Quetiapine and Premature Ejaculation

Any other sexual dysfunctions not properly addressed by medical science.
SeroquelTroubles
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Joined: Sun Jun 27, 2021 2:55 am
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Quetiapine and Premature Ejaculation

Unread post by SeroquelTroubles »

I noticed a major issue arising with premature ejaculation since I was started on quetiapine XR (Seroquel) mono therapy 300mg/day 5 years ago for bipolar disorder. My psychiatrist added 100mg sertraline, which definitely helped the PE, but caused minor ED. I was switched to escitalopram 20mg in 2020, but since January 2021, I tapered off the escitalopram. I noticed definite improvement in ED, but worse PE again. I am now medication free after tapering the quetiapine XR and some improvement in PE. Has anyone else experienced issues with PE while on Seroquel? Could this be due to an increase in prolactin even though the medication is supposed to be PRL-sparing? I feel much better off the medication and am glad I stopped. I am considering using 100mg 5-HTP for both mood and residual PE. I think the Seroquel was a major cause of my PE. Any thoughts? For PE I am using topical lidocaine these days instead of any pharmacological treatments.
OCDemon
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Re: Quetiapine and Premature Ejaculation

Unread post by OCDemon »

Rexulti, an atypical antipsychotic, caused PE for me, as well as a host of other issues (soft glans during erection, unsatisfying orgasm, and going flaccid immediately upon beginning ejaculation, to the point of finishing ejaculation while flaccid).

Rexulti is different from Seroquel but I have no doubt these meds can cause crazy issues with sexual function. It's not as well known as with SSRI's but people like you and me are clear examples that they can be just as destructive.

Looking on Wiki, Seroquel shares the same property as Rexulti, in agonizing 5-HT1A and antagonizing 5-HT2C. The PE issues I got from Rexulti were extremely obvious, very markedly different from anything I had experienced before, and have continued to last two years after discontinuing it. My guess is the 5-HT1A agonism is the biggest culprit but the 5-HT2C antagonism could be another. Lots of mechanisms of action here but it has primary effects on serotonin receptors known to have a critical function in ejaculation latency.
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