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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 10 of 10. This is the beginning of the thread.
Posted by SLS on February 4, 2005, at 6:23:23
Hi All.
First of all, my depression just about wipes out my sex-drive. That sucks, but is no real surprise. However, it seems that whatever was left has somehow been stolen. I haven't had a libido since about the time I started taking Abilify. That was two years ago. I never gave it much thought before, but I am beginning to wonder if the Abilify is responsible. Any thoughts?
- Scott
Posted by bipolarspectrum on February 4, 2005, at 8:59:10
In reply to ABILIFY may have trashed my LIBIDO, posted by SLS on February 4, 2005, at 6:23:23
SLS,
I'd just like to thank you for your continious responses to my posts... I can't help but believe that you and I both experience bipolar depression from reading your posts oveer the last few months... I'm not a fan of atypicals and one of the main reasons is the cognitive dysfunction but I also find they zap my sex drive.. I believe its related to dopamine-receptor blockade, which reduces the 'rush' when experiences during sex... also, althought they claim abilify has low antihistamine qualities, it can be generally sedating, which might also reduce ur libido... now, i'm not representative of these guys, but have u tried em powerplus? I tried it, and I experienced a little relief but it send me hypomanic.. It reminded me of my experience with lamictal.. I think the zinc in em powerplus is the active psychotropic as it interacts with NMDA receptors to indirectly affect dopamine release.... anywayz, good luck
bps
Posted by olysi79 on February 4, 2005, at 14:38:16
In reply to ABILIFY may have trashed my LIBIDO, posted by SLS on February 4, 2005, at 6:23:23
Hey Scott, I'm thinking this is possible because those APs block dopamine, which I once heard is responsible for those types of things, then again, I could be wrong. I hope this gets worked out. Do you have the depression where you feel tired out or a more anxious depression or a combo of the 2?
> Hi All.
>
> First of all, my depression just about wipes out my sex-drive. That sucks, but is no real surprise. However, it seems that whatever was left has somehow been stolen. I haven't had a libido since about the time I started taking Abilify. That was two years ago. I never gave it much thought before, but I am beginning to wonder if the Abilify is responsible. Any thoughts?
>
>
> - Scott
>
Posted by SLS on February 4, 2005, at 16:11:40
In reply to Re: ABILIFY may have trashed my LIBIDO, posted by bipolarspectrum on February 4, 2005, at 8:59:10
Hi BPS.
> I'd just like to thank you for your continious responses to my posts...
Your welcome. We live in a nice neighborhood, don't we? :-)
> I can't help but believe that you and I both experience bipolar depression from reading your posts oveer the last few months...Exactly. It's a MF.
> I'm not a fan of atypicals and one of the main reasons is the cognitive dysfunction but I also find they zap my sex drive..
Thanks for the heads up (or should I say heads down). I might try to take a "holiday" from the Abilify to see if it is the culprit. For some reason, the atypicals help get me out of a suicidal state when the antidepressants fail or changes are made in my treatment regime.
> I believe its related to dopamine-receptor blockade,
You could be right. The other thing I was thinking is that it might produce a pro-serotonin effect like the SSRIs by acting to stimulate 5-HT1a receptors, but I really haven't thought the whole thing through yet.
Thanks for your input.
- Scott
Posted by SLS on February 4, 2005, at 16:20:40
In reply to Re: ABILIFY may have trashed my LIBIDO » SLS, posted by olysi79 on February 4, 2005, at 14:38:16
> Hey Scott, I'm thinking this is possible because those APs block dopamine, which I once heard is responsible for those types of things, then again, I could be wrong. I hope this gets worked out. Do you have the depression where you feel tired out or a more anxious depression or a combo of the 2?
I would say that it is predominantly the anergic tired type. When I was younger, though, there was quite a bit of anxiety that went along with it. I think I learned some good coping skills to combat the anxiety. However, when my chemistry really turns foul and I head in the direction of suicidality, there is quite a bit of anxiety.
What sort of condition do you have to contend with?
- Scott
Posted by rod on February 4, 2005, at 18:58:01
In reply to ABILIFY may have trashed my LIBIDO, posted by SLS on February 4, 2005, at 6:23:23
> Hi All.
>
> First of all, my depression just about wipes out my sex-drive. That sucks, but is no real surprise. However, it seems that whatever was left has somehow been stolen. I haven't had a libido since about the time I started taking Abilify. That was two years ago. I never gave it much thought before, but I am beginning to wonder if the Abilify is responsible. Any thoughts?
>
>
> - Scott
>
absolutely. My libido also got quite trahsed by Abilify, I figured out after quitting it. Might be the same in your case...bye
Roland
Posted by zeugma on February 4, 2005, at 19:10:33
In reply to Re: ABILIFY may have trashed my LIBIDO » bipolarspectrum, posted by SLS on February 4, 2005, at 16:11:40
The other thing I was thinking is that it might produce a pro-serotonin effect like the SSRIs by acting to stimulate 5-HT1a receptors, but I really haven't thought the whole thing through yet.
hi Scott. And I apologize for 'tossing your name around' before, I was trying to help Maxime and your experience is matchless (which I know is something of a mixed blessing- nonetheless you are truly knowledgeable and reliable as well as experienced). Buspirone stimulates 5-HT1A receptors and yet it can reverse SSRI s/e, and one of the few things positive that anyone generally says about this is that it is one of the few meds that doesn't dampen the libido. Of course, buspirone also metabolizes to an alpha-2 antagonist, so this could be responsible, but at the very least its 5-HT action doesn't block its pro-sexual effect, and may very well enhance it.Have you ever tried seroquel? I think that it and clozapine are the only AP's that don't increase prolactin, which could be behind the sexual side effects. Of course, I've read that buspirone, too, increases PRL, so who knows...
-z
Posted by SLS on February 5, 2005, at 6:13:00
In reply to Re: ABILIFY may have trashed my LIBIDO » SLS, posted by zeugma on February 4, 2005, at 19:10:33
Hi Z.
> > The other thing I was thinking is that it might produce a pro-serotonin effect like the SSRIs by acting to stimulate 5-HT1a receptors, but I really haven't thought the whole thing through yet.
> hi Scott. And I apologize for 'tossing your name around' before,
:-)Don't be silly! I was extremely happy and flattered that you did!
> Buspirone stimulates 5-HT1A receptors and yet it can reverse SSRI s/e,One of the things that must be considered is which 5-HT1a receptors are being stimulated and in which brain circuits these neurons operate. Some receptors act at inhibitory autoreceptors and exist both presynaptically and at somatodendritic cites. Others receptors are stimulatory at postsynaptic cites. I could be wrong, but I think Abilify has a much higher affinity to these receptors than has buspirone.
-> I'm just playing devil's advocate. The net effect could be inhibitory upon serotonergic neurons as you describe. I hope you are right. Abilify seems to be helpful to me, and I would rather not have a reason to do without it. I am going to try, though, as an experiment. I'd like to see what happens to my libido and mood. I'll let you know.
On another note, I saw my doctor yesterday. He "allowed" me to go up to 70mg of Parnate. I had wanted to go up to 80mg. I know that it represents a dead-end for me, but I was hoping to squeeze a little more out of my current treatment. I'm simply using it as a bridge until something new comes along. I might have to pull some teeth, but I might pursuade him to let me go to 120mg if I can get him to talk to my old doctor. Unfortunately, my current doctor had a bad experience with the only patient he tried high-dosage Parnate therapy on. At 120mg, this patient reported having a crushing headache. He was sure that it was NOT a spontaneous hypertensive event, but still, he is extremely reluctant to see it happen again.
Thanks, Zeugma. I always appreciate your help and sharp mind.
