monoamine oxidase inhibitor (MAOI)

[Ihavequestionsplease]

just wondering what these drugs are like? and if they are still precribed today by gps. do any of these have less sexual side effects? my citalopram gives me sexual side effects and i have tried mirtazapine but no good. therefore i guess there are no antidepressants to swap to with no or less sexual side effects?

[johnep]

Mono Amine Oxidase Inhibitors do what it says on the tin, they inhibit the breakdown of serotonin (5 hydroxy tryptamine). This is a regulator of mood in as rather like levothyroxine regulates metabolism.
If 5HT levels high, than mood elevated. Too high can lead to mania.
Unfortunately, MAOIs also inhibit breakdown of other active amines and some of these can raise blood pressure. These amines have precursors present in foods such as cheese, chocolate, broad beans and marmite.

Because of these side effects, MAOIs rapidly fell out of general use. They have been used to treat premature ejaculation so this could be called a sexual side effect.

Interestingly, MAOIs followed observation of TB pts mood being elevated when treated with isoniazid. One of them (Marsilid) actually was originally introduced as a patentable derivative of isoniazid for TB treatment.
johnep

[Shwampa]

If you love your cheese..better stay away from them. They're sometimes still prescribed for resistant depression or a subtype called:"atypical depression". The AD probably without sexual dysfunction is bupropion. Good luck, it won't be an easy path...

[bobbin]

just wondering what these drugs are like? and if they are still precribed today by gps. do any of these have less sexual side effects? my citalopram gives me sexual side effects and i have tried mirtazapine but no good. therefore i guess there are no antidepressants to swap to with no or less sexual side effects?

There are various antidepressants which you could swap to. The choice depends partly on where you live. What country are you in?

Shwampa mentioned bupropion, which is widely used as an antidepressant in some countries but not in the UK.

MAOIs are sometimes very effective for severe depression and social phobia. Like citalopram, MAOIs cause sexual side effects quite frequently and can inhibit orgasm.

The tricyclic antidepressants lofepramine and nortriptyline do not usually cause sexual side effects. Lofepramine is often prescribed in the UK for moderate/severe depression. Lofepramine is not available in the United States, but they do have nortriptyline.

All of the SSRIs can cause sexual dysfunction, not just citalopram. The same applies to venlafaxine (Efexor) and duloxetine (Cymbalta).

[bobbin]

Sorry, I read in your previous post that you're being treated for anxiety and panic. Lofepramine and nortriptyline are not normally used to treat anxiety.

[Ihavequestionsplease]

yes i take citalopram which is actually good now for my anxiety. im just so frustrated with reduced sexual function. someone mentioned viagra on here but i am 29 and feel embarrised to ask doctor. i wish i could add something to reverse sexual side effects. i can only think of adding buspar but i think it was mentioned that it would only be given from a specialist. therefore as a patient am i entitled to demand an antidote or can my gp just say live with this side effect or be anxious? I guess it is a matter of cost, add on drugs for the nhs.

P.S i am a patient in cornwall, in the cornwall and islces of scilly health trust.

[bobbin]

yes i take citalopram which is actually good now for my anxiety. im just so frustrated with reduced sexual function. someone mentioned viagra on here but i am 29 and feel embarrised to ask doctor. i wish i could add something to reverse sexual side effects. i can only think of adding buspar but i think it was mentioned that it would only be given from a specialist. therefore as a patient am i entitled to demand an antidote or can my gp just say live with this side effect or be anxious? I guess it is a matter of cost, add on drugs for the nhs.

P.S i am a patient in cornwall, in the cornwall and islces of scilly health trust.

I don't think it's a matter of cost, it's more a case of your GP not knowing what to do. If you request a referral to psychiatry you will be able to speak to someone more experienced.

I don't think you should be embarrased to speak to your GP about these matters. This is not an uncommon side effect of SSRIs.

[johnep]

Must be something in the water in Cornwall.
johnep

[Ihavequestionsplease]

thanx for your help. perhaps if unsure my gp may ask for advice from a specialist, as opposed to an actual referral, as my anxiety is actually now under control?

[bobbin]

thanx for your help. perhaps if unsure my gp may ask for advice from a specialist, as opposed to an actual referral, as my anxiety is actually now under control?

Possibly.

Perhaps you could manage on a lower dose of citalopram? The side effects could be milder.