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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 4 of 4. This is the beginning of the thread.
Posted by johnb11 on August 29, 2005, at 17:01:24
For the last 5 weeks, I've been taking cabergoline (trade name Dostinex) at 2 mg/week, in an attempt to overcome Nardil induced sexual dysfunction. Dostinex is a dopamine agonist. It is very expensive ($300 for 8 mg, in .5 mg capsules).
For me, the 5 week experiment has shown no improvement in sexual functioning (libido and orgasm).
I think I will go back to Parnate. The one issue I had with Parnate was dry mouth. Now, I understand Evoxac @ 30 mg/day will treat that.
John11
Posted by utopizen on August 29, 2005, at 19:38:58
In reply to Combating Nardil Sexual Dysfunction, posted by johnb11 on August 29, 2005, at 17:01:24
> I think I will go back to Parnate. The one issue I had with Parnate was dry mouth. Now, I understand Evoxac @ 30 mg/day will treat that.
>
> John11Yup. 3-4x/day, and you're good to go. Also, Xyitol-- oh my goodness, Xyitol brochure was at my college's employee benefits office today-- the selling points were incredible.
Decreased tooth decay in controlled trials of children by like 70%.
Combine Evoxac with biotene toothpaste, which has Xyitol (sp?) and Biotene mouthwash, a decent toothbrush (I use the Braun Oral-B 3-D, total overkill, heh) and some refreshing dental chewing gum.
Orbitz, Arm and Hammer, whatever-- look for "Xyitol" and chew it. It kills bacteria that causes plaque.
Posted by Chairman_MAO on August 30, 2005, at 10:12:00
In reply to Combating Nardil Sexual Dysfunction, posted by johnb11 on August 29, 2005, at 17:01:24
Before giving up entirely, realize that Nardil's sexual dysfunction I believe, anyway, is mediated by several different mechanisms.
Serotonergic inhibition of dopamine and high prolactin are only two of many. Dostinex is not a cure-all. You should also try a cholinergic drug (bethanechol, neostigmine, galantamine) before giving up on Nardil. Galantamine has a history of use in Europe for psychogenic impotence, btw.
You can also try amantadine which is a dopamine RELEASER, but if dostinex didnt work it probably won't either. BTW, when dostinex worked for me, I needed at LEAST 500mcg/day for it to work; the twice weekly dosing is only good enough for an anti-prolactin effect. As an antidepressant augmentor, Dostinex is used at around 2mg per DAY (See pubmed for a case report).May I ask, is your problem libido, arousal, erection, orgasm, or all 4?
Posted by johnb11 on August 31, 2005, at 10:07:02
In reply to Re: Combating Nardil Sexual Dysfunction » johnb11, posted by Chairman_MAO on August 30, 2005, at 10:12:00
> Before giving up entirely, realize that Nardil's sexual dysfunction I believe, anyway, is mediated by several different mechanisms.
>
> Serotonergic inhibition of dopamine and high prolactin are only two of many. Dostinex is not a cure-all. You should also try a cholinergic drug (bethanechol, neostigmine, galantamine) before giving up on Nardil. Galantamine has a history of use in Europe for psychogenic impotence, btw.
> You can also try amantadine which is a dopamine RELEASER, but if dostinex didnt work it probably won't either. BTW, when dostinex worked for me, I needed at LEAST 500mcg/day for it to work; the twice weekly dosing is only good enough for an anti-prolactin effect. As an antidepressant augmentor, Dostinex is used at around 2mg per DAY (See pubmed for a case report).
>
> May I ask, is your problem libido, arousal, erection, orgasm, or all 4?
>
>---------------------
Hi,
Thanks. For me, the sexual dysfunction is all 4 - libido, erection, arousal, and orgasm. Problem with Dostinex is it didn't help with these problems and reversed the efficacy of Nardil. My psychopharmacologist thought increasing Dostinex could possibly bring back sexual functioning. However, my question was, "What about the SP?" His thinking was any dopamine agonist would have the same effect. He said this is why pre-treatment with deprenyl or Parnate (having dopaminergic component), frequently delays onset of efficacy of Nardil. I think I'm probably just a little too sensitive to Nardil's effects. Also, when I've tried increasing the does, I got orthostatic hypotension. Dostinex seem to exacerbate that, as well.
This is the end of the thread.
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