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Re: Best Antidepressants for men?

Posted by linkadge on July 5, 2009, at 18:43:27

In reply to Re: Best Antidepressants for men?, posted by bulldog2 on July 5, 2009, at 18:08:37

>ssri's should be avoided by men. They are the >worst ad's men can take. There is evidence they >lower dopamine and elevate prolactin. That >lowers testosterone and human growth hormone. >Parnate (maoi) and certain tcas should not have >as much impact on sexual performance as ssris >which work specifically on serotonin where most >tcas work more on serotonin.

Eh. I don't know if I'd go that far. I know a few men that did horrible on drugs like wellburtin or remeron (major increase in anger) but did just fine on SSRI's. It really depends on the depression. I certainly think there can be a serotonergic component to depression in men as well.

Where I think SSRI's should be avoided is in later life depression in men. This is more likely due to decreased androgen production.

>Be aware that if a man is on an ssri long term >the suppression of testosterone could become >permanant as the testes may not be able to >bounce back after being inactive for so long.

Well, testosterone is still definately being produced when patients are on SSRI's. There is a decrease, but I don't think it necessarily has to do with drug interference at the level of the testicles. Instead, it is probably due to lower levels of dopaminergically mediated release of testosterone. Hormone imballences may exist post SSRI use, but to be honest most AD's are neuroendocrine disruptors. I think time will probably help.

Linkadge


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