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How to cure antipsychotics-induced sexual dysfunction (desire, arousal, libido, orgasm) in male with the use of drugs?

antipsychotics sexual dysfunction desire libido dopamine testosterone dopamine agonists dri prolactin

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#1 User4656

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Posted 27 July 2016 - 06:00 PM


1. Dopamine receptors
 
Antipsychotics are potent dopamine antagonists and the dopamine blockade is probably a major factor in sexual dysfunction. I was told that after the discontinuation of drugs, dopamine receptors that were blocked can be used again and that there is a receptors recycling and the new dopamine receptors are being formed. This proccess of forming should take up to 4 months according to neurologist. Should I be concerned about the receptors that were once blocked? Do anyone knows what impact has the antagonist's blocking on receptor and it's functioning and sensitivity after being "unblocked"? Or should I just do not to have to be concerned about them anymore, since recycling, and the fact that receptors are dying anyway?
 
I'm not sure what should be the right approach in curing dopamine receptors after antipsychotics use. Should I increase the number of receptors to grow new healthy ones? I think I read that antipsychotics causes upregulation though...
 
If that's the right approach, what drugs or nootropics do you consider as effective to increase DA receptors?
 
I found the combo of Triacetyluridine, CDP-choline, DHA and Methylcobalamin should do the trick. And Phenylpiracetam.
 
 
2. 5-HT2 receptors
 
Antipsychotics has agonistic serotonergic effects on 5-HT2 receptors which are associated with a decreased ability to achieve orgasm.
 
How to fix it?
 
 
3. Elevated prolactin
 
Is it sufficient enough to use Cabergoline (or Lisuride, Pramipexole, Bromocriptine) to put the prolactin down?
 
 
4. Reduced dopaminergic transmittion
 
E.g. Risperidone reduces dopaminergic neurotransmission in mesolimbic, prefrontal cortex limbic, and tuberoinfundibular pathways.
 
Would the administration of Amanantadine (which should increase dopaminergic neurotransmission in nigrostriatal, mesolimbic and frontostriatal pathways), Levodopa (eg. Carbidopa/Levodopa) fix the problem?
 
 
5. Hypothalamic–pituitary–gonadal axis and testosterone
 
Dopamine receptor blockade causes hyperprolactinaemia with subsequent suppression of the hypothalamic–pituitary–gonadal axis and hypogonadism. It causes low testosterone.
 
Do antipsychotics cause any damage to hypothalamic–pituitary–gonadal axis or do they just lower FSH and LH?
 
I'm aware that Cabergoline slightly increases both with testosterone along. I'm sceptical to use Clomiphene to fix pituitary gland because of it's Estradiol and SHBG increasing tendencies. I would have to administer drugs that counteracts it. So I'm just waiting till the seperated Enclomiphene will hit the market. I'm also sceptical to use TRT due to its FSH, LH suppression, infertility issues and due to the fact that it would have to be asministered probably for the rest of the life.
 
 
6. H1 receptors antagonism
 
Antipsychotics antagonizes H1 receptors which decreases libido through sedation.
 
Would the use of Betahistine or Pitolisant fix the problem that may still persist after discontinuation?
 
 
7. Triglycerides increase, serum cholesterol increase
 
 
and there is probably some more shit involved (affinity for noradrenergic, cholinergic neurotransmitter systems)...
 
Are you aware of anything else?
 
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Does the use of dopamine agonists helps to cure this induced sexual dysfunction, and why? Are there any long-term benefits from using them or is it just the short term dopamine receptor activation while using the drug? And most importantly, why would be DA receptor activation good for treating antipsychotics induced sexual dysfunction?
 
---
 
I will mention some drugs that I think should be effective as a cure for all of the above issues:
 
Cabergoline
Lisuride
Amantadine
Levodopa
Trihexyphenidyl
Procyclidine
Betahistine
Pitolisant
DRIs (Dopamine reuptake inhibitors)
Triacetyluridine, CDP-choline, DHA and Methylcobalamin
Phenylpiracetam
Proviron
Enclomiphene
Pramipexole (caused some weird ED and orgasm delay when I used it)
Ropinirole
Nefazodone
COMT Inhibitors
Niacin
Zinc
Selenium
Vitamin D
 
I was taking Risperidone 1mg, Olanzapine 5mg, Amisulpride 50mg, Sulpiride 50mg, Clonazepam 2mg for the period of 2 months (not all together).
 
It would be very kind if someone who knows the mechanism of how antipsychotics work and who knows what drugs to use to completely cure the sexual dysfunction in all areas (desire, arousal, libido, orgasm) would write some treatment plan and what drugs to use.
 
Thank you!






Also tagged with one or more of these keywords: antipsychotics, sexual dysfunction, desire, libido, dopamine, testosterone, dopamine agonists, dri, prolactin

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