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Animus

Ropinirole dosage to induce hypersexuality?

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Hello. I do not have Parkinson's, but after using an SSRI antidepresant for a short while I now suffer a seemingly permanent and complete loss of my sexuality (Post-SSRI Sexual Dysfunction). I was prescribed the dopamine agonist ropinirole for this, and am now increasing the dose to 1 mg 3x a day, as directed by my psychiatrist. So far, all I'm noticing is diarrhea (which I bought loperamide for). My question is, what dosage should I take to induce hypersexuality (or, in my case, restore normal sexuality, at least partially)? 6, 8, 16 or 20 mg a day of ropinirole? Maybe another dopamine agonist is more linked to hypersexuality, like pramipexole or apomorphine (I'm not willing to take ergot DAs)?

Sorry if this is the wrong place to ask, but I just thought you guys would know best. Would really appreciate an answer.

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Talk to your doctor!

 

Ropinirole may induce a hyper sex drive.  I think medically it occurs in something like 16% of the PD patients taking it.  Keep in mind with Parkinson's we may have a reduced sex drive due to other reasons, hence ropinirole just restores that (which makes it seem like hyper sexuality to us!).

 

I did take Paxil for a few years to treat depression. It took maybe two years after I stopped taking Paxil for the sex drive to return. So not uncommon at all. Anything that goes into the brain.... slow ramp up and slow ramp down is a good thing.  Psychiatrist like medications to help solve things, but my best support came from a Psychologist.  Best medicine I had was a crazy dog that would harass me every night until we went walking. 

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Hello. I do not have Parkinson's, but after using an SSRI antidepresant for a short while I now suffer a seemingly permanent and complete loss of my sexuality (Post-SSRI Sexual Dysfunction). I was prescribed the dopamine agonist ropinirole for this, and am now increasing the dose to 1 mg 3x a day, as directed by my psychiatrist. So far, all I'm noticing is diarrhea (which I bought loperamide for). My question is, what dosage should I take to induce hypersexuality (or, in my case, restore normal sexuality, at least partially)? 6, 8, 16 or 20 mg a day of ropinirole? Maybe another dopamine agonist is more linked to hypersexuality, like pramipexole or apomorphine (I'm not willing to take ergot DAs)?

Sorry if this is the wrong place to ask, but I just thought you guys would know best. Would really appreciate an answer.

Animus, as you told us, ropinirole was prescribed from your psychiatrist, for treatment of your sexual dysfunction.

 

Didn't he inform you about the dose required for this purpose ?

 

I hope you are not self-medicating. I also hope  you understand you shouldn't rely on the advice of strangers on the web.

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Talk to your doctor!

 

Ropinirole may induce a hyper sex drive.  I think medically it occurs in something like 16% of the PD patients taking it.  Keep in mind with Parkinson's we may have a reduced sex drive due to other reasons, hence ropinirole just restores that (which makes it seem like hyper sexuality to us!).

 

I did take Paxil for a few years to treat depression. It took maybe two years after I stopped taking Paxil for the sex drive to return. So not uncommon at all. Anything that goes into the brain.... slow ramp up and slow ramp down is a good thing.  Psychiatrist like medications to help solve things, but my best support came from a Psychologist.  Best medicine I had was a crazy dog that would harass me every night until we went walking. 

Just 16%, you say? That's disappointing. Glad your drive returned, gives me hope.

 

Animus, as you told us, ropinirole was prescribed from your psychiatrist, for treatment of your sexual dysfunction.

 

Didn't he inform you about the dose required for this purpose ?

 

I hope you are not self-medicating. I also hope  you understand you shouldn't rely on the advice of strangers on the web.

Well, yes, but the thing is, it's her first time prescribing DAs, she hardly knows anything them and only prescribed them 'cause I asked. So I could suggest the right dosage to her. On askapatient.com, people report increased sex drive on anythere from 1 mg to 32 mg a day.

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Just 16%, you say? That's disappointing. Glad your drive returned, gives me hope.

 

Well, yes, but the thing is, it's her first time prescribing DAs, she hardly knows anything them and only prescribed them 'cause I asked. So I could suggest the right dosage to her.

Animus, you can't be serious!

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Animus, you can't be serious!

Which part surprised you, her not knowing anything about them or me suggesting the dose? It is what it is, I'm glad I got them at all. Since they're prescribed for a relatively benign condition such as RLS, don't think DAs should be too harmful. I have rare episodes of mild RLS too, btw. I could go to a neurologist, but it's doubtful one would prescribe me DAs for sexual anhedonia.

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"I could go to a neurologist, but it's doubtful one would prescribe me DAs for sexual anhedonia."

 

If a neurologist with experience prescribing DAs won't give them to you, and your psychiatrist with no experience prescribing them will, that might be something to think about.

