs do not have a direct DA antagonist effect.
> >
> >
>
> If you look at sexual function as being divided into three phases, desire, arousal, and orgasm, SSRIs can have direct negative effects in both the desire and orgasm phases. The mechanism is slightly different in each case, however. The problems in the desire phase are thought to be caused by stimulation of serotonin 2A receptors in the brain, with reduction of dopamine in the brain's pleasure centers. The orgasm problems are thought to be due to stimulation of serotonin 2A receptors in the spinal cord, with inhibitory effects on the reflexes involved in orgasm. In either case, a drug that blockades serotonin 2A receptors such as trazodone or Remeron should theoretically correct the problem, but a pro-dopaminergic agent such as Wellbutrin or Mirapex would appear to mainly be useful only for those problems that are primarily libido related.
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>Effexor has destroyed my libido, but my arousal worked fine. Effexor also removed my ability to Orgasm. Remeron has fixed my Orgasm problem(5-HT2A blockade as King Vultan says) but has done nothing for my libido. I also believe Remeron's Alpha-2 NE blocking can help with a poor erection, but Effexor didn't give me that problem.
My lack of libido is actually a blessing at the moment as my wife has been sick for the last few months.
Cheers,
Panda.
poster:Sad Panda
thread:323962
URL: http://www.dr-bob.org/babble/20040313/msgs/324256.html