taarn wrote:I would have tried bupropion or pramipexole first cause these were shown to desensitize DRN 5-ht1a, or maybe started with buspirone. Vortioxetine simply scares me away. But I wish you good luck bro, hope you’ll have success with your regimen!
Bupropion is a potent nNOS inhibitor and I believe that's the main reason it causes PSSD-like syndrome after being taken for a while, since nNOS is extremely important for the sexual response.
https://www.ncbi.nlm.nih.gov/pubmed/17509558
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3991030/
The SRI that gave me PSSD was Venlafaxine while other SSRIs (Sertraline, Fluoxetine, etc) never managed to give me any sexual dysfunction. Venlafaxine is an nNOS inhibitor, same as Bupropion:
Involvement of L-arginine-nitric oxide-cyclic guanosine monophosphate pathway in the antidepressant-like effect of venlafaxine in mice:
Pretreatment of mice with 7-nitroindazole (7-NI) (25 mg/kg, i.p.) [a specific neuronal nitric oxide synthase (nNOS) inhibitor] produced potentiation of the action of subeffective dose of venlafaxine (2 mg/kg, i.p.). In addition, treatment of mice with methylene blue (10 mg/kg, i.p.) [direct inhibitor of both nitric oxide synthase (NOS) and soluble guanylate cyclase (sGC)] potentiated the effect of venlafaxine (2 mg/kg, i.p.) in the FST. Furthermore, the reduction in the immobility time elicited by venlafaxine (8 mg/kg, i.p.) was also inhibited by pretreatment with sildenafil (5 mg/kg, i.p.) [phosphodiesterase 5 inhibitor].
https://www.ncbi.nlm.nih.gov/pubmed/17379375
So, I don't think it's a good idea for me to take Bupropion. As for Pramipexole, I'm extremely wary of dopamine agonist withdrawal syndrome (DAWS) even if it's a small chance for happening.
Buspirone, as I mentioned, is counter-productive since it's a partial agonist at the postsynaptic 5HT1A with low intrinsic activity. It beats the point, since I believe my type of PSSD is due to hypoactivation of those receptors (since I benefited greatly from Flibanserin and Baclofen) and I'm trying to restore their activity, not dull them further with Buspirone.
I'm still feeling really out of it. Presynaptic 5HT1A agonists always make me feel horrendous. Felt the same way on Buspirone and lavender oil. The latter is a calcium channel blocker on top of being a 5HT1A agonist, so it's also counter-productive since it would inhibit glutamate transmission.