Re: Two and half years on and still persistent sexual side effects

[Guest guest]

Any one, any experience with this medication?

>

> Interesting article on how agomelatine might improve libido...

>

> ... " Finally, 5-HT2C receptor antagonists promote slow-wave sleep and

libido. " ....

>

> http://www.nature.com/nrd/journal/v9/n8/box/nrd3140_BX2.html

>

[Guest guest]

Hi,

Thanks for replying. My E2 was normal. LH and FSH high indicating that the brain

was screaming at my nuts to up testosterone production. Since I have quite low

cholesterol I tried DHEA, a precursor sex steroid to testosterone. Makes a

little difference, but not a whole lot.

However, many factors can influence the ability of the gonads to manufacture

testosterone apart from the pituitary hormones. As you say zinc etc. Tried that.

B6 helps a little, but barely noticeable.

Mucuna Pruriens tried that. Just makes me sleepy.

Cabergoline, tried that. Again just makes me sleepy.

The dopamine agonists will probably only work if they do not significantly

antagonise ACh. In my case I think they do because of the sedation as a result

of broad spectrum dopamine agonism D1,D2,etc across all regions of the brain.

What I thought would be better would be a more targeted approach using a 5HT2c

antagonist or reverse agonist, which should increase situational dopamine

release in the frontal cortex. This has in theory a stimulatory effect rather

than a sedating effect - probably because it does not antagonise ACh. This is

why atypical modern anti psychotics are not as sedating as first generation,

because of the ability to release dopamine selectively into the frontal cortex

via 5HT2c antagonism, whist antagonising dopamine release elsewhere.

> >

> > My journey started almost 3 and a half years ago. I was diagnosed with

> mild depression with anxiety and prescribed 20mg generic fluoxetine for

> 6 months only. Prior to this my libido, erections and orgasms were just

> fine, even when I felt depressed. I had not been on any medication at

> all prior to this and am have been on no medication subsequent to the

> fluoxetine cessation.

> >

> > During the six month treatment I experienced all sorts of extra

> pyramidal-like side effects. Including involuntary motor movements,

> severe limb twitching, bruxism, involuntary twisting of by back muscles,

> benign myoclonic jerks, severe inner restlessness and the need to pace

> and inability to sit still. Well that should have been the warning sign.

> Classic symptoms of either serotonin syndrome or Neuroleptic Malignant

> Syndrome ie the severe antagonism of the dopamine system.

> >

> > My GP said don't worry about it. Wish I knew then what I know now.

> >

> > The side effects described above remained for some two years post

> fluoxetine cessation. My libido has not returned to baseline levels.

> >

> > I had some bloodwork done and discovered that my testosterone level

> was low and prolactin high. This was some 6 months post cessation. I

> think the SSRI induced increase in prolactin has permanenetly damaged my

> testicles as they shrunk during treatment and have never returned to

> baseline.

> >

> > I have tried TRT but with minimal benefit. Have also tried DHEA with

> again modest benefit. Also tried LDOPA, but this just makes me sleepy.

> >

> > I want to try some of the new 5HT2C antagonists to see if that might

> be of benefit. One possibility is that Fluoxetine permanently

> upregulated 5HT2C receptor expression, amongst other things I'm sure.

> >

> > I'm shocked that these permanent effects are not disclosed more

> clearing on the labeling or highlighted as a risk by the Dr.

> >

> > Thanks, Garch

> >

>

[Guest guest]

Hi,

Sounds like you might have a bit of depersonalization disorder. Quite common

with persistent anxiety disorders + frequent panic attacks. Again, loss of

spacial awareness could be a symptom of depersonalization disorder, or low

neurosteroid hormones. If you don't suffer from persistent anxiety then might

want to try 10mg DHEA for a week to see if that helps. DHEA-S is used in the

brain to innervate Sigma-2 receptors, which in turn potentiates D2 dopamine

receptors and ACh release. The ACh release is important as this is one of the

" wakefullness " neurotransmitters which counterbalances D2 agonism, which would

make you feel a bit spaced out and detached. Too much ACh agonism and you would

probably feel a bit dizzy, stiff and anxious. I like DHEA a lot because there is

no pharma equivalent ie both dopamine and ACh agonism + neurogenesis.

>

> Cant speak on behalf of fluoxetine but I was on 40mg citalopram for 6

months, but my testicles are a lot fuller now, than when i first was on

citalopram, there is sensation a bit as well.  My symptoms are more mental tho,

sometimes i feel i am not myself and have to have peple to touch me to reliase i

still exist.  Also my spatial awareness is off.  These things really mess you

up.

