My doctor wants me to try 75mg wellbutrin to raise my libido. My prolactin is slightly high, and he hopes with the increase in dopamine my prolactin will fall, and therefore my testosterone could rise
any opinions?
This is not enough information. Do you have labs? Please post.
As far as libido, if Wellbutrin is an SSRI, these are notorious for lowering libidos rather than increasing them. If prolactin is an issue, stick to cabergoline.
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This doc is thinking correctly. Wellbutrin is not an SSRI and can have positive sexual effects if oneâs is been held back by low dopamine. Wellbutrin worked for me and I had to move on as it was too stimulating [for me]. If one tolerates Wellbutrin, it is cheap and can be prescribed. If it does not work out for you, you can tell the doc that cabergoline is a good alternative. Prescribing cabergoline to brighten oneâs mood is really a long reach of understanding for most docs.
Lowering prolactin can increase T if elevated levels were repressing your HPTA.
Low levels if prolactin can easily also contribute to a lack of motivation and lack of enjoyment or satisfaction with things in life. Makes sense that a lack of the ârewardâ neural transmitter would lead to such things. Can make you feel dumpy, not necessarily depressed or profoundly sad. But low dopamine can be a strong factor if one otherwise is depressed.
We all loose dopamine levels with age. Some faster than others. Maybe someday we will be finding and treating the dopamine deficiencies that that we all get sooner or later. Many of the aspects that we observe in aging people is caused by low dopamine and of course there are low sex hormones with all at some point in aging as well. When low dopamine levels are severe it becomes a disease called Parkinsonâs, then you can get medical treatment, otherwise rarely.
With anything that you do to increase dopamine, make it hang around longer in your brain with low dose seleginine/Deprenyl. 2.5mg EOD does a nice job. When stacking dopergenic drugs, you will need to use less of each. Too much dopamine is unsettling. I would call these things âmood brightenersâ.
If you have trouble sleeping, trazodone is very cheap and effective, as well as dopergenic.
here is some labs and a story from another post
I am 21 years old, eat healthy, and work out all the time. For the last two years or so I have had low testosterone problems. I have seen nine doctors, and have had many labs taken. I have been desperate to find a correctable problem. I accept that I will eventually have to get on trt, but I am trying to avoid it if at all possible because I want to become an officer in the air force. Needing trt automatically makes me not eligible to join the military.
In March of 2010 I had surgery for a level 3 varicocele in hopes that removing it would help my testosterone at least a bit. Before the surgery my total test. average mid 300âs now in July my total test is around the high 300âs to an all time best of 450 recently. However my free t keeps dropping. In a normal range of 9 to 26. I was at 9 and then 11, but recently only 6.
History:
- Had varicocele since at least 14 or 15 on my left testicle
- March 4th surgery for varicocele in hopes that removing the (Grade III) varicocele could boost my testosterone levels. My doctor said if my testosterone values were to increase they would increase probably within 90 days. Through ultrasound the varicocele has been confirmed gone.
- I have had testosterone tests every month since the surgery, and well there has not been an increase yet (except for that freak 11.5 free valueĂ¢?ĂÂŚthen a month later went back down to 9).
- Over the last year or so I have developed near impotencyĂ¢?ĂÂŚpreviously (16-19 years old) I did not have problems, and frankly this is one thing I canĂ¢??t deal with. I will do anything to fix this problem.
My urologist has high hopes with my recent LH improvement. In a normal range of 2 to 9, I also got a 2, 2.4 , 1.9 etc. But recently in June my LH came back as a 5 ( the same time as the 450 total test). He says that he thinks while I had my varicocele my LH eventually just stoped working since my testicles were so unresponsive with the varicocele. Now that they are unhampered by the varicocele the LH is going back up since the testicles are responding better. My endo says this is bull shit and my primary care is skeptical. Whos is right? My urologist (the guy who did the surgery) thinks that my testosterone is going to gradually increase over the next six months. But its already been four months since surgery almost.
Furthermore my endo shot down the LH argument saying because LH is emitted in pulses there is not much of a difference between a 2 and a 5 since it could be a trough or peak reading.
Here are some recent labs, questions below:
Summary of labs:
TIBC 310 250 - 450 ug/dL
UIBC 109 150 - 375 ug/dL
Iron 201 40 - 155 ug/dL
Iron % saturation 65 15 - 55 %
Ferritin 63 30 - 400 ng/mL
HGB 17.0 12.5 - 17.0 g/dL
Could my high iron and high iron saturation be enough to effect my test. levels. My endo isnât sure. He said the high saturation and high iron are strange with the normal ferritin level.
