shaun1's picture
shaun1
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+ 2 seroquel and prolactin issues

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Gentleman how's it going. For the past 6 or so months now my Dr has had me on Seroquel for my Bipolar and insomnia. Right at about a month and a half I started having some light issues with being able to get a solid erection and at times it would just go completely dead right in the middle of action. I've noticed that I've wanted to be intimate with my wife but the excitement of it hasn't been there. Now the 6 or so months have gone by and the problem has gotten worse and way out of hand to the point where my wife is getting upset and I'm about to lose my mind. I finally Googled Seroquel and impotence. It seems that many Antipsychotic medications carry a major risk for Sexual Dysfunction side effects, 45-80% of male patients complain of this issue.

From what I can gather the mechanisms by which antipsychotic drugs may cause sexual dysfunction are as follows: histamine receptor antagonism, dopamine receptor antagonism, dopamine D2 receptor antagonism, cholinergic receptor antagonism, and alpha-adrenergic alpha receptor antagonism.4,5

Concretely, being bound to histaminergic receptors may impair arousal by directly increasing sedation. Dopaminergic receptor antagonism may decrease the libido by inhibiting motivation and reward. Blockade of dopamine D2 receptors in the tuberoinfundibular pathway by antipsychotics may decrease the libido, impair arousal, and impair orgasm indirectly, by leading to elevated prolactin levels. Cholinergic receptor antagonism may induce erectile dysfunction by reducing peripheral vasodilation. Alpha-adrenergic alpha receptor antagonism can reduce peripheral vasodilation, resulting in erectile dysfunction in men and decreased lubrication in women. Additionally, abnormal ejaculation is correlated with the anti-adrenergic effects of treatment.
it is also very well known that hyperprolactinemia is a major cause of sexual dysfunction in men and women taking antipsychotics by the aforementioned mechanisms.6,7 Depending on the blockade of dopamine D2 receptors, haloperidol, risperidone, and amisulpride are classed as prolactin-elevating antipsychotics.

So of course now after reading this I'm freaking out, the seroquel is working wonders for my Bipolar and insomnia, but it is killing my sex life or lack thereof. The only way I'm going to know for certain if my problem is a prolactin issues is to have my Dr send me to a Endo and have some Blood work ran to check all my levels and honestly it's the safest way as well. So my question is have any of you guys been through this same issue and what was your out come. I have a bottle of Caber but I don't want to take and to say" Just to see if it would help" and fuck myself up anymore.

Bulkdaddy's picture

By the way Seroquill is one of the worst psych meds in my opinion.

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Bulkdaddy's picture

Before any good psych doctor should diagnose a mental illness. They should run a full hormone panel to rule that out.

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shaun1's picture

Paxil was rough. I was on it for a little while. I couldn't get off if my life depended on it. And it never seemed to help my depression neither do it was a lose, lose.

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Dacky's picture

Mate with respect the OP has bipolar and frankly adding antidepressant to his mix of meds could very well send him manic/hypomanic. This is a significant risk with anyone who’s bipolar especially those that have had previous episodes of antidepressant induced mania/hypomania. And while Wellbutrin is a very effective antidepressant in its own right it’s mechanism of action as a dopamine and norepinephrine reuptake inhibitor tends to be one of the most dangerous options in terms of antidepressant to add to a someone who has bipolar. As an interesting aside did you know that Wellbutrin is in effect a synthetic Cathinone and it’s no wonder it works so effectively. The following link will explain what cathinones are, their synthesis, use in medicine and as illicit drugs. You can draw your own conclusions from there and will hopefully have better information to decide on whether this med is right for you - sort and/or long term

https://link.springer.com/chapter/10.1007%2F164_2018_178

Dacky's picture

All very true brother and good points +2. You did add all those caveats. I was just concerned that you focused on how excellent it was for managing sexual side effects brought on my some psychotropic meds (which it is) but there was no specific mention of the increased risks and considerations in the context of bipolar as opposed to the more general ones you mentioned. I unfortunately have seen first hand and been affected by a loved one going hypomanic as a result of bupropion so I’ll admit this particular topic and use of bupropion in the context of bipolar is personal for me. The research shows bupropion, meds acting primarily on dopamine other meds with a dual selective reuptake inhibition mechanism are of greater risk for inducing mania/hypomania. I like you are not trying to argue and my thanks for setting it straight in your reply to me. Cheers fella!

shaun1's picture

My Dr took me off the seroquel and put me on Abilify and my ED issues have gone away, along with my TRT I'm like a 17yr old all over again. I'm waiting for my referral to the Endo to go through as I speak so I can see about having a DR put me on TRT so that I can get completely back to Norm. My PCP said I should have an appointment by the end of the month.

