anti depressants and peyronies

[peter123]

so I finally had my appointment with a psychiatrist today. it went better than expected and they took my issues very seriously. apparently I am exhibiting massively symptoms of a major depression, red in every test there is.

i have been prescribed escitalopram(Lexapro) for trying out and should report back if I get any side effects and if the medication works at all. the obvious problem is side effects, I dont care about diarrhea etc but sexual side effects are a big issue with this kind of medication.

for example drugs known to stabilize peyronies such as potaba work by decreasing tissue serotonin. ssris do the opposite, they down regulate NO synthase in the penis as well. it snot a good thing for peyronies. also last thing I could need know is sexual dysfunction, impotence as that would massively exacerbate the reasons im taking the medication in the first place.

does anyone here have any experience with this class of drugs and peyronies? how do they work(not biologically but what is different for the patient) and what are the sides, impact on peyronies development? I asked the psychiatrist but obviously they dont know anything about peyroneis disease(actually she did know it from med school so that was cool as I didn't have to explain the trauma associated with it)


given my background of quite severe mental health problems and peyroneis now, should I try them?

[Hawk]

I have never seen respected study that suggest serotonin levels affect Peyronies Disease.

ED and Priapism as well as difficulty reaching orgasm are all uncommon side-effects of Lexapro but most people do not get them and it they do they might be temporary so give it a good chance to work.

If it doesn't ask if you can try Wellbutrin which is kind of known for having fewer sexual side-effects.  Women have reported spontaneous and repeated orgasm on it but that was probably some media hype to sell more Wellbutrin.

[Tortão Pra Direita]

I tried to send you a message, but your inbox is full.

Well..

SSRI's may lower your libido. If you have a high libido, as you said on the forum, it will just diminish. SSRI's are the first-line treatment for anxiety and depression. I don't think this class of antidepressants can make your Peyronie worse. Maybe Paroxetine, because it directly inhibits nitric oxide synthase and is responsible for a higher rate of Erectile Dysfunction on the patients.

You can talk to your doctor about other options if you really don't want to use a SSRI. You can argue that you must not have a diminished libido in the moment because you're dealing with Peyronie, and you need constant blood flow in your penis.
Some anti-depressants that won't lower your libido: mirtazapine, bupropion, moclobemide, trazodone...
Buspirone is a good anti-anxiety med that can be used along with an AD.

There are always more options. For example, for depression treatment-resistant, a lot of people are getting success with ketamine infusions. I don't know if it's already available in Germany, but it is in a lot of countries.

Some people are getting success microdosing psilocybin mushrooms and LSD: https://www.reddit.com/r/microdosing

And there are some over-the-counter substances that are used for anxiety and depression:
Agmatine: https://old.reddit.com/r/depressionregimens/comments/i8qdew/agmatine_sulfate_is_a_godsend/
Agmatine also increases NO synthase: https://pubmed.ncbi.nlm.nih.gov/9010916/
It's a common substance used on pre-workout supplements.

Black seed (Nigella Sativa) is a really good substance used for anxiety.

Cannabidiol (CBD) is another good substance used for anxiety and mood problems.

These substances are safe and very easy to find on the internet. As you have major depression, probably they won't solve it alone but can be used along with an AD.

If I were your psychiatrist, I'd put you on Mirtazapine + bupropion. This is a good combo and can even increase your libido.
Mirtazapine is very sedative and should be taken at night. It increases your hunger.
Bupropion is more stimulating and should be taken in the morning. It decreases a bit your hunger.
So you can see they kind of cancel each other side effects.
If you are an anxiety-prone guy, then maybe bupropion is not good for you. It can increase anxiety.

[TonySa]

It's great you found a good doc Peter.  I'd def give lexapro a try and work  w your doc to get the dose right or change if ultimately needed.  There's a lot of trial and error w anti-depressants as many folks respond differently to each med.  please keep us updated.  Fingers crossed you start to see a bit of change in your mood over the next couple weeks!

[jan.schaller1958]

Yes, good luck with the antidepressants. If you get side-effects, you can always just stop taking the drug and switch to something else. Sounds like you are off to a good start.  

[Paolo]

SJW (St. John's Wort) is also a possibility, but it needs to be this one;

https://zellerag.com/en/products/remotiv-ze-117/

Ze 117 is better tolerated than SSRIs and has very low potential for drug-drug interactions due to special extract containing low hyperforin levels (≤1%), suitable for long-term treatment

If you need to it can be taken for 6 weeks or more and is very safe. Many Years ago I was on Prozac and switched to SJW for long term support, I only occasionally use it now.

Good luck  

[Paolo]

Oh, forgot to mention Inosine for depression/mood;

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5432480/

From the above link;
It was already demonstrated that inosine has a highly safety profile and is devoid of significant side effects, even after prolonged treatment [29, 28]. These results suggest that inosine is able to target signaling pathways related to cell survival, neuroprotection, and neuroplasticity, further reinforcing the ability of the purinergic system to favorably impact mood.

https://www.nature.com/articles/srep04199

Inosine is a naturally occurring purine nucleoside, it is super safe and has also been shown to help with Parkinson's disease, plus brain damage from stroke.

As a bonus it will help with sleep even at 1 gram per day.