In one case report, nefazodone 150mg taken 1 hour prior to sexual activity completely reversed sertraline-induced anorgasmia. Nefazodone and mianserin are antidepressants with strong postsynaptic blocking properties. The mechanism of action of buspirone in treating sexual dysfunction may be reduction of serotonergic tone via stimulation of presynaptic autoreceptors or the alpha-2 antagonist effects of one of buspirone's major metabolites, 1-pyrimidinylpiperazine. The dosage is the same as that used for anxiety (15mg to 60mg daily). Most patients using buspirone to treat sexual dysfunction take it daily.
#PAXIL SEXUAL SIDE EFFECT SERIES#
One case series reported that buspirone reversed both decreased sexual interest and orgasmic dysfunction caused by SSRIs. Cyproheptadine is effective when taken either on an as-needed basis (typically, 1 to 2 hours before intercourse) or on a regular basis.īuspirone is a serotonin-IA partial agonist typically prescribed to treat persistent anxiety. Anorgasmia is the sexual side effect most often reported to be alleviated by cyproheptadine. In the most recent and largest case series, 12 of 25 patients described improvement in sexual function when treated with cyproheptadine (mean dose, 8.6mg). Only case reports and case series attest to its efficacy. Among the reported antidotes, the only 2 without antiserotonergic effects or catecholaminergic activity are gingko biloba and urecholine.Ĭyproheptadine is an antihistamine with antiserotonergic properties that has been reported for over a decade to reverse antidepressant-induced sexual dysfunction. Medications enhancing dopaminergic tone include amantadine, bupropion, and stimulants, with yohimbine showing noradrenergic effects. The antiserotonergic antidotes are cyproheptadine, buspirone, nefazodone, and mianserin. Most of these antidotes either have serotonin-blocking properties (especially 5HT-2 antagonistic effects) or augment catecholamine activity, especially that of dopamine.
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