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Dr. Bob is Robert Hsiung, MD,
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Posted by CarolAnn on April 8, 2000, at 13:59:22
In reply to Re: brand new beef/Cam, posted by Cam W. on April 8, 2000, at 12:02:50
Doh! (picture my hand slapping my forehead!)! Wrote the wrong name in original post.
The drug is called "Uprima", made by TAP Pharmaceuticals. It is not swallowed, but placed "under the tongue, simulating the brain chemical dopamine, which starts the signal for an erection"(news quote). It's supposed to work faster then Viagra.
I know these things don't actually work on libido, but it would sure increase my interest in having sex, if I had a pill that, at least, increased the odds of having an orgasm! And since I've read (on this board even) that Viagra does effect quality of orgasm, I have to stand by my initial rant that more research should be done on the female side of these things. This was the point of the initial post, any input ladies? or guys? CarolAnn
Posted by Liz on April 8, 2000, at 14:27:56
In reply to Re: brand new beef/Cam, posted by Cam W. on April 8, 2000, at 12:02:50
Cam, now you've got me laughing out loud. As long is my husband is happy, I should be content with a cold shower? So if someone offered you the alternative of cold shower vs. getting your rocks off, you' be just as satisfied with the cold shower? Typical male...(just kidding!) Liz
> Liz - The 100mg of Wellbutrin SR in the morning is to help those with "decreased" libido, not increased. God help your husband if you add Wellbutrin to your regimen (just kidding, it probably wouldn't increase your libido any more).
>
> Also, in my experience, the adding of 100mg of Wellbutrin SR in the morning to reverse sexual dysfunction (eg anorgasmia) of SSRIs works about only 20% of the time (unscientifically arrived at hypothesis).
>
> To decrease your sex drive, I don't know - a cold shower? (works for us guys) - Cam W.
Posted by Cam W. on April 8, 2000, at 20:53:27
In reply to Re: clarification, please read everyone(esp. Cam), posted by CarolAnn on April 8, 2000, at 13:59:22
KarenB - Since I've been fixed I never hold back on anything. I do know about some people using bromocriptine for sexual dysfunction, but I am not a fan of the drug.Bromocriptine was used (until recently) to dry up breast milk in lactating women, until researchers discovered it just delayed the drying up process. Thus, the drug was prolonging the agony of engorged boobs in new moms who could not (or would not) breast feed. (Ya think it was male scientists who can up with this use for the drug? - no doubt.) You ladys are constantly getting screwed by medical research. (no pun intended).
Today, we use bromocriptine mainly in people (both men and women) who have a hormone elevation (prolactin) when taking the older antipsychotics or the newer Risperdal. Increased prolactin levels can cause some long term problems (eg osteoporosis, gynecomastia, and hormone imbalances - I think) and some immediate problems (eg lactation). We use it to dry up men and women who lactate when taking these drugs.
Bromocriptine is also used in several hormonal disorders and in Parkinsonism. It is a dopaminergic drug similar to ergot-like drugs. It has agonist activity at dopamine-D2 receptors and antagonist propeties at dopamine-D1 receptors. Bromocriptine also directly inhibits the release and synthesis of prolactin from the pituitary.
I can't remember what the mechanism of action in sexual dysfunction is, but I believe it involves dopamine-D1 blockade (my notes are at work and I never reccomend the drug).
Because bromocriptine stimulates dopamine-D2 receptors, it would probably be contraindicated in those with severe dopamine dysfunction (severe schizophrenia), unless closely watched by a doctor.
Side effects include (frequently) - nausea, vomiting, headache, upset tummy, and (sometimes) hypertension, hallucinations, depression, confusion, abnormal involuntary movements and nightmares. These side effects are more annoying (I believe) than sexual dysfunction. Actually, with my wife, I just use the Paxil-induced sexual dysfunction as a challenge.
Hope this helps - Cam W.
Posted by Cam W. on April 8, 2000, at 21:29:37
In reply to Re: clarification, please read everyone(esp. Cam), posted by CarolAnn on April 8, 2000, at 13:59:22
CarolAnn - I have not heard of Uprima. I did a MEDLINE search with no hits. Do you know it's drug name? I cannot tell you if this drug would help with libido.The reason it would work faster than Viagra is that it is absorbed directly into the bloodstream (it is very vascualr under the tongue - lots of blood vessels). This means that it doesn't have to go to the stomach, then drop into the small intestine, and then absorb into the bloodstream. It is the same principle as Ativan SL working faster than regular Ativan (esp. in panic disorder).
