Sexual dysfunction on Effexor

[MeDieViL]

Anti parkinson drugs, pramipexole in particular has been shown to have potent antidepressant effect, which is not suprising since da, rather then se is implicated in depression, ill provide references if asked.

 

[JohnBoy2000]

Wellbutrin is a NE releaser not a NRI with neglible da activity, 20& reuptake inhibition to be exact, which MAY be sufficient for some people, that said NRIS are usually sedating by activating one of the ne receptors which decreases NE, i forgot which kind it was, as an example reboxetine a pure nri is sedating initially.

That said from reports it seems that bupropion has unique prosexual effects which may be unrealted to its NE release but that is just speculation.

In the worst cases the addition of amphetamine or another strong dopaminergic would be needed, but that depends on your individual case.

Yeah that theory that a stimulant would counter the dysfunction, well, it doesn't apply to me at least.

Dopaminergic - again, my familiarity with pharmacology is quite lacking but, a dopamine agonist vs a dopamine antagonist.
Does antagonist suggest reuptake inhibition?? As oppose to secretion... as something like a stimulant would do.

Noradrenaline reuptake inhibition acts in a sedating manner??
Does that explain why something like Cymbalta is reported as more sedating than effexor - given the NorAdren to serotonin reuptake inhibition ratios??
Because from what I understand - effexor is considered a stimulating anti-depressant, carrying hardly, if ever, sedative properties, when examined subjectively.
Where as (correct me if I'm wrong), cymbalta carries frequent reports of drowsiness, fatigue, lethargy etc.


I'm 9 days in on 225 mg of effexor, and had an off day today.
I'm hoping to mitigate these off days, so I can get back to work.

A poster mentioned earlier in the thread, that reuptake inhibitors, as oppose to agonists, take time to reach equilibrium and carry the full anti-depressant effect.
How long would we be taking??

Max dose 375mg of effexor, so I have two more titrations before I consider switching.... moving either to cymbalta, or the tricyclics, probably elavil or something.

So - fill free to enlighten me.

Or, if someone can point me to a research link where I can read up on this material myself, that would be swell.

 

[JohnBoy2000]

Anti parkinson drugs, pramipexole in particular has been shown to have potent antidepressant effect, which is not suprising since da, rather then se is implicated in depression, ill provide references if asked.

Yes, references would be swell.

 

[MeDieViL]

Yeah that theory that a stimulant would counter the dysfunction, well, it doesn't apply to me at least.

Dopaminergic - again, my familiarity with pharmacology is quite lacking but, a dopamine agonist vs a dopamine antagonist.
Does antagonist suggest reuptake inhibition?? As oppose to secretion... as something like a stimulant would do.

Noradrenaline reuptake inhibition acts in a sedating manner??
Does that explain why something like Cymbalta is reported as more sedating than effexor - given the NorAdren to serotonin reuptake inhibition ratios??
Because from what I understand - effexor is considered a stimulating anti-depressant, carrying hardly, if ever, sedative properties, when examined subjectively.
Where as (correct me if I'm wrong), cymbalta carries frequent reports of drowsiness, fatigue, lethargy etc.


I'm 9 days in on 225 mg of effexor, and had an off day today.
I'm hoping to mitigate these off days, so I can get back to work.

A poster mentioned earlier in the thread, that reuptake inhibitors, as oppose to agonists, take time to reach equilibrium and carry the full anti-depressant effect.
How long would we be taking??

Max dose 375mg of effexor, so I have two more titrations before I consider switching.... moving either to cymbalta, or the tricyclics, probably elavil or something.

So - fill free to enlighten me.

Or, if someone can point me to a research link where I can read up on this material myself, that would be swell.

I suppose effexor acts so strongly on ne that it doesnt induce sedation, that said most reuptake inhibiting stims arent sedating and its the ne that causes wakefullness, ill have to compare cymbaltas affinitys with most stims.

