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Re: Any potent Alpha-1 adrenergic agonist

Posted by JohnX on March 16, 2001, at 0:05:29

In reply to Re: What sexual side effects?: Phoenix Girl, posted by AndrewB on March 15, 2001, at 10:36:44

> Sexual side effects are physical and I believe only effect men. Specifically it causes a tightening of certain (smooth?) muscles surrounding the urinary canal and, apparently, the groin region in general. Alpha 1 agonism can result in difficulty in achieving erection and retorgrade ejaculation. Flomax is an alpha 1 receptor blocker used for enlarged prostate conditions but also has been used in combo with reboxetine (an NE reuptake inhibitor) to eliminate the sexual and urinary difficulties that reboxetinbe can cause. As I said, I think these sexual (an urinary?) problems are limited to men.
>
> AndrewB


Ok, my original thought was what medication could be combined with the a1 partial antagonists to offset the side-effects caused by a1 antagonism?
A lot of people complain about the side effects
of Serzone/Zyprexa et. al who are sensitive to the weight gain or dizziness and so it just seems like dosing in a countermeasure to go straight after the problem is worthwhile.

Here is my summary of a1 antagonism side effects:

-priapiam (particularly in Trazodone, the older Serzone)
-dizziness
-drowsiness
-weight gain
-low blood pressure (postural hypotension)

Here are the a1 agonist side effects

-urinary retention
-impotence
-excitability
-weight loss
-possible improvement in cognition

I'm always willing to take two meds even if I can't stand them by themselves, but their side effects cancel out. Seems to have worked for me
in the past if you get the dosing ratio of the
two meds correct.

That being the case, it seems like dosing in some amount of the meds adrafinil/reboxetine/etc may
be extremely useful to me if I want to try
Serzone again (which was overwhelmingly drowsy and
dizzy after a long trial), or an anti-psychotic with similar properties like Zyprexa. Geodon does not have the alpha-1 antagonism to the same extent and as such would be less likely to cause the problems.

I have read about the Flomax trick adding it to Reboxetine. This is just the same idea in reverse. Always wondered if anyone tried a Serzone/Reboxetine combo (to combat the impotence and urinary retention)?

Also, back to my original post. Do you guys know if Modafinil (Provigil) is an A1 agonist? I have a script for this (expensive!, insurance whines)and tried it for 3 days as a substitute for Adderall. It made me less irritated, but gave me a big headache as if I drank 8 pots of coffee and had little impact on my mood (although it did help with concentration).

Thanks for all your feedback.

I'm on page with AndrewB who a long time ago
told me that he's a big fan of "clean" meds.
My take is that if we've gone through the ringer
and have found a med(s) that address a large portion of our difficulties with just 1 or 2 unbearable side-effects, then dosing in a clean-med that directly counteracts the well-known biological reason for the side-effect is a good idea.

-John



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