Viagra does increase the quality of orgasm (more bang for youe buck), but that does not necessarily equate to greater desire. Like I said before, many men do not need desire to be able to perform, especially when young (they're just gettin' it! - the bragging rights are more important).
The only other drug that we have in Canada for erectile dysfunction is MUSE (alprostadil) and it comes in the form of a penile suppository. You insert it directly into the flacid penis (with an unlubricated plunger device) about 15 minutes before it is needed. I cannot think of anything that would get in the mood more than that (sarcasm).
I very much agree with you that medication (or any other) research for women is woefully lacking. The main reason for this is that many of you are able to get pregnant. It is very hard to trust someone to use protection (shower with a raincoat) while undergoing drug trials. This is not just the woman's fault (probably less so), but also the man's. Things happen, moments occur, condoms break, and the pill may skew results. The drug companies are extremely worried about lawsuits if someone does happen to get pregnant while taking their drug in a clinical trial. Waivers can be signed, but a "good" lawyer can get around anything.
Sincerely - Cam W.
Posted by bob on April 8, 2000, at 23:43:19
In reply to to CarolAnn, posted by Cam W. on April 8, 2000, at 21:29:37
Hmmm ... hallucinations as a side effect? Cam, that can be beneficial for some people's sex lives (not that I'm pointing any fingers or fessing up to anything...).
Rather than looking for beef, how about some meat substitutes?
Isn't ginko biloba one of the "natural" products recommended as one means of addressing this issue other than Viagra? What else in the local health food store or vitamin shop(pe) that might help?
An aside to the issue of not enough research being done on women...and this ain't going to be a popular one at that. Another reason that women get excluded from studies is to remove one possible alternative explanation from a study--if the study is done on men only, any differences found cannot be attributable to the gender of the participant.
[I know ... some of you are thinking "Sure it can!" because such studies only have men in the first place. That there is no data on women for a particular study, or no variability in terms of gender, means no conclusions can even be considered with respect to that construct.]
yet another male research scientist of western european descent,
bob
Posted by Cam W. on April 9, 2000, at 0:04:43
In reply to Where's the beef?, posted by bob on April 8, 2000, at 23:43:19
> Isn't ginko biloba one of the "natural" products recommended as one means of addressing this issue other than Viagra? What else in the local health food store or vitamin shop(pe) that might help?bob - Gingko biloba is a vasodilator (as is Viagra), so may help in erectile dysfunction, but I doubt with libido.
Others:
1) Ginseng(the real Korean stuff, not that fake Yankee kind) - maybe work if you really believe.2) Bee Pollen - if you believe even harder.
3) Ma Huang - if your heart doesn't blow up first.
4) Spanish Fly or Rhinoceros horn - now we're talkin'.
5) Exercise (vigorous) - no kidding, worked for one person I knew.
6) Cocaine or MDMA - short term gain; long term pain.
I'm falling asleep. I really wish I did know what would work to increase libido. I would like to know of something that would work at least some of the time. I wonder how much a positive attitude would help.
Just musing - Cam W.
Posted by Phil on April 9, 2000, at 6:36:40
In reply to to CarolAnn, posted by Cam W. on April 8, 2000, at 21:29:37
Cam, Did I read that right? A penile suppository? What kind of miserable b-st-rd would think that one up?
"Just a moment dear, I'm packing the musket!!"Just wonderin..Phil
Posted by Julie on April 9, 2000, at 7:40:30
In reply to brand new beef (to the women), posted by CarolAnn on April 8, 2000, at 9:13:43
I have recently been prescribed a testosterone cream for this very problem. Seems to increase blood flow to the area, but whether or not it helps to get me to that wonderful place is still up for grabs!
Anyone else hear of this product?