Dopamine and other neurotransmistters are thrown in a dumb where they are recycled, reuptake inhibitors inhibit the pumps that throw them in the garbage so the neurotransmitters stay around longer,

ill explain with regards to dopamine, there are several dopamine receptors, like D1, D2 basicly like differened rooms, reuptake inhibitors allow more da to go in each room.

Agonist or antagonist either enter or block a room specifically, like a d1 agonist would only activate d1, in contrast to all the rooms.

Does this explanation make any sense? its hard to type as the combo of ethyl and apvp makes my mind scattered, was testing wheter their unique propertys could work in synergy but its not the case.

 

[Jabberwocky]

Yeah that theory that a stimulant would counter the dysfunction, well, it doesn't apply to me at least.


Does antagonist suggest reuptake inhibition?? As oppose to secretion... as something like a stimulant would do.


Max dose 375mg of effexor, so I have two more titrations before I consider switching.... moving either to cymbalta, or the tricyclics, probably elavil or something.

.

Antagonist means does not activate the receptor -- and blocks activation agonism/antagonism have nothing to do with releasing

 

[MeDieViL]

Simple, to the point, well explained.

 

[Former drug rep]

I used to sell Effexor XR when I was a drug rep with Wyeth. Sexual disfunction is considered a "class effect", meaning it is a common side effect in SSRI's and SNRI's. However, I learned some great advice for patients from some of the psychiatrists who conducted the clinical trials. One, which has been mentioned, is to increase the dose to 225mg or higher. The ratio of serotonin to norepinephrine is inversely related...as the dose increases the level of norepinephrine increases while the level of serotonin hits a plateau or slightly decreases. Another tip is to take a medication vacation and not take your dose of Effexor the day you plan or anticipate you will have sex. Or you can take the daily dose after you have sex. Another tip was to switch to Wellbutrin for the day you are having sex or take Wellbutrin in addition to the Effexor that day. However, this is not recommended if you have high blood pressure since both medications can raise BP. There are other things you could try, but the most important thing is to remember that sexual dysfunction is typically a transient effect and will likely go away with time. The worst thing you can do is worry and stress about it because that adds an additional component. Be grateful that the medication is helping and with time you will be not depressed and getting an erection!

Another item...it is impossible to directly compare the rates of sexual dysfunction from the package inserts or a website for Cymbalta and Effexor XR. The makers of Cymbalta were smart when doing the clinical trials and purposely asked sexual dysfunction questions that would result in a perceived lower rate when compared to Effexor XR. I have seen, but don't remember the exact questions that were asked in both clinical trials and they were not the same questions. So, you can't compare the rates fairly unless the exact same questions are asked of the trial participants. You can compare rates of nausea, weight gain, blood pressure changes, etc. because they can be directly measured. Do not switch medications based on the reported rates of sexual dysfunction! It is known that all of the SSRIs have the most sexual dysfunction, followed by the SNRIs and then Wellbutrin.

It's great to hear you were able to get an erection and to orgasm. That tells me that with time, your body will adjust and you will do well on Effexor. Good luck and be grateful that it is reducing your depression symptoms!

 

[JohnBoy2000]

Like I said before, cabergoline is the " go to" dopamine agonist for ed issuers related to ssri treatment.

Cabergoline has issues (potential cardiotoxicity) -- discuss with your doc.

Honestly, if it is because of high prolactin -- NOTHING will work other than a dopamine agonist.

Alright, doc appointment on monday.

What dose of cabergoline should I be looking at?

My doc shouldn't even be practicing, he's a fucking space cake.
I go in, tell him what I want, he gives - that's how it works.

I'd be surprised if he ever even heard of this drug.
So I'll need to know the dose to request.

???

 

[JohnBoy2000]

Anti parkinson drugs, pramipexole in particular has been shown to have potent antidepressant effect, which is not suprising since da, rather then se is implicated in depression, ill provide references if asked.

wud that counter dysfunction also, given da effect?

might as well kill two birds with one stone.