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Dacky's picture

That’s excellent news to here mate. I never heard back from you in PM about the blood work but I guess it showed your prolactin as super high and hence the discontinuation of the seroquel. Glad to hear you’re doing well on the abilify. It’s a completely underrated drug for bipolar especially with certain comorbidities.

Keep us posted and if you’d like to drop me a PM sometime and full me in on the details I’d appreciate it.

giardap's picture

it is one of the most horrible AP's
Risperidone is worse again for prl and testo issues

i would go with the caber, but periodically
you should get bloods to prove it works though
watch out for lh and fsh dropping too as hypogonadism follows then

seroquel is a cunt

shaun1's picture

Our brother Dacky has been helping me in DM, I'm going in for a complete blood work to get to the bottom of this, im afraid to just blindly self medicate with the caber, don't want to get anymore fucked up than I am, I can't take much more of this problem, got to get the bloods to get to the bottom of this. POYB

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giardap's picture

Trust in Dacky bro
Not only is he the nicest guy on here but he knows all about your issues.
Respect on the caber attitude, don't forget to measure lh fsh too

addicted.to.pain's picture

my Dr has had me on Seroquel for my Bipolar and insomnia.

That crap is over prescribed, the young people I see coming through the hospital with that on there current medication list is shocking .

Seroquel is number one a Tranquilizer , and second an anti psychotic . There are plenty of medications your doctor could give you to help you sleep and even out your mood besides that crap.

shaun1's picture

I'm on a very low dose, 150mgs a day, but I take it at night, but I only take 75mgs 150 is way to strong, I'm also on latuda 60mgs at night as well. I've been on just about every med under the sun and not much has really helped like the seroquel has,

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shaun1's picture

Much appreciated brother, I'll definitely look into them, I'm glade you got off that shit. POYB, all I take now is my legit meds, come September I'll be clean from pain pills for 10yrs, I self medicated for along time until one day I woke up and said enough is enough, I have metal issues and it's time to handle them the right way.

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kodiakGRRL's picture

I agree with you Jay .... there was a very good book out about ten years or so that discussed the issues with psychiatric meds. being in the research field I am aware of how a lot of studies get suppressed in order for the meds to be approved. Big pharma spends billions on research and advertising. Most people don't know that if they don't meet standards for major depressive disorder that taking an anti depressant prolongs their depression AND Increases the recurrence of depression.... no shit and docs hand out anti depressants like candy

Porkbythapound's picture

Yea they do! YEARS ago when I was going to the zoo for pain management I had been having issues sleeping and first thing the doc gives me is Celexa. Took one and it made me feel crazyish. Never took it again. Very few docs I’ve seen were ever helpful.

shaun1's picture

Paranoid Personality Disorder, PTSD, along with my Bipolar, is what I've told is my problem but who really knows.

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kodiakGRRL's picture

its been a few year since Ive picked up a DSM or ICD ... I gather they've added a few new names to the pot so we can further label a person and make some money off of them.

Dacky's picture

I hear you and while I do not discount for one second that way too many people are put on psychotropic medications they don’t actually need and significant harm is done it is also true that these meds do save lives and can significantly improve quality of lives of those living with genuine severe mental health illnesses.

The biggest issue here in the UK is that anyone going to their GP with anxiety and/or low mood are popped straight on antidepressants which in most cases work temporarily then symptoms reappear and doses are increase and on and on it goes. New meds are tried and dosages increased etc. CBD and counselling should be tried first but the reality is they are more expensive and so pills are the go to. The psychiatrists here are actually very thorough and conservative in their approach but the problem is by the time the patient get there the damage from the antidepressants have been done and they’re doing damage control in these cases. But for those that have a genuine problem meds are often the thing the will quite literally save the persons life.

