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Re: Ropinirole for AD sexual problems

Posted by SLS on February 11, 2014, at 7:17:23

In reply to Re: Ropinirole for AD sexual problems, posted by jono_in_adelaide on February 10, 2014, at 23:21:19

> Current med regime
>
> Nardil 30mg tds
>
> Xanax 1mg tds
>
> Nortriptyline 75mg qhs
>
> Risperidone 1mg qhs

How long have you been taking Nardil for? A substantial number of people regain their ability to orgasm after 3 months, although it can still be somewhat difficult. You could try taking a small amount of cyproheptadine (Periactin) as long as you don't mind falling asleep afterwards. It is a serotonin 5-HT2a/b/c receptor antagonist. It is also a histamine H1 receptor antagonist, which explains the sedation. I think there is a window of opportunity where orgasm becomes possible and before sedation occurs. Buspirone (Buspar) is another drug used to help with orgasm due to its ability to stimulate serotonin 5-HT1a autoreceptors.

What do you take risperidone (Risperdal) for?

I don't know about ropinerole (Requip). It might be a perfect answer. I am not a big fan of DA receptor agonists, though. For depression, its therapeutic effects are usually fleeting. Personally, I have only tried bromocryptine (Parlodel) for depression. I was not experiencing anorgasmia at the time. I also worry that DA autoreceptor downregulation might persist after DA agonist discontinuation.

For depression and anorgasmia, you might be better off using aripiprazole (Abilify) in place of risperidone due to its DA D2/3 and 5-HT1a partial agonism. Risperdal increases prolactin secretion, which doesn't help matters. Aripiprazole has recently been reported to be a serotonin 5-HT7 antagonist, an action that may contribute to its antidepressant effect. Risperidone also acts to reduce 5-HT7 activity via irreversible binding to that receptor. Lurasidone (Latuda) is another antipsychotic with 5-HT7 receptor antagonism as well as 5-HT1a agonism.

Bupropion (Wellbutrin) seems to increase desire, but has no direct effect on orgasm. I don't know about methylphenidate.


- Scott


Some see things as they are and ask why.
I dream of things that never were and ask why not.

- George Bernard Shaw

 

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URL: http://www.dr-bob.org/babble/20140123/msgs/1060542.html