Here are more labs any thoughts:
From labcore
estradiol sensitive 13 in a normal range of 3 to 70
test percent free and weakly bound 27.7 percent in range of 9 to 46 percent
testosterone free plus weakly bound 105.8 in range of 40.0 -250
Component Your Value Standard Range Units
Prolactin 16.1 4.0 - 15.2
Component Your Value Standard Range Units
T4, Free 1.20 0.82 - 1.77
Cholesterol, total 170 100 - 199 mg/dL
Triglyceride 84 0 - 149 mg/dL
HDL Cholesterol 49 >39 mg/dL
VLDL, calculated 17 5 - 40 mg/dL
LDL, calculated 104 0 - 99
Glucose 85 65 - 99 mg/dL
BUN 16 5 - 26 mg/dL
Creatinine 1.05 0.76 - 1.27 mg/dL
GFR est non-AA >59 >59 mL/min/1.73
GFR est AA >59 >59 mL/min/1.73
BUN/Creatinine ratio 15 8 - 27
Sodium 138 135 - 145 mmol/L
Potassium 4.3 3.5 - 5.2 mmol/L
Chloride 100 97 - 108 mmol/L
CO2 25 20 - 32 mmol/L
Calcium 9.2 8.7 - 10.2 mg/dL
Protein, total 6.8 6.0 - 8.5 g/dL
Albumin 4.5 3.5 - 5.5 g/dL
GLOBULIN, TOTAL 2.3 1.5 - 4.5 g/dL
A-G Ratio 2.0 1.1 - 2.5
Bilirubin, total 0.7 0.0 - 1.2 mg/dL
Alk. phosphatase 60 25 - 150 IU/L
AST 39 0 - 40 IU/L
ALT 34 0 - 55 IU/L
WowâŚafter reading about Wellbutrin, I wonder if I should give it a try! Lemme know how it goes JRV
My PCP prescribed this for me to help with my low test symptoms, and I didnât take it. I went to Dr. O and HAN and they were able to CORRECTLY diagnose that I wasnât producing enough cortisol (impacting adrenals) and contributing secondary hypothyroidism. So basically my doctor that prescribed Wellbutrin was either not knowledgeable enough to look more deeply, or was too lazy to do so. Make sure you have the full story before going on anti-depressants.
Well and good, but Wellbutrin is not a typical anti-depressant. But I agree that docs are too quick to script those things and send you out the door.
Yeah, I agree. I am usually of the impression of no anti-depressants until you look for a hormonal imbalance since depression is a symptom of low-testosterone, hypothyroidism etc.
However, many users notice an incredible libido increase while on Wellbutrin. I am not certain as to whether it would increase your testosterone levels, but it very well may. Trazodone is another anti-depressant that is well-known for causing libido increases; however it also causes some priapism in users.
Melanotan II is another drug that is known to increase libido using a peptide hormone called alpha-melanocyte. It isnât approved yet by the FDA however.
Iâve been on ADHD drugs for nearly 10 years now and I sometimes wonder if all those years of methylphendidates have completely rendered my dopamine levels kaput. I wonder if there is such thing as DRT?
Where are Dr. O and Han located?
I will probably just go to lapcorp and get my cortisol tested on my own.
Any adrenal tests I should run?
For cortisol and other tests suggested please suggest what time i should get blood drawn.
[quote]jrvswim wrote:
Where are Dr. O and Han located?
I will probably just go to lapcorp and get my cortisol tested on my own.
Any adrenal tests I should run?
For cortisol and other tests suggested please suggest what time i should get blood drawn.
[/quote]
The a.m. cortisol blood test for me came back relatively normal, and didnât tell the whole story. In addition to the blood test though, I took the saliva test from Genova Diagnostics which takes 4 samples throughout the day and maps how your cortisol changes from morning to bedtime. Mine was pretty much flatlined the entire day (doh!) whereas it should have high cortisol in the morning and taper off gradually towards the end of the day.
Dr. O and HAN are located outside of Philly. I have been very happy with my experiences with them thus far.
From what I understand, all blood draws for hormonal issues should be no later than a couple hours after waking for the day at your usual waking time.
Thanks for all the help so far.
There have been very very few reports of priapism with trazodone. But everyone keeps talking about it and then it appears to be the problem that it is not. When something like that occurs, I suspect that any dopergenic drug would create the same effect in those individuals. Ditto for increasing libido and again, perhaps only in the context of a long term dopamine deficiency. And then we can rightly expect these effects to be transient to some extent.
Yeah, the only reason I even mentioned it in the first place was that Dr. Mariano mentioned some of his clinical experiences with trazodone and those included a couple of bouts with priaprism. It probably is in less than .5% of cases but itâs still interesting.
Iâm sure itâs like the whole âViagraâ>please call for an erection lasting longer than 4 hoursâ.
There have been very very few reports of priapism with trazodone. But everyone keeps talking about it and then it appears to be the problem that it is not. When something like that occurs, I suspect that any dopergenic drug would create the same effect in those individuals.
Ditto for increasing libido and again, perhaps only in the context of a long term dopamine deficiency. And then we can rightly expect these effects to be transient to some extent.
I have been using trazadone for a while now, on and off, and have had no problems other than possibly an increase in morning wood, which really is not much of a problem and probably not related to priapism. It did not increase my libido, but has been great for allowing me to get a restfull nightâs sleep. I take 50 mg every night at bedtime.
Thanks for the input pcdude! Itâs nice to get actual feedback from people whoâve used it.
I should mention that 50 mg is a really low dosage for anti-depressant usage. I use it âoff labelâ as a sleep aid.
I donât think anyone uses traz as a front line anti-depressant, you would be sleepy all day. It does not drag over to the next day if dosed correctly. Does not mess you up like long term benadryl or other anti-histamines that have sleepy side effects.
Ksman,
can you elaborate on this quote
âWellbutrin is not an SSRI and can have positive sexual effects if oneâs is been held back by low dopamine. Wellbutrin worked for me and I had to move on as it was too stimulating [for me]. If one tolerates Wellbutrin, it is cheap and can be prescribed.â
Is this your personal experience or patients you have had? What do you mean by too stimulating if i can ask? Like your mood or wood 24/7 if thats a bad thing haha
Too stimulating like drinking way too much coffee. That was my experience and I have see reports of others having same issues. Some do not have such problems.
When one takes a stimulant drug, one can easily go too fast and the rest of the body cannot keep up. One then feels excited and exhausted at the same time. Things get out of balance.
I am a Mechanical Engineer, not a doc.