Sign-in to Ask A Doctor - 24x7
OR
Sign in with Google
Suggest Treatment For Low Sex Drive While On Levosulpiride
Question: My current symptoms include Low sex drive, Phimosis, long refractory period (4-6 days), premature ejaculation, pain in perineum and anal area on second and subsequent ejaculations.
I have been on Levosulpiride for the last 7-8 years which has caused low testosterone and high prolactin levels, it is now being tapered off after consultation with an endocrinologist. (Cabergolin has also been prescribed for 4 weeks)
I have been on Levosulpiride for the last 7-8 years which has caused low testosterone and high prolactin levels, it is now being tapered off after consultation with an endocrinologist. (Cabergolin has also been prescribed for 4 weeks)
Brief Answer:
Bupropion could be option for you
Detailed Answer:
Dear XXXXX,
Thanks for using Healthcaremagic.
I read your query and understand your concerns about poor sexual health and other limitations.
First of all please provide the relevant information about your illness
Second provide the latest blood chemistry reports such as serum testosterone, serum prolactin, TSH, LH, FSH, Vitamin B12, Vitamin D3 and blood sugar.
In my view for the current symptoms (provided blood chemistry is normal) there must be add on therapy with use of bupropion. The medication will help you in low sex drive as well as long refractory period. There is also possibility of positive response in fatiguability and premature ejaculation with use of bupropion.
The usual dose is 150 mg per day for the first four days which is increased to 150 mg twice a day from the fifth day of treatment.
I hope this assists you.
If you have any further query, I would be glad to help you.
If not, you may close the discussion and if possible you may rate the answer for my future patients.
In future if you wish to contact me directly, you can use the below mentioned link:
http://doctor.healthcaremagic.com/doctors/dr-ashok-kumar/67386
Thanks and regards.
Bupropion could be option for you
Detailed Answer:
Dear XXXXX,
Thanks for using Healthcaremagic.
I read your query and understand your concerns about poor sexual health and other limitations.
First of all please provide the relevant information about your illness
Second provide the latest blood chemistry reports such as serum testosterone, serum prolactin, TSH, LH, FSH, Vitamin B12, Vitamin D3 and blood sugar.
In my view for the current symptoms (provided blood chemistry is normal) there must be add on therapy with use of bupropion. The medication will help you in low sex drive as well as long refractory period. There is also possibility of positive response in fatiguability and premature ejaculation with use of bupropion.
The usual dose is 150 mg per day for the first four days which is increased to 150 mg twice a day from the fifth day of treatment.
I hope this assists you.
If you have any further query, I would be glad to help you.
If not, you may close the discussion and if possible you may rate the answer for my future patients.
In future if you wish to contact me directly, you can use the below mentioned link:
http://doctor.healthcaremagic.com/doctors/dr-ashok-kumar/67386
Thanks and regards.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Hi doctor,
Thank you for your response.
I have had a Depressive Disorder with psychosomatic symptoms - for the last 10 years
Symptoms include fatigue, weakness, uneasiness and nausea, IBS, constipation, hemorrhoids, headaches, low concentration, brain fog, diplopia, muscle tension, nasal heaviness and post nasal drip, irritability and anger issues, apart from the ones mentioned above.
My recent blood reports show the following values:
Serum Testