Posted by Dave001 on August 24, 2004, at 20:22:44
In reply to Re: Article for Men trying Cymbalta, posted by linkadge on August 23, 2004, at 19:31:52
> Some people find that prozac is one of the better ones for sexual problems. Paxil seems to be the worst because of NO synthase inhibition. But prozac seems to be the best because it has a reasonable blockade of the 5-ht2c receptor can help some of the anorgazmia.
>Paxil does seem to be the worst on paper, but according to the studies I have seen, escitalopram/citalopram seems to be the best of the SSRIs. (Es)citalopram is the only SSRI I have not seen evidence of causing NO inhibition. Granted, there are other mechanisms to take into account. See the abstract below and in my other post in this thread for reference to citalopram's apparent lack of peripheral NO inhibition.
Dave
Differential effects of serotonin reuptake inhibitors on erectile responses, NO-production, and neuronal NO synthase expression in rat corpus cavernosum tissue.
Br J Pharmacol 2001 Nov;134(6):1190-4 (ISSN: 0007-1188)
Angulo J; Peiro C; Sanchez-Ferrer CF; Gabancho S; Cuevas P; Gupta S; Saenz de Tejada I Fundacion para la Investigacion y el Desarrollo en Andrologia, Department de Investigacion, Hospital Ramon y Cajal, Madrid, Spain.
Increased incidence of impotence is associated with some selective serotonin-reuptake-inhibitors (SSRIs), but the pathophysiological mechanism is unknown. Paroxetine and citalopram are extensively used SSRIs, but only paroxetine has been shown to inhibit nitric oxide synthase (NOS) activity. NO is a key mediator of penile erection. Thus, the aim of this study was to determine the effects of paroxetine and citalopram on erectile function and NO production, in a rat model. Application of cavernosal nerve electrical stimulation produced frequency-related intracavernosal pressure (ICP) increases, which were inhibited by the NOS inhibitor, N(G)-nitro-L-arginine (0.3 mg x kg(-1)). Acute or chronic (2 weeks) paroxetine-treatment (10 mg x kg(-1)) reduced ICP-responses, while citalopram did not. Paroxetine, but not citalopram, significantly reduced nitrite+nitrate plasma levels by 61.4% and inhibited penile neuronal NOS (nNOS) protein expression by 31.2% after chronic treatment. The results show that paroxetine inhibits erectile responses in rats. We propose that this effect is due to reduced NO production and nNOS expression.
poster:Dave001
thread:380801
URL: http://www.dr-bob.org/babble/20040821/msgs/381903.html