Posted by Cam W. on April 9, 2000, at 10:07:58
In reply to Re: to Cam-P.S., posted by Phil on April 9, 2000, at 6:36:40
Phil - Wouldn't that just put (or keep) you in the mood? MUSE is used for erectile dysfunction, like Viagra. Actually, those that have used MUSE and Viagra much prefer the MUSE (go figure); fewer heart problems, I think. Also, if anyone plans to use it, do not keep it in the console of your car in winter. Freezing it makes it harder to insert (I would guess melting it would, too). One guy left his in the car in February and ended wasting 2 and having to try to insert it 5 times (without lubrication - affects absorption). He claims he "was pretty f***ing sore" (his words) and the session wasn't as pleasant as he had hoped (but he still uses MUSE and swears by it). Still, I don't find the method of application very aMUSEing.
- Cam W.
Posted by Phil on April 9, 2000, at 11:53:40
In reply to Re: to Phil -P.S., posted by Cam W. on April 9, 2000, at 10:07:58
If I needed it, I'd go w/ da pill and heart risks.
My philosophy pertaining to that 'unit' of my anatomy is output only.
Posted by NikkiT on April 9, 2000, at 14:28:35
In reply to brand new beef (to the women), posted by CarolAnn on April 8, 2000, at 9:13:43
I had a huge dicussion like this with a group of mates.. OK, they were mainly male!!
In the UK, drugs aren't advertised as in the US (I was *so* shocked to see the adverts for drugs on a visit over there!!), but Viagra has had alot of press covergae.
Anyway, we decided that so much more help is offered to men, as their arosul is... erm... alot more physically obvious, and this is needed for intercourse. where as with us women, they ssee it that we can just "lay back" and arousal isn't as important to actually undertake the act!!
And it seems men run the drug world!!!
> I have read, just this morning, that there is yet another Viagra "type" drug coming on the market, it's called Ultram.
> I don't know about you all, but it really ticks me off that men are getting all this help, and nobody(as far as I know) is even doing any research on this type of drug for women. I know that some sources say that Viagra can help women, but why aren't any companies researching products especially for women? It's very sexist if you ask me. There are a lot of women who have libido problems, without even taking into consideration the women who have problems due to their antidepressants.
> This is not a male bashing thing, I'm not saying that they don't deserve these medications, I'm just saying that women deserve equal time. And, by ignoring women, I think the drug companies are missing out on a very large market base. Wadda ya think, girls. Am I right or am I nutty (or both?)?? CarolAnn
Posted by Leighwit on April 10, 2000, at 12:40:48
In reply to brand new beef (to the women), posted by CarolAnn on April 8, 2000, at 9:13:43
My Pdoc has prescribed Viagra for me to specifically help with a decreased libido (the result of adding Celexa to my Wellbutrin regime.) She has several women on it to counteract AD-related libido problems. I haven't tried it yet, but I don't think the information on this thread is entirely accurate (that it doesn't help women at all.) I've seen Pdocs in several major cities over the past nine years, and I think this one is outstanding — so I suspect she knows what she's talking about in terms of women using Viagra to counteract the side effects of AD meds resulting in diminished libido.
Any women reading here who are actually using (or have used) Viagra?
Leighwit
Posted by ruth on April 10, 2000, at 15:17:15
In reply to Re: brand new beef (to the women), posted by Leighwit on April 10, 2000, at 12:40:48
Yeah, I used it and wasn't impressed. It didn't
make a noticeable difference and it clogged my
nasal passages for a couple of hours. I could
tell a LITTLE difference, but not enough to make
it worth the effort...we ended up remedying the
problem with sex toys :-)
Posted by liz on April 11, 2000, at 8:30:48
In reply to Re: clarification, please read everyone(esp. Cam), posted by CarolAnn on April 8, 2000, at 13:59:22
CarolAnn, hi! This morning, CNN had a story about the hearings on the approval of Uprima. They explained, as you mentioned, that the drug works similarly to Viagra, but quicker due to method of absorbtion. It sends a "message" to the hypothalmus which in turn releases dopamine which travels directly to the genital area to increase blood flow which aids erection in males. (They also reitterated it has no effect on libido, but that there were mood enhancers that would help with that; no mention of what those are!). Anyway, their description of the drug action sure made me think that increased blood flow to the genitals has got to help women too. After all, the female clitoris becomes erect when stimulated as the whole area is suffused with blood, somewhat similar to the male reaction. If this is accurate, then I cannot see why it would not aid in or enhance orgasm in females. Perhaps we can all volunteer to be in the test group?!