 

I've been using a DA for several months with no compulsive side effects. I'd drop it immediately if any showed up (including hypersexuality). These are serious drugs, with powerful effects on fundamental areas of the brain.

 

I get that sexual dysfunction from SSRIs is distressing, and I get that untreated depression is even worse. But it seems like trying to adjust dose or switch to another antidepressant (esp. since you've only been using it a short while) would be a better place to start than adding more meds.

 

Edit to add: Apparently there was a clinical study to see if Requip (ropinirole) helped SSRI-induced sexual dysfunction: https://www.clinicaltrials.gov/ct2/show/study/NCT00334048

 

Study was concluded 2007--8 years later, and still no results posted. Doesn't seem too promising--I would have expected banner headlines if GlaxoSmithKline found a new use for their drug.

Edited by ShopGuy

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I get that sexual dysfunction from SSRIs is distressing, and I get that untreated depression is even worse. But it seems like trying to adjust dose or switch to another antidepressant (esp. since you've only been using it a short while) would be a better place to start than adding more meds.

Maybe I wasn't too clear - I only used the antidepressant for a few weeks and discontinued it, but the sexual dysfunction persists for a year now, medication-free. It's possible that it will persist for the rest of my life. Some people have been suffering from this for 23+ years now.

 

Edit to add: Apparently there was a clinical study to see if Requip (ropinirole) helped SSRI-induced sexual dysfunction: https://www.clinicaltrials.gov/ct2/show/study/NCT00334048

 

Study was concluded 2007--8 years later, and still no results posted. Doesn't seem to promising--I would have expected banner headlines if GlaxoSmithKline found such a promising new use for their drug.

Yeah, I'm familiar with that link, but some people on Post-SSRI Sexual Dysfunction forums report that DAs help them.

If DAs don't work, I'm seriously considering learning dutch, moving to The Netherlands (I'm from the EU), and smoking pot daily. Because I read that marijuana is very effective against sexual anhedonia. I'm that desperate.

Edited by Animus

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Okay--never heard of PSSD until now.

 

It's been a very long time since I smoked pot, but I do recall it sometimes having the effect you're after, at least with the right set and setting.

 

Based on some of the daily pot smokers I've known, I suspect chronic use will have the opposite effect, but as long as you have a comfortable couch, and enough junk food and bad TV, you might not care.

 

Seriously though, with regard to DAs: I doubt you get to pick which compulsive side effect you get, or whether you get to have just one rather than the whole suite (compulsive shopping, eating, gambling, etc). There are people on these forums who have suffered quite badly from DA side effects--including hypersexuality. I have a close friend (also with PD) whose experience with DAs has been very troubling--unfortunately, she can't drop the DA, as her hypersensitivity to l-dopa results in unacceptable dyskinesias if the l-dopa dose increased.

 

As Tom above points out, PD can also cause lack of libido (along with everything else), and that's obviously distressing to those affected, and a source of worry for those who aren't (yet). But I don't recall anyone posting the DA-induced hypersexuality was good thing. 

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Which part surprised you, her not knowing anything about them or me suggesting the dose? It is what it is, I'm glad I got them at all. Since they're prescribed for a relatively benign condition such as RLS, don't think DAs should be too harmful. I have rare episodes of mild RLS too, btw. I could go to a neurologist, but it's doubtful one would prescribe me DAs for sexual anhedonia.

What you described us is almost an impossible situation. It's highly unlikely for a doctor to prescribe a drug with which he has no experience.

 

Anyway, if that's what really happened I agree with MM that you should find a doctor who knows what he is doing.

BTW, how do you know you have RLS? Were you diagnosed by a neurologist?

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Also, I wanted to add that dopamine agonists are among the drugs used for treatment of sexual dysfunction induced by SSRIs. Their efficacy in this settings remains to be proven in future placebo-controlled clinical trials, but, they can be prescribed  for this purpose.

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Call me crazy, but why don't you have your doctor refer you to someone who DOES know how to treat the problem?

I would do just that, but I live in a small european country, probably only a handful of doctors know about Post-SSRI Sexual Dysfunction (PSSD) in the country, let alone know how to treat it. It's a very obscure condition. Prominent doctors who know about PSSD are Dr. Irwin Goldstein and Dr. David Healy, but I don't think they have some special knowledge about it's treatment (word would have soon gotten out if they would). Dopamine agonists, amphetamines, buspirone, flibanserin, bupropion, testosterone and some illegal aphrodisiac drugs (Xyrem, pot) treat PSSD.

 

What you described us is almost an impossible situation. It's highly unlikely for a doctor to prescribe a drug with which he has no experience.

It's true and I'm thankful she did. I would get the drugs from the internet if I wasn't afraid of the law.

BTW, how do you know you have RLS? Were you diagnosed by a neurologist?