- Scott
Posted by olysi79 on February 5, 2005, at 12:31:24
In reply to Re: ABILIFY may have trashed my LIBIDO » olysi79, posted by SLS on February 4, 2005, at 16:20:40
Hi Scott,
I have BP II, OCD, and Panic Disorder. The depressions I get are mixed, anxious depressions. I've also had the lethargic kinds too, no fun whatsoever. Some meds that I've taken in the past have caused those libido problems, very frustrating for me and my partner. Overall though, things tend to go ok. I hope you're doing ok.
Chris
Posted by zeugma on February 8, 2005, at 17:24:17
In reply to Re: ABILIFY may have trashed my LIBIDO » zeugma, posted by SLS on February 5, 2005, at 6:13:00
Abilify seems to be helpful to me, and I would rather not have a reason to do without it. I am going to try, though, as an experiment. I'd like to see what happens to my libido and mood. I'll let you know.>>
Yes, please let me know. I am similarly trying the reverse: adding buspirone back in to my regimen. The main reason is because buspirone seems to have an antidepressant effect for me, though it is not a useful drug for most. So I took 15 mg am, plus I plan to take another 15 mg soon (with nortriptyline).
scott, what do you think of this report:
Prog Neuropsychopharmacol Biol Psychiatry. 2004 Aug;28(5):819-27. Related Articles, Links
Role of presynaptic alpha2-adrenoceptors in antidepressant action: recent findings from microdialysis studies.Invernizzi RW, Garattini S.
Istituto di Ricerche Farmacologiche Mario Negri, Via Eritrea 62, 20157 Milano, Italy. rinvernizzi@marionegri.it
The therapeutic effect of an antidepressant drug takes at least 2 to 3 weeks to develop and a significant proportion of patients have no or only partial benefit regardless of the class of antidepressant used. Research into the neurobiological basis of antidepressant action has suggested new strategies to improve the antidepressant effect. Recent microdialysis studies show that hypofunction of the presynaptic autoreceptors enhances the increase of extracellular serotonin (5-HT) induced by selective serotonin reuptake inhibitors (SSRIs) so it has been suggested that the antidepressant effect may be speeded up by blockade of the autoreceptors. The similarity between the synaptic mechanisms controlling serotonergic and noradrenergic transmission has stimulated preclinical research into the role of presynaptic alpha(2)-adrenoceptors in the effect of noradrenaline (NA) reuptake inhibitors (NRIs) on NA availability at central synapses. The microdialysis studies reviewed here indicate that NRIs including desipramine, reboxetine and atomoxetine, the mixed 5-HT/NA reuptake inhibitors sibutramine, duloxetine, venlafaxine or the NA/DA reuptake inhibitor amineptine, increased extracellular NA in various regions of the rat brain. The effect was enhanced by chronic treatment and even more by the co-administration of alpha(2)-adrenoceptor antagonists. The results support the theory that desensitization of the alpha(2)-adrenoceptor contributes to enhancing the effect of NRIs seen after chronic administration and may account for the slow onset of the antidepressant effect. Finally, they suggest that co-administration of an alpha(2)-adrenoceptor antagonist may improve the therapeutic effect of NRI.
I knowm this idea has been kicked around for a long time, and that alpha-2 antagonism had an adverse effect on you, but that might have been idiosyncratic to the drug you were on (e.g. atomoxetine induces depression in me invariably now, although it didn't at first, while nortriptyline continues to be well-tolerated).I also notice that Abilify has a long half-life, while buspirone is metabolized rapidly and thus might be conjectured to produce a more fleeting effect on 5-HT 1A receptors. Nonetheless I remember reading in a book that I consider highly ("The Antidepressant Era" by David Healy) that 5-HT 1A agonists are pro-sexual and promote orgasm. Of course the only 5-HT 1A agonist in wide use at time of writing was buspirone itself, and buspirone is the most erratic of psychotropics. So who knows... anyway, please report on your experiment.
-z
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