Dopamine agonists instead of ED meds

Discussion in 'Erectile Dysfunction / Delayed Ejaculation' started by hogus, Jul 25, 2013.

  1. hogus

    hogus Well-Known Member

    I found some interesting studies where apomorphine (a D1/D2 agonist) was successfully used to treat psychogenic ED. YBOP also has a small mention of it but not much more.

    What can we theorize about the effect of using something like apomorphine for rewiring? From a sensitization perspective the more dopamine released when you rewire, as long as it's not from unnatural (ie porn-like sex) cues, the better.

    There's also the issue of forming a dependence on it to get erections and never letting your brain reset itself.
    And also which one would be best to try, if any. e.g. half life, safety.
  2. SwimAddict

    SwimAddict New Member

    Seems the problem would be that you end up rewiring to the drug instead of letting dopamine levels creep back to their natural levels. Instead of curing the addiction you would just transfer it to a (not available 100% of the time legally and free) med.

    That being said, I can see this becoming a cure for some sort of "early onset ED" that becomes a new fad disease haha. They won't call it PIED though guaranteed.
  3. confusedguy

    confusedguy Member

    I feel like people keep missing the fact that there's so so so so so much more to this addiction than dopamine...
  4. hogus

    hogus Well-Known Member

    The point here is to get erections and help with rewiring. Not cure the addiction. What else is there to it other than dopamine that's relevant to this thread?
  5. confusedguy

    confusedguy Member

    Excerpt from wikipedia:

    In the presence of mechanical stimulation, erection is initiated by the parasympathetic division of the autonomic nervous system (ANS) with minimal input from the central nervous system. Parasympathetic branches extend from the sacral plexus into the arteries supplying the erectile tissue; upon stimulation, these nerve branches release acetylcholine, which, in turn causes release of nitric oxide from endothelial cells in the trabecular arteries.[1] Nitric oxide diffuses to the smooth muscle of the arteries (called trabecular smooth muscle[2]), acting as a vasodilating agent. The arteries dilate, filling the corpora spongiosum and cavernosa with blood. The ischiocavernosus and bulbospongiosus muscles also compress the veins of the corpora cavernosa, limiting the venous drainage of blood.[3] Erection subsides when parasympathetic stimulation is discontinued; baseline stimulation from the sympathetic division of the ANS causes constriction of the penile arteries, forcing blood out of the erectile tissue.[4]

    There is absolutely NO mention of dopamine. I find it interesting that you say these pills would be to help with erections, not the addiction, when the way I see it, if anything related to dopamine would help at all, it would be with the addictive urges, not the erections.

    Maybe dopamine agonists would have some affect on rewiring (although I don't know what it is), but it should be noted that these drugs could also have drastic effects on the rest of one's daily life. However, I see no reason whatsoever that they would help with erections, because dopamine isn't involved in the erection process at all.

    Edit: actually, I was wrong. I did some more research and found this :
  6. hogus

    hogus Well-Known Member

    You should spend more time on YBOP. There's no mention of dopamine because the brain isn't usually considered in matters of not being able an erection. Generally people think that if it's not your dick, your nervous system, spinal cord etc then it's performance anxiety, depression etc; psychological.

    The entire premise behind PIED is insufficient dopaminergic stimulation to the parts of the brain controlling erections (nucleus accumbens, hypothalamus etc) because of lack of wiring (to put it vaguely). What did you think it was :p
  7. hogus

    hogus Well-Known Member

    It seems the pharma cure to PIED came way before it's time. Apomorphine was actually prescribed by doctors for ED. It was shown to have low efficacy but for some reason doctors never thought to separate physical from non-physical ED.

    It isn't available as a generic yet and isn't produced anymore under its rx name so it's pretty much out of the question.

    Are you around Gary?
  8. Gosplan

    Gosplan Member

    I never heard of apomorphine. Cabergoline seems to be the preferred dopamine agonist when it comes to enhancing sexual life.

    Of course any dopamine agonist will lead to degree of desensitization and tolerance on the long term. So unless you have a condition that demands it like hyperprolactinemia I don't think it's worth.
  9. Gosplan

    Gosplan Member

    I'm on Cabergoline myself and I assure you that dopamine agonists are NOT the cure to PIED. Dopamine is only one of the factors involved in porn addiction, and not the most important one. DA won't do shit to reverse the porn sensitized pathways in someone's brain.
  10. hogus

    hogus Well-Known Member

    What about boosting the effect of sensitization to real girls and short term or long term sporadic use? And you're not the first to say dopamine isn't the only or biggest factor but what else is there? Everything I can think of links back to dopamine somehow.

    What effects did you notice on cabergoline?
  11. sak1234

    sak1234 Member

    I just wanted to chime in about dopamine agonists and how they would fit into the grand scheme of the issues we are dealing with.

    The main issue isn't necessarily the amount of dopamine, but the dopamine receptor density on the postsynaptic cells. With the ever increasing dopamine spikes from porn over the years, the reward center and the postsynaptic dopaminergic cells adapt by bringing dopaminergic receptors from the membrane into the cell (learning and plasticity) so there are less that are available to bind to the dopamine. If you try to counter using dopamine agonists in this situation, you won't see an increase in erection that you are looking for. If you have been rebooting for a while, your dopamine receptors may be back up to a decent amount and the agonists may help, but if you have full blown PIED, I don't think agonists will do much.

    In fact, if you are looking for a solution for psychogenic ED, using agonists may make things worse over time by convincing the brain that less dopamine is needed to be created since all of the artificial dopamine (agonist) is in the system. That will probably only be the case if you over do the orgasms using the agonists though. If you have minor psychogenic ED and are nervous about having sex, go ahead and use it to see what happens, but I wouldn't use it as a means to overriding lack of ED like most of us have used porn to override lack of erections.