Well, occasionally, in the evening, when going to sleep, I feel this strange, hard to describe uncomfortable sensation, urge to move my leg(s) that's temporary alleviated by moving it. My RLS was more severe when I was a teenager. What I would do to relieve this is stretch my shank muscle long and hard until it hurt. That would work for a couple of minutes, hopefully, enough time for me to fall asleep.

Edited by Animus

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I just caught this because I am searching for other experiences to understand my experience more.  I have been taking ropinirole in place of Neupro since late Oct, and both can cause hypersexuality. After switching, I realize the Neupro was stronger on that side effect.  I thought ropinirole solved side effect issues, but I have increased the dose slightly for a month, and now it seems I am fading in and out of the strong desires. 

 

I never had a real libido problem, but PD did probably slow me down a little.  However, I find myself seriously considering things I wouldn't normally focus on.  Not harmful things, but I must be careful not to harm my marriage.

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Well, I got a little more obsessive and compulsive.  I had to switch back to Neupro and I feel a lot better.   My head was getting filled with more and more obsessive thoughts/desires.   I guess the Ropinirole built up in my system or something, but was getting into unhealthy behavior.

 

Thankfully, my wife stepped in.  I didn't go too far, but some there is some damage to be dealt with.  May have to stick to Neupro for my sanity even though the VA doesn't want to provide it.  I still work, but this stuff is $$$!

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MurrayPD2,

I'm glad you were able to get a handle on things and are being proactive to help yourself.  Kudos to your wife also.  Thanks for sharing so others may be more aware and on the look out for similar experiences in their own journey.  Take care.

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MurrayPD2,

I'm glad you were able to get a handle on things and are being proactive to help yourself.  Kudos to your wife also.  Thanks for sharing so others may be more aware and on the look out for similar experiences in their own journey.  Take care.

Thanks.  It could have gone too far in just a few days.  I started to realize I was exhibiting classic addictive behavior when I was becoming more of a "slave"  to the compulsions and desires.  I kind of wanted to get caught at that point.  It is somewhat like having an alternate person taking over with the original person inside, but nearly powerless.

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Inquiring minds want to know MORE :-P

 

Truthfully, I am a bit hypersexual in thought lately, in that I'm always looking at women in a sexual way. I didn't USED to be like this, so it might be the sinemet OR the Azilect. I seem to want to flirt with every woman I see that is even the least bit attractive. God help me if if I was on Neupro.....

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Well MM I'm using Azilect as Monotherapy and my husband is still complaining it's never enough so it has to be the Sinemet...Lol

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Inquiring minds want to know MORE :-P

 

Truthfully, I am a bit hypersexual in thought lately, in that I'm always looking at women in a sexual way. I didn't USED to be like this, so it might be the sinemet OR the Azilect. I seem to want to flirt with every woman I see that is even the least bit attractive. God help me if if I was on Neupro.....

I did notice flirting, or at least thinking of flirting often on both of the drugs I mentioned.  That was going on for a while and I am usually not that flirtatious because I would tend to be more shy.  It seemed fine and harmless, then it grew to media online that I normally don't look at.  Then it grew to looking at dating sites and flirting there.   Then it was obsession with looking at all the profiles, then getting it stuck in my head to meet someone and have an affair.  Like I needed to take some big risks.

 

The appetite was growing stronger and stronger while subduing my morals or rational thought.  At least on Neupro I can have a "healthy" drive and have more self-control. IDK, I will see what the MDS says about meds and this whole issue. 

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Well MM I'm using Azilect as Monotherapy and my husband is still complaining it's never enough so it has to be the Sinemet...Lol

LOL.  There are several factors I am sure. :0 

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Hello. I know this discussion is quite old but just wanted to seek advice. In my situation I have experienced hypersexuality and urge to gamble / speculate with impulsive business ideas since I started dopamine meds about 10 yrs ago...firstly Parlodel, for depression and after that Ropinirole, for RLS. The meds have helped with the underlying problems but these side affects are so troublesome (I have gambled about £25,000 over this period and addicted to soft porn). Relationship with wife not good owing to my over sexuality behaviour (look at other women ) and money situation not good.....any ideas welcomed! Is there a drug to counter-act these effects? Are there dopa drugs that don't have these effects? thanks

 

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Get off the Ropinirole quickly!  I was badly affected and almost ruined a lot of things. Don't try other agonists either.

 

Have you tried MAO inhibitors? An increase in L-dopa and using Entacapone to reduce wear off has helped.  I am also going to get a DBS next month.

 

I haven't gone deep into MAO inhibitors, but I am taking Amantadine; which also helps.

 

- Michael

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Thanks for the info Michael,

 

Yes, like you, the two agonists I have taken have caused me a lot of problems.  I will see if I can try what you suggest.

 

All the best, Osborn

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May I suggest you seek advice from your neurologist as to gradual weaning off Ropinirole.  Do not stop Ropinirole cold turkey ! Although you want to act quickly, you still need to follow certain dosage reduction.

 

Good luck !

 

Mireille

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