************************************************
Doh! (picture my hand slapping my forehead!)! Wrote the wrong name in original post.
>
> The drug is called "Uprima", made by TAP Pharmaceuticals. It is not swallowed, but placed "under the tongue, simulating the brain chemical dopamine, which starts the signal for an erection"(news quote). It's supposed to work faster then Viagra.
> I know these things don't actually work on libido, but it would sure increase my interest in having sex, if I had a pill that, at least, increased the odds of having an orgasm! And since I've read (on this board even) that Viagra does effect quality of orgasm, I have to stand by my initial rant that more research should be done on the female side of these things. This was the point of the initial post, any input ladies? or guys? CarolAnn
Posted by CarolAnn on April 11, 2000, at 18:05:27
In reply to Re: clarification, please read everyone(esp. Cam), posted by liz on April 11, 2000, at 8:30:48
Your reasoning sounds right to me, liz. Also, the dopamine factor intrigues me. If the drug signals the hypothalmous to release dopamine, I wonder if it could be researched as a possible antidepressant? At any rate, if dopamine affects the genitals the way it affects the brain, well, that's got to be a good thing! CarolAnn
Posted by liz on April 11, 2000, at 20:25:44
In reply to Re: sign me up! (to liz) any opinion Cam?, posted by CarolAnn on April 11, 2000, at 18:05:27
Based on your reasoning and what I heard this morning, I think I will buy stock in this company first thing tomorrow. Also, I'm glad your "life of crime" was relatively easy to resolve! I followed your thread there and hesitated to add anything based on my own experiences, but it turned out positively for you and I'm glad! Take care, Liz
Your reasoning sounds right to me, liz. Also, the dopamine factor intrigues me. If the drug signals the hypothalmous to release dopamine, I wonder if it could be researched as a possible antidepressant? At any rate, if dopamine affects the genitals the way it affects the brain, well, that's got to be a good thing! CarolAnn
Posted by Cam W. on April 11, 2000, at 23:19:39
In reply to Re: sign me up! (to liz)/CarolAnn, posted by liz on April 11, 2000, at 20:25:44
liz - Sorry, I don't know the drug; and sexual function involves so many different receptors. Scientists are still fighting over what causes SSRI-induced delayed orgasms. I can't seem to get a straight answer anywhere, the deeper I look into the subject.A hypothesis - An increase in circulating dopamine may decrease serotonin levels, as the two interact opposingly. Decreased serotonin would lead to decreased serotonin-2A receptor stimulation (if indeed that is what is causing SSRI-induced sexual problems), thus resolving the delayed orgasm. The downside is what is the decrease in serotonin doing to the depression? Maybe nothing, as when we deplete someone of serotonin, they do not get depression. Decreased levels of serotonin are just a symptom of depression and these symptoms can be resolved by increasing serotonin. I don't know.
Thinking out loud - Cam W.
Posted by AndrewB on April 12, 2000, at 9:45:11
In reply to Re: clarification, please read everyone(esp. Cam), posted by liz on April 11, 2000, at 8:30:48
Uprima is more commonly known as apomorphine. I guess that Uprima is the trade name that they will market apomorphine under as a medicine for sexual dysfunction. Apomorphine has been around quite awhile and is used as a drug to help with parkinsons disease. It is both a D2 and D1 receptor agonist. Like many other dopamine agonists (bromocriptine, pergolide, lisuride) and dopaminergenics (selegiline), it has been noted to have the ability to enhance sexual function in both men and women. Apomorphine has been used off label for quite some time as a sexual enhancer. Its relatively short half-life (1-2 hours) makes it well suited for this purpose. I believe Uprima will be in a sublingual form. Side effects include nausea, which is common with dopamine agonists. Domperidone, a peripheal dopamine receptor blocker, offsets the nausea but is available only in Europe.
From all that I have read, excepting this CNN story you refer to Liz, apomorphine is a libido enhancer. It works in both men and women. Its action is most probably through the stimulation of the central D2 receptors. Its ultimate action may be due to the release the hormone oxytocin or the lowering of the level of the hormone prolactin. I wonder if the CNN story isn't correct also and possibly these hormones have an effect on vasodialation in the genital area of both men and women.