    Dopamine antagonists may actually prove to be a better option as they limit the amount of the dopamine that can bind dopamine receptors. Over time, the brain may feel that there isn't enough dopamine around since the antagonists are binding to them. Also, with less dopamine binding the post synaptic cells may decide to start bringing those dopamine receptors back out to the surface. If you were to take a dopamine antagonist, like sulbutiamine, you would probably need to take it for a long period of time to see any sort of plasticity changes. In fact, if you are looking to have sex soon, dopamine antagonists would worsen the ED initially since the dopamine-dopamine receptor activity that you need for erections would be hindered.
  12. hogus

    hogus Well-Known Member

    Yes but that still only refutes the receptor regulation perspective behind this which was never my reasononing.
    What about the sensitization perspective and lack of dopamine released during specific activities (ie sex)? The agonists would reinforce learning of the new behaviour.
  13. sak1234

    sak1234 Member

    Fair enough. I still think that you would need to reboot for a bit before trying this out since you would need those baseline dopamine levels to come up at least a little bit. The agonist wouldn't be able to bring them up as high as we would like I'm guessing. You may have touched up on this earlier in conversation so I apologize for not paying attention if that is the case, but how efficiently do agonists cross the blood brain barrier? You have been rebooting for a while now hogus so I don't doubt that an agonist or ED drugs won't help you. It's those earlier in the process that it could be risky for.

    Secondly, how often would you use an agonist? Let's say you use the agonist for 2 nights/week for a month and have sex until orgasm. Once you stop using it, the baseline levels will drop again and you may not be able to have sex. There is a possibility that you have reinforced the enjoyment of sex and have no problem getting erect without the agonist, but you never know. I think comparing this to someone getting off of a regular ED drug or at least looking at a narrative about someone weaning themselves off of an ED drug may be helpful in figuring out if this is worth it. There have been guys on here who haven't been able to reinforce the sexual learning using ED drugs and other guys who have. My only worry is that you or anyone else who tries this will dig themselves into a deeper flatline hole.

    Of course, most of this is tied to speculation and narratives so take my opinion with a grain (maybe a teaspoon) of salt.
  14. Stefke

    Stefke New Member

    @Hogus: Last year i also read about Apomorfine and ED, so I went to my doktor and aksed him i could try it.
    I used injectable Apomorfine that is used for parkinson patients in a very very very small dose, and used it about 10 times.
    It defiinitely works to get natural erections within 5 minutes,.... BUT!

    This drugs is dangerous!
    The dosis has to be so perfect, otherwise you will get realy nasty side effects.
    As you may already know, Apomorfine is also used to make you vomit.
    If you use the correct dose, then you will get nauseous for the first 20 minutes, and at the same time you can get natural erection for about 1 1/2 hour. A second dose does not work that same day anymore.

    When you overdose just a tiny little bit, well..... THEN YOU'RE IN HELL for about 30 to 40 minutes. Just a few minutes after you used the Apomorfine, you're going to start sweating, feel a little dizzy, and start to feel realy nauseous. Then you try to find your way to the toilet, and just when you get there, HELL MAN,.... you're starting to vomit so much that you think your gonna die. Non stop vomiting for 30 to 40 minutes, and not just a little bit, I never knew a person could vomit that much.
    My wife was in total panick, and wanted to call an ambulance. I knew this could happen, and told her to just stay with me and wait it out.
    This was just a very tiny little overdose.
    So, please stay off the Apomorfine!

    This learned me 3 things.
    1. Because the Apomorfine worked, this proved that it was a Dopamine related problem.
    2. Because a second dose of Apomorfine didn't work any more, it proved that it desensitized the Dopamine receptors even more

    In my honest opinion, the only thing one can do, is to stay off PMO.
    I don't count the days without PMO, but I'm about 4 months without PM now, and feel much better.
    Every now and then I have sex, but found that its the orgasm that keeps me sending back into flatline and not the sex.
    The way things are going now, I think it will take me about a year to heal.
    I PMO'ed for 12 years.
  15. hogus

    hogus Well-Known Member

    The bioavailability of most of them is basically unknown. Cabergoline in particular has been suggested to have a massive range (30-60%) but only in rats - no human trials, so it's possible that extensive dose testing would be needed for purposes that it's not prescribed for. It also has a half-life on the scale of days so it's not great for this since normal dosing would promote dependence on top of rewiring.

    A completely linear dosing pattern might not be necessary. One with the drugs, one without and other non-standard patterns. Since it's more for embedding behaviour and sensitization it makes sense not to always take it to avoid needing it for erections. But theoretically it would be easier to recover from DA erection dependence after it's used to build the new sensitizations since you only need to abstain for a while to restore baseline levels and not rewire the old way. Plus also you can taper.

    I'm not sure how far we can apply the ED drug analogy. That dependence is either psychological (anxiety) or it just simply masks the fact the brain doesn't have the required sensitization by forcing it in the plumbing. Using a DA would reinforce the behaviours going on in a way that ED drugs wouldn't.

    But I agree, I think we've pretty much gone as far as we can go with speculation. I bet some pharma company will start marketing a DA ED drug again and of course this time, the studies will isolate people with psychogenic ED to show it works ::)
  16. hogus

    hogus Well-Known Member

    That sounds horrendous! Apomorphine isn't supposed to be taken without an antiemetic (anti-vomiting) though. I'd be wary of any doctor who prescribed it to you without one :-\

    How far off porn were you when you tried it and were you in a flatline?
  17. Stefke

    Stefke New Member

    I took anti vomit, but didn't help.

    I still didn't know about PIED when I used the Apomorfine. I learned about PIED last April.

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