Info. Wanted re. Drugs Used to Treat Sexual Dysfunction Caused by Anti-Depressants
Michael Current
choloride (Urecholine), or cyproheptadine HCL (Periactin) to treat
sexual dysfunction caused by the use of anti-depressant medications?
These are the two agents mentioned most often in the literature, based
on a Index Medicus search I did for the years 1980 to the present.
For reasons that are not clear to me - perhaps because it has been tried
more with patients on drugs like fluoxetine (Prozac) that are currently
in vogue, the use of cyproheptadine seems to be more common and better
known. Cyproheptadine is an antihistaminic and antiserotonergic agent,
usually prescribed for allergies. It is my understanding that it is
fairly sedating and has additive effects when given with CNS depressants
and MAOI's.
Bethanechol, on the other hand, is a cholinergic agent that is usually
used to treat urinary retention. The PDR suggests that this drug tends
to have few side effects in oral dosages, except for occassional nausea
if taken immediately after meals, and some hypotension. It lists no
interactions with CNS or anti-depressant drugs.
The literature on the use of both drugs to treat sexual dysfunction does
not report any problems associated with the use of either drug, except
for one case in which one patient was withdrawn from cyproheptadine due
to unspecified "side effects." Both drugs have cholinergic effects, and
it has been suggested to me that a "cholinergic crisis" can sometimes
occur.
I would be interested in hearing about anyone's experience with either
drug. My own doctor says he has sometimes prescribed cyproheptadine,
with mixed results, but was not familiar with the use of bethanechol. I
am interested in the later because there are specific reports of its
effectiveness in counteracting sexual dysfunction among persons on
fairly high doses of the MAOI tranylcypromine (Parnate), which is what I
am taking.
This is a particular problem for me. It can be very difficult to
impossible for me to have an orgasm, and sometimes to get or maintain an
erection, both when having sex with another person and when
masturbating. This is made even more difficult due to the fact that I
am a gay man who will not have sex with another person without the use
of a condom. While many depressed persons report having a decreased sex
drive and therefore do not complain a lot about these effects, I have an
"atypical" depression and my sex drive has never been impaired except at
points of extreme crisis. I frankly think that Parnate increases my sex
drive even more. If one of these drugs could be helpful, without
causing a whole new series of problems, I would like to give it a try.
Michael
(who has managed to type this whole post without becoming *too*
embarrased)
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________________________________________________________________________
Michael J. Current mcur...@ins.infonet.net mcur...@nyx.cs.du.edu
Currently unemployed (: gay/lesbian/bisexual/transgender rights activist
P.O. Box S, Des Moines, IA 50311-0210