Have a read of this for an alternative perspective of how mental health / depression should be approached. It’s long but facinating - https://www.vox.com/the-big-idea/2018/2/25/16997572/causes-depression-pi...

kodiakGRRL's picture

people have been taught to believe that they are supposed to be happy all the time .. that's not reality we get sad we get depressed we get better .. we work through things without pills. We've been taught there is a pill for everything ... there isn't. Yes some people are truly in need of psychotropics but quite a few don't need them.

Kgp's picture

100%

Life isn't always great. A pill should not be a fix for every bit of non-happy emotion. Can't enjoy the sunshine without a little rain. Very true words.

kodiakGRRL's picture

of course not ... completely unnecessary ...

addicted.to.pain's picture

it messed my life up and changed who i was. And it made me a diabetic.

That infuriates me bro , fucking psychiatrist are the scum of all doctors they are nothing but drug pushers all of them. A psychiatrist put me on Adderall and Prozac in middle school, those two medications messed me up for years, they completely changed my personality and not for the better. It was a 100% misdiagnoses, I was just a kid trying to adjust to growing up and that Psychiatrist put me in mental chains. It took me years to get back to my old self after that cock sucker finally took me off those poisons.

Bulkdaddy's picture

Seroquel Is horrible. Made me fat as shit.

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johnmarshall12's picture

The right doc may have a fix. A different antipsychotic drug may help you without the sexual side effects!

IrishMack's picture

That's your tradeoff. Tell your doc how you feel and he may change your script. Almost all antipsych or depression meds cause lack of libido and no erections. You have to let the doc know so he can give you something else. Dont try and self med it will male it worse.

shaun1's picture

Yea these trade offs suck, it's just bad because I have the desire to be intimate I just don't have the ability, there's no pleasure, I want self medicate, I know the dangers of that, I learned that the hard way when I was much younger, much older and wiser now.

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kodiakGRRL's picture

Your Doc is going to be the answer as well as having a conversation with someone who has directly experienced the issues.. the main problem is that whomever you speak to isn't YOU and their biochemistry isn't going to be exactly the same. so.. back to the doctor ... get as much anecdotal evidence you can so you can as much info but those lab tests are crucial. and Rusty is right polypharmacy is a big hamster wheel waiting to happen avoid it if you can and don't self medicate you may create more issues than you solve.

shaun1's picture

It seems like the past year I've lived at the Dr office, but I truly know that's where my answers lay and await me, and their are way to many things that I can screw up and can go wrong if I was to self medicate.

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kodiakGRRL's picture

go ask questions and do some research .. don't blindly take what he hands you, especially if he wants to change the seroquel ... it is working and working well from what you are saying so let the doc know changing it isn't an option. chances are you walk out with viagra or cialis .

shaun1's picture

I've tried Viagra and cialis both and neither of them work for me, v gives me a warm flush feeling in my face and my eyes get warm feeling and blurry with like blue tracers, and I feel absolutely nothing with C. If I don't have my seroquel I don't sleep none and it has helped with my moods and biP a good bit.

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Kgp's picture

I agree that getting hard is not going to fix the problem. If your not interested in sex, then going through the motions isn't going to help much. Well, maybe for her it will.

addicted.to.pain's picture

If I don't have my seroquel

Amazing how quickly it turns into my seroquel, and not " the seroquel."

GreatSpear's picture

You could always try PT-141 for ED. It works on the CNS and not on PDE-5 receptors, improving sexual function even in those that PDE-5 inhibitors do not help.

kodiakGRRL's picture

prescriptions from the doc or ugl ?

shaun1's picture

Both.......

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Dacky's picture

I have a lot of experience here. Let’s take it offline. Ill shoot you a PM.

Bearded_muscle's picture

also If that’s their drug classification as “prolactin-elevating” that may be a crucial mechanism for how they work and their effectiveness. See the doc and see what they usually do. I’m betting it’s a viagra (or similar) script but I’d be interested to hear what they say.

Dacky's picture

We’re chatting in PM. First stop is getting the doctor to order the blood work assuming he’s willing. If not I’ve suggested he does them himself. Once blood levels are known the doctors can come up with some options. It could be antipsychotic induced hyperprolacinaemia and then again it may be something else entirely. Got to see the full hormone and biochemistry picture first.