AndrewB
Posted by liz on April 12, 2000, at 9:50:06
In reply to Re:to liz - serotonin and dopamine - musings, posted by Cam W. on April 11, 2000, at 23:19:39
Cam, when you muse like this my eyes start to cross. I certainly don't have your science background and couldn't get it if I tried. I sort of preferred the little drawing on the TV screen, where they drew on a schematic a red line that went straight from the hypothalamus to the crotch. Now that I could understand! Sometimes ya gotta just take this stuff as an act of faith, lay back and enjoy the results! (I hope you can tell that my inflection is entirely teasing :-O ) Liz
liz - Sorry, I don't know the drug; and sexual function involves so many different receptors. Scientists are still fighting over what causes SSRI-induced delayed orgasms. I can't seem to get a straight answer anywhere, the deeper I look into the subject.
>
> A hypothesis - An increase in circulating dopamine may decrease serotonin levels, as the two interact opposingly. Decreased serotonin would lead to decreased serotonin-2A receptor stimulation (if indeed that is what is causing SSRI-induced sexual problems), thus resolving the delayed orgasm. The downside is what is the decrease in serotonin doing to the depression? Maybe nothing, as when we deplete someone of serotonin, they do not get depression. Decreased levels of serotonin are just a symptom of depression and these symptoms can be resolved by increasing serotonin. I don't know.
>
> Thinking out loud - Cam W.
Posted by liz on April 12, 2000, at 10:28:11
In reply to Re: Uprima, apomorphine, posted by AndrewB on April 12, 2000, at 9:45:11
Andrew, thanks for the interesting input! My Dad has Parkinson's disease; I don't believe he has ever been on Apomorphine, but perhaps he should be!
Anyway, you are correct that Uprima is to be taken sublingually. CNN also touched briefly on the approval hearings; apparently the (rare) side effects of the drug during trials were fainting or passing out, even some sudden heart failures, although the controversy has been if those effects could be unequivicably attributed to the drug. Understandably, those results and the surrounding controversy have slowed down the approval process.
BTW, what does "off label" mean?
************************************************
Uprima is more commonly known as apomorphine. I guess that Uprima is the trade name that they will market apomorphine under as a medicine for sexual dysfunction. Apomorphine has been around quite awhile and is used as a drug to help with parkinsons disease. It is both a D2 and D1 receptor agonist. Like many other dopamine agonists (bromocriptine, pergolide, lisuride) and dopaminergenics (selegiline), it has been noted to have the ability to enhance sexual function in both men and women. Apomorphine has been used off label for quite some time as a sexual enhancer. Its relatively short half-life (1-2 hours) makes it well suited for this purpose. I believe Uprima will be in a sublingual form. Side effects include nausea, which is common with dopamine agonists. Domperidone, a peripheal dopamine receptor blocker, offsets the nausea but is available only in Europe.
>
> From all that I have read, excepting this CNN story you refer to Liz, apomorphine is a libido enhancer. It works in both men and women. Its action is most probably through the stimulation of the central D2 receptors. Its ultimate action may be due to the release the hormone oxytocin or the lowering of the level of the hormone prolactin. I wonder if the CNN story isn't correct also and possibly these hormones have an effect on vasodialation in the genital area of both men and women.
>
> AndrewB
Posted by Fred Potter on April 12, 2000, at 20:48:29
In reply to Re: Uprima, apomorphine, posted by AndrewB on April 12, 2000, at 9:45:11
How can you have sex when you feel sick?
Posted by liz on April 12, 2000, at 21:12:47
In reply to Re: Uprima, posted by Fred Potter on April 12, 2000, at 20:48:29
Fred, hello. Well, some of us don't have much choice, our spouses or partners feel fine! Also, for some of us, the "timeout" from illness through sex can be pretty healing. I feel like I need to apologize, but I've pretty much enjoyed sex with my husband, even when I haven't been in the mood or am not well. There is something, ideally, about closeness that is very healing and comforting, INHO. I don't think anyone should feel compelled to have a sexual relationship; it is certainly not the cure for everything that ails us, but it has its merits. Ummm, maybe its different for women; we have the luxury of being somewhat passive and I know men do not, as a rule.
How can you have sex when you feel sick?
Posted by Scott L. Schofield on April 13, 2000, at 7:51:08
In reply to Re: Uprima/Fred, posted by liz on April 12, 2000, at 21:12:47
>> How can you have sex when you feel sick?
