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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 5 of 5. This is the beginning of the thread.
Posted by Questionmark on June 3, 2004, at 1:55:11
Okay, i have a prescription for 4mg cyproheptadine (Periactin) tablets to help combat my atrocious anorgasmia from Nardil (60mg/day). The other night i took a full 4mg tablet for only the second time and am now pretty convinced that i hate it. Not only did it not help with the anorgasmia, but during the process of doing what i was using it for, i was so stINKing drowsy that any caresses and what not just kept putting me into little microsleeps! i was so dang tired that i couldn't even concentrate on what i was doing or even stay fully awake! And on top of all THAT, Mr. Softy Jenkins complETEly "fell asleep"!! (And i do not normally suffer from ED so this was especially surprising and frusterating.) All of this also occurred the only other time i took a full 4mg of cyproheptadine (which really isn't even that much either, i believe).
And then today-- as with the 1st time-- i have been HORRIbly tired and lethargic all freaking day. It feels remarkably similar to antihistamine "hangovers" from other H1 antagonists. This is not surprising since it also has H1-blocking properties, but i read somewhere that it had a half-life of 4 hours so i didn't think i would have to deal with the next-day fatigue and stupifaction like i do with diphenhydramine and, ugh, Remeron. But no, i have slept almost this entire day. FORTunately i didn't have anything important to do today. Also, fortunately, i didn't really notice any antiserotonergic effects, and i tried to be observant about that (although i wANTed the antiserotonergic property of an ease in ability to orgasm). But the antihistamine effects were enough to make me ticked off and hate the stupid drug.
Thus, cyproheptadine, like Remeron, was a bust. And i would advise anyone interested in it who is sensitive to antihistamine effects to either be very judicious or to use another route.
Why can't they make a 5-HT2 (is it 5-HT2A or 5-HT2C, or both?) antagonist that's not also a potent antihistamine?!
Next up, amantadine. (No more H1 blockers for awhile).Oh, P.S., if anyone has any idea, what do you think the reason would be for the ED that i experienced with cyproheptadine? Is it strongly anticholinergic?
Posted by Sad Panda on June 3, 2004, at 3:11:08
In reply to cyproheptadine sucks, posted by Questionmark on June 3, 2004, at 1:55:11
> Okay, i have a prescription for 4mg cyproheptadine (Periactin) tablets to help combat my atrocious anorgasmia from Nardil (60mg/day). The other night i took a full 4mg tablet for only the second time and am now pretty convinced that i hate it. Not only did it not help with the anorgasmia, but during the process of doing what i was using it for, i was so stINKing drowsy that any caresses and what not just kept putting me into little microsleeps! i was so dang tired that i couldn't even concentrate on what i was doing or even stay fully awake! And on top of all THAT, Mr. Softy Jenkins complETEly "fell asleep"!! (And i do not normally suffer from ED so this was especially surprising and frusterating.) All of this also occurred the only other time i took a full 4mg of cyproheptadine (which really isn't even that much either, i believe).
> And then today-- as with the 1st time-- i have been HORRIbly tired and lethargic all freaking day. It feels remarkably similar to antihistamine "hangovers" from other H1 antagonists. This is not surprising since it also has H1-blocking properties, but i read somewhere that it had a half-life of 4 hours so i didn't think i would have to deal with the next-day fatigue and stupifaction like i do with diphenhydramine and, ugh, Remeron. But no, i have slept almost this entire day. FORTunately i didn't have anything important to do today. Also, fortunately, i didn't really notice any antiserotonergic effects, and i tried to be observant about that (although i wANTed the antiserotonergic property of an ease in ability to orgasm). But the antihistamine effects were enough to make me ticked off and hate the stupid drug.
> Thus, cyproheptadine, like Remeron, was a bust. And i would advise anyone interested in it who is sensitive to antihistamine effects to either be very judicious or to use another route.
> Why can't they make a 5-HT2 (is it 5-HT2A or 5-HT2C, or both?) antagonist that's not also a potent antihistamine?!
> Next up, amantadine. (No more H1 blockers for awhile).
>
> Oh, P.S., if anyone has any idea, what do you think the reason would be for the ED that i experienced with cyproheptadine? Is it strongly anticholinergic?
>
>Your ED problem was probably due to a lack of interest since you were falling asleep.
Not surprising that Periactin but you to sleep, it is mostly used as an antihistamine or secondly for migranie prevention. Remeron works for me, but you have to take it daily so you can build tolerence to the sedating effect of H1 blockade. I take mine at midnight, but I can still stay up untill sunrise if I want as I have developed 100% immunity from it.
Cheers,
Panda.
