@The450Man 1107 wrote:

Well im contemplating on going on an ssri to help my anxiety and depression issues once again…….. I just hate the one major side effect of impaired sexual functioning. Would the use of dopamine agonists fix this issue? Anyone have experience with this?

A dopamine agonist may help counteract the reduction in dopamine signaling that occurs from increasing serotonin signaling from the use of a serotonin-reuptake inhibitor.

The use of Ginkgo Biloba may also help counteract erectile dysfunction resulting from direct and indirect effects of serotonin on erectile function. There is a small risk for stroke on Ginkgo Biloba, though generally it is a safe product, with overall risk lower than the use of aspirin. Interestingly, in fairly well-designed studies, Ginkgo Biloba has not been shown to be effective in improving memory.

@The450Man 1115 wrote:

yea when i was on ssri’s i tried many “antidotes”

buspar
tyrosine
ginkgo
ginsang
l-arginine
l-dopa
tribulus
macca

nothing!

but everytime i come off an ssri i am hypersexual for 1-3 days.

Some people have more problems with SSRIs than the majority.

This doesn’t negate the fact that SSRIs are highly useful medications. Though there are alternatives (e.g. 5HTP, Tryptophan supplementation, etc. – which may also be used simultaneously with an SSRI), there really isn’t a better first-choice alternative to an SSRI in specifically raising serotonin signaling.

Dosing is also an important consideration. Generally, it is important to use a low enough dose to avoid unwanted side effects. Then if problems still occur, address the problems using a different signaling system intervention (e.g. dopamine, thyroid, cortisol, GABA etc.) or metabolic intervention or behavioral intervention. Since most problems (such as depression, anxiety, premature ejaculation, etc.) have multiple simultaneous causes, addressing the problem from different angles is what will need to be done anyway.

Other conditions may make adverse effects more likely, making any serotonin-increasing intervention less tolerable. For example, iron deficiency makes it more likely that a person taking an SSRI would become agitated, restless, fidgety, would have sexual dysfunction, anxiety or insomnia, etc. If enough iron was present, then the side effects are less likely to occur. Thus, the blame for an adverse effect may actually lie in another problem a person has. Low iron, itself, may predispose a person to depression or anxiety or sexual dysfunction. This again goes to the issue of how multiple causes may underlie the primary problem a person has.

For some people, the “antidotes” for sexual dysfunction arising from an SSRI work well. Thus, one’s mileage may vary. But this does not also negate the fact that these alternatives may be worthwhile to consider and try.

Generally, however, my approach would be to dose low enough to avoid unwanted adverse effects and approach the problem simultaneously from a different angle – addressing a different cause of the problem.

Any medication may cause significant side effects in some people. Aspirin, for example, may cause bleeding, ulcers, strokes, etc. Testosterone may cause acne, excessive body hair, male pattern hair loss (as DHT), high blood pressure (when not balanced by estrogen, DHEA, progesterone), aggression (as estrogen), etc. It is a matter of balancing the risks versus benefits of a treatment and examining what may mitigate the risk (dose reduction, augmenting or side effect-alleviating treatments, etc.) or may be additionally causing the risk (e.g. low iron making SSRIs intolerable).