> I feel like I need to apologize, but I've pretty much enjoyed sex with my husband, even when I haven't been in the mood or am not well. There is something, ideally, about closeness that is very healing and comforting, INHO.
I agree with this. This has been my experience as well.
I really don't mean this to be one of my stupid play on words, but for me, sex is in the head.
Bipolar depression has left my libido as being close to nil. However, my desire remains high. I know this at first seems to be contradictory, but I do not equate the word "desire" with "libido". I just like to have sex. I like to eat too, even when I'm not hungry.
My last heavy-duty sexual relationship was with a girl who suffered from depression as well. Actually, she suffered from double-depression. She knew exactly what it felt like to not have a libido. With the exception of a two-month period of severe depression, she remained in a state of dysthymia while we were together. During the previous eight years of sickness, she had been married. Unfortunately for her husband, with infrequent exceptions, she declined to have sex with him. She had no libido, and would not reach orgasm with him when they did become involved. She was not in love with him, even though he loved her very deeply. Sex for her during this time was, at best, mechanical. However, even without libido, she would regularly masturbate and reach orgasm.
When we first became involved, I was feeling a bit better due to experiencing a partial response to a drug I had recently begun taking. She was dysthymic at the time. We had sex once or twice a day. I had little, if any libido. I guess this sort of thing is not unexpected at the start of a relationship. The thing is, we were good for at least five times a week for over two years. I had lost the improvement fostered by the medication after the first three months, however. Having been severely depressed herself, she did not understand how I could be interested in having sex at all, let alone "perform". Except for the time we were physically involved, I pretty much just sat motionless on the couch with the television on and staring at the floor. I would still look forward to dinner, though. I think one of the keys for me was to not perform at all. It is too easy to get stage-fright. She had no expectations of me, and I had none of myself.
We did have one ace-in-the-hole, however (perhaps a little self-amusement here this time). We were in love. There was no need for anything other than closeness. But we did enjoyed playing in our "sand-box". More often than not, the emotions were more intense than the orgasms. Very often, it was the other way around. However, there was always a caring of the other person and a nurturing of a mutually satisfying experience. There was no such thing as "failure", even if neither of us reached orgasm. Any enjoyment was absolute success. To experience such closeness was absolute success.
All of this being said, I find that it is not necessary for me to be in love to want and enjoy sex, even while being sick. But I will say this. Sex for me is still much more psychological than it is libidinal. For this I feel blessed.
- Scott
Posted by Scott L. Schofield on April 13, 2000, at 10:08:18
In reply to Re: Uprima/Fred, posted by Scott L. Schofield on April 13, 2000, at 7:51:08
Although of Uprima (apomorphine) can be made to induce copulatory behavior when injected into specific areas of the brain in rats, I have not encountered anything to suggest that oral or parenteral administration results in increased libido in humans. It may prove itself to do so, but I don't find enough medical literature on Medline to indicate this with any confidence. The CNN report seems accurate.
Apomorphine has long been recognized as being capable of producing erections. There seem to be two mechanisms involved.
1. Stimulation of the medial preoptic area and/or paraventricular nucleus of the hypothalamus.
- I believe these are the same mechanisms involved in the induction of the nocturnal erections that occur during rapid eye movement sleep (REM).
* The preoptic area may also be involved with libido.2. Increasing the pressure of the "balloon" (corpus cavernosum) located within the penis, causing it to grow in size and stiffness.
Among the more important observations regarding this issue is the lack of the ability of apomorphine to reverse the decrease of libido in mice caused by the loss of testosterone brought about through castration.
------------------------------------------
For Andrew:Apomorphine is one of those drugs that produce opposite effects at low dosages versus high dosages. Apomorphine represents the antithesis of sulpiride and amisulpride. Low dosages produce sedation, while high dosages produce activation and stereotypic behavior. Presynaptic versus postsynaptic regulation.
- Scott
Posted by AndrewB on April 13, 2000, at 10:57:45
In reply to Re: Uprima - libido vs erection, posted by Scott L. Schofield on April 13, 2000, at 10:08:18
Thanks Scott,
Sounds like apomorphine makes one more functional but we're still looking for the love potion that makes the one beside us the object of our desire.
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Dr. Bob is Robert Hsiung, MD,
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