Posted by King Vultan on June 3, 2004, at 8:07:14
In reply to cyproheptadine sucks, posted by Questionmark on June 3, 2004, at 1:55:11
> Okay, i have a prescription for 4mg cyproheptadine (Periactin) tablets to help combat my atrocious anorgasmia from Nardil (60mg/day). The other night i took a full 4mg tablet for only the second time and am now pretty convinced that i hate it. Not only did it not help with the anorgasmia, but during the process of doing what i was using it for, i was so stINKing drowsy that any caresses and what not just kept putting me into little microsleeps! i was so dang tired that i couldn't even concentrate on what i was doing or even stay fully awake! And on top of all THAT, Mr. Softy Jenkins complETEly "fell asleep"!! (And i do not normally suffer from ED so this was especially surprising and frusterating.) All of this also occurred the only other time i took a full 4mg of cyproheptadine (which really isn't even that much either, i believe).
> And then today-- as with the 1st time-- i have been HORRIbly tired and lethargic all freaking day. It feels remarkably similar to antihistamine "hangovers" from other H1 antagonists. This is not surprising since it also has H1-blocking properties, but i read somewhere that it had a half-life of 4 hours so i didn't think i would have to deal with the next-day fatigue and stupifaction like i do with diphenhydramine and, ugh, Remeron. But no, i have slept almost this entire day. FORTunately i didn't have anything important to do today. Also, fortunately, i didn't really notice any antiserotonergic effects, and i tried to be observant about that (although i wANTed the antiserotonergic property of an ease in ability to orgasm). But the antihistamine effects were enough to make me ticked off and hate the stupid drug.
> Thus, cyproheptadine, like Remeron, was a bust. And i would advise anyone interested in it who is sensitive to antihistamine effects to either be very judicious or to use another route.
> Why can't they make a 5-HT2 (is it 5-HT2A or 5-HT2C, or both?) antagonist that's not also a potent antihistamine?!
> Next up, amantadine. (No more H1 blockers for awhile).
>
> Oh, P.S., if anyone has any idea, what do you think the reason would be for the ED that i experienced with cyproheptadine? Is it strongly anticholinergic?
Most antihistamines are also anticholinergic, but I do not believe cyproheptadine is as strong, as say, diphenhydramine, as it is not discussed in my book "Psychotropic Drugs" as a treatment for Parkinson's Disease as diphenhydramine is (due to that drug's anticholinergic properties). Cyproheptadine is not even listed in the index, but it does show up in a table of drugs used to treat sexual dysfunction. It is indicated for anorgasmia and hypoactive desire, but your experience is certainly not encouraging.It's thought that it is stimulation of the serotonin 2A receptors that are responsible for the anorgasmia problems caused by Nardil, the SSRIs, and Effexor. As you are finding out, this can be very difficult to treat. Many of the drugs that block these receptors such as Remeron, trazodone, and nortriptyline also have H1 blockades that cause sedation/hangover problems for some people (myself included). One other one I can think of that might work is nefazodone, which is less sedating than trazodone, but I don't know if you can get away with using this with an MAOI. I've seen warnings, but they may or may not be valid, as I've seen warnings for drugs like the tricyclics also, many of which can be used with MAOIs. Another option is the blasted atypical antipsychotics, which all blockade 5HT-2A receptors. Incidentally, the drugs specifically listed for anorgasmia in the table in my book are amantadine, bupropion, buspirone, cyproheptadine, dextroamphetamine, granisetron, methyphenidate, pemoline, and yohimbine. Of these, my understanding is that buspirone is definitely prohibited with an MAOI, but some of the others may be problematic also.
Todd
Posted by Sad Panda on June 4, 2004, at 15:20:52
In reply to Re: cyproheptadine sucks » Questionmark, posted by King Vultan on June 3, 2004, at 8:07:14
> > Okay, i have a prescription for 4mg cyproheptadine (Periactin) tablets to help combat my atrocious anorgasmia from Nardil (60mg/day). The other night i took a full 4mg tablet for only the second time and am now pretty convinced that i hate it. Not only did it not help with the anorgasmia, but during the process of doing what i was using it for, i was so stINKing drowsy that any caresses and what not just kept putting me into little microsleeps! i was so dang tired that i couldn't even concentrate on what i was doing or even stay fully awake! And on top of all THAT, Mr. Softy Jenkins complETEly "fell asleep"!! (And i do not normally suffer from ED so this was especially surprising and frusterating.) All of this also occurred the only other time i took a full 4mg of cyproheptadine (which really isn't even that much either, i believe).
> > And then today-- as with the 1st time-- i have been HORRIbly tired and lethargic all freaking day. It feels remarkably similar to antihistamine "hangovers" from other H1 antagonists. This is not surprising since it also has H1-blocking properties, but i read somewhere that it had a half-life of 4 hours so i didn't think i would have to deal with the next-day fatigue and stupifaction like i do with diphenhydramine and, ugh, Remeron. But no, i have slept almost this entire day. FORTunately i didn't have anything important to do today. Also, fortunately, i didn't really notice any antiserotonergic effects, and i tried to be observant about that (although i wANTed the antiserotonergic property of an ease in ability to orgasm). But the antihistamine effects were enough to make me ticked off and hate the stupid drug.