>

>

> ________________________________

>

> To: SSRIsex

> Sent: Sunday, 1 January 2012, 20:56

> Subject: Two and half years on and still persistent sexual side

effects

>

>

>  

> My journey started almost 3 and a half years ago. I was diagnosed with mild

depression with anxiety and prescribed 20mg generic fluoxetine for 6 months

only. Prior to this my libido, erections and orgasms were just fine, even when I

felt depressed. I had not been on any medication at all prior to this and am

have been on no medication subsequent to the fluoxetine cessation.

>

> During the six month treatment I experienced all sorts of extra pyramidal-like

side effects. Including involuntary motor movements, severe limb twitching,

bruxism, involuntary twisting of by back muscles, benign myoclonic jerks, severe

inner restlessness and the need to pace and inability to sit still. Well that

should have been the warning sign. Classic symptoms of either serotonin syndrome

or Neuroleptic Malignant Syndrome ie the severe antagonism of the dopamine

system.

>

> My GP said don't worry about it. Wish I knew then what I know now.

>

> The side effects described above remained for some two years post fluoxetine

cessation. My libido has not returned to baseline levels.

>

> I had some bloodwork done and discovered that my testosterone level was low

and prolactin high. This was some 6 months post cessation. I think the SSRI

induced increase in prolactin has permanenetly damaged my testicles as they

shrunk during treatment and have never returned to baseline.

>

> I have tried TRT but with minimal benefit. Have also tried DHEA with again

modest benefit. Also tried LDOPA, but this just makes me sleepy.

>

> I want to try some of the new 5HT2C antagonists to see if that might be of

benefit. One possibility is that Fluoxetine permanently upregulated 5HT2C

receptor expression, amongst other things I'm sure.

>

> I'm shocked that these permanent effects are not disclosed more clearing on

the labeling or highlighted as a risk by the Dr.

>

> Thanks, Garch

>

[Guest guest]

agomelatine is a very very new class of antidepressant and not much is known

about it. It is not even readily available in the US or the UK. However, the

theory about 5HT2c antagonism improving libido is well documented in the

scientific literature with experiments on male mice, as well as anecdotal

evidence via message board users who report a massive increase in libido. This

makes sense as 5HT2c is implicated in sexual desire (libido) and 5HT1a in

erections. Orgasm is even more complicated, but probably includes other 5HT

receptor types that modulate ACh and central Histamine release.

> >

> > Interesting article on how agomelatine might improve libido...

> >

> > ... " Finally, 5-HT2C receptor antagonists promote slow-wave sleep and

libido. " ....

> >

> > http://www.nature.com/nrd/journal/v9/n8/box/nrd3140_BX2.html

> >

>

[Guest guest]

I've tried this stuff and it sent my anxiety through the roof. It put me in a

deep sleep, as well and made it hard to wake up in the morning. I was in a

stupor in the morning. I had no previous problem sleeping and I was concerned

that I would become reliant on it to fall asleep. When I stopped using it, I

did have problems for a week or so falling asleep.

I had no libido enhancement on the medication.

I still have a healthy supply of Valdoxan to try and have considered re-trying

it, but there is some evidence that this drug is very harmful to the liver. It

appears it may not be much more effective than placebo, as well. The word in

forums on the web suggest that the research done on Valdoxan was not exactly

honest in how it was reported.

If you are looking for a slight libido enhancement, try this drug companies

(Servier) older antidepressant, Stablon. I did experience results on this. I

took it for 6 months and was pleased. I haven't used it since 2009, and might

try it again to see if there are any further gains to be had with it. I didn't

perceive discontinuation symptoms with Stablon, although, forums on the net,

suggest there may be.

I can't say what the long term affects are with these drugs, as I am certainly

not cured of PSSD and the other associated symptoms, after 5 years. My libido,

as a whole, and my ability to have sex, has returned somewhat, but at this

point, I'm not sure I'd go so far as to say it's even at 50%. But considering

it was at ZERO, there has been an improvement.

> >

> > Interesting article on how agomelatine might improve libido...

> >

> > ... " Finally, 5-HT2C receptor antagonists promote slow-wave sleep and

libido. " ....

> >

> > http://www.nature.com/nrd/journal/v9/n8/box/nrd3140_BX2.html

> >

>