Posted by King Vultan on November 2, 2004, at 0:15:40
In reply to Re: Does Nortriptyline cause sexual side effetcs?! » King Vultan, posted by Iansf on November 1, 2004, at 18:54:33
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> I'm somewhat confused about which side effect(s) doxazosin is helping with. Is it only urinary retention or is it sexual dysfunction as well?
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> I had virtually total urinary retention when I tried desipramine (Reboxetine also), even at an extremely low dose. But my doctor told me it was the tricyclic least likely to cause cholinergic problems, so we didn't bother trying any others. Now you're saying its the most likely. I wonder if I gave up on tricyclics unnecessarily.
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> John
Flomax/tamsulosin and Cardura/doxazosin are both alpha-1 blockers and blockade these receptors in the prostate. These receptors can cause a problem when taking either drugs that are anticholinergic or drugs that increase norepinephrine transmission. Desipramine does have the lowest anticholinergic effects in the tricyclic class but has an extremely powerful blockade of norepinephrine reuptake, as does reboxetine. These NE effects are likely the reason both of these drugs can cause urinary hesitation and retention.Nortriptyline is a little more anticholinergic than desipramine and somewhat less powerful at blocking NE reuptake, but it also has a stronger alpha-1 blockade that tends to mitigate the adverse effects on urinary flow. In my case, with my annoyingly hypersensitive alpha-1 receptors, the alpha-1 blockade in nortriptyline improved urinary function to noticeably better than normal. It was quite a shock when I moved on to desipramine and things became quite a bit worse than normal; although, they did improve over time.
As far as these alpha blockers, they are mainly designed to combat urinary flow issues, but they also can have sexual effects. Actually, one of the reasons I take doxazosin is because it does have some minor but worthwhile positive sexual effects, in addition to the urinary improvements. However, priapism is a possible (but rare) side effect of alpha blockers, and they can also have some strange effects on ejaculation.
Todd
poster:King Vultan
thread:409345
URL: http://www.dr-bob.org/babble/20041029/msgs/410431.html