> > Thus, cyproheptadine, like Remeron, was a bust. And i would advise anyone interested in it who is sensitive to antihistamine effects to either be very judicious or to use another route.
> > Why can't they make a 5-HT2 (is it 5-HT2A or 5-HT2C, or both?) antagonist that's not also a potent antihistamine?!
> > Next up, amantadine. (No more H1 blockers for awhile).
> >
> > Oh, P.S., if anyone has any idea, what do you think the reason would be for the ED that i experienced with cyproheptadine? Is it strongly anticholinergic?
>
>
> Most antihistamines are also anticholinergic, but I do not believe cyproheptadine is as strong, as say, diphenhydramine, as it is not discussed in my book "Psychotropic Drugs" as a treatment for Parkinson's Disease as diphenhydramine is (due to that drug's anticholinergic properties). Cyproheptadine is not even listed in the index, but it does show up in a table of drugs used to treat sexual dysfunction. It is indicated for anorgasmia and hypoactive desire, but your experience is certainly not encouraging.
>
> It's thought that it is stimulation of the serotonin 2A receptors that are responsible for the anorgasmia problems caused by Nardil, the SSRIs, and Effexor. As you are finding out, this can be very difficult to treat. Many of the drugs that block these receptors such as Remeron, trazodone, and nortriptyline also have H1 blockades that cause sedation/hangover problems for some people (myself included). One other one I can think of that might work is nefazodone, which is less sedating than trazodone, but I don't know if you can get away with using this with an MAOI. I've seen warnings, but they may or may not be valid, as I've seen warnings for drugs like the tricyclics also, many of which can be used with MAOIs. Another option is the blasted atypical antipsychotics, which all blockade 5HT-2A receptors. Incidentally, the drugs specifically listed for anorgasmia in the table in my book are amantadine, bupropion, buspirone, cyproheptadine, dextroamphetamine, granisetron, methyphenidate, pemoline, and yohimbine. Of these, my understanding is that buspirone is definitely prohibited with an MAOI, but some of the others may be problematic also.
>
> Todd
>
>I think it's more likely to be 5-HT2C that is linked to anorgasmia & most psychoactive meds seem to be selective for 5-HT2A.
Cyproheptadine is a H1 & non-selective 5-HT1 & 5-HT2 antagonist that is a used as migraine prophylaxsis mostly in children. Methysergide might be worth a try too, it is a 5-HT1A agonist/non-selective 5-HT2 antagonist that is said to be the best drug for use as migraine prophylaxsis. It is an ergot derivative that has a rather mixed bunch of potential side effects including euphoria & hallucinations which probably shouldn't be too surprising since it is a relative of sorts to LSD.
Cheers,
Panda.
Posted by Questionmark on June 10, 2004, at 21:13:20
In reply to Re: cyproheptadine sucks » Questionmark, posted by Sad Panda on June 3, 2004, at 3:11:08
Panda, thanks for your comments. You said "Your ED problem was probably due to a lack of interest since you were falling asleep." Hah, good point. But i should have mentioned that the night i took the cyproheptadine, i was not considerably drowsy (though slightly), but i still experienced E.D. The next day the E.D. was even worse, but i was extremely tired, which is, as you mentioned, quite a reasonable explanation for the problem. But i can't think of an obvious explanation for why i experienced E.D. the night i took (nor for why i was so much more tired the following day).
Also, i did take Remeron daily once-- for about 5 or 6 weeks-- but now that i think of it i think i was only taking 15mg and i think i had just stopped taking Paxil (& Effexor) so i was not dealing with any significant anorgasmia, i believe. i'm curious to how Remeron would work for me again if i eventually started taking 30mg or more daily, but the thought of dealing with that ungodly H1 antagonism for that long again is a put-off.Todd (KingVultan), thanks for your comments too. Yeah, i have been interested in using nefazadone for these purposes, but i don't know if it's okay with an MAOI either. And i doubt very much that my pdoc would prescribe it anyway.
Yeah, antipsychotics are a no-go, too. Their side effects are too many & too severe and their DA blockade prevents them from being useful for this side effect anyway.
i'm in the process of experimenting with amantadine, but so far it is surprisingly weak-- sometimes unnoticeable. If it does not help then i am moving on to another, more potent dopaminergic.
Oh, and bupropion did not help either (with my Paxil-induced anorgasmia).
i detest this side effect. And there is nothing that alleviates it. Unbelievable.P.S., i have seen contradictory articles and views on 5-HT2A & 5-T2C agonism and which is responsible for serotonergic anorgasmia, and you guys disagreed as well. Is there ANywhere to verify the answer to this?? Actually, i'm gonna start a new thread asking this question.
This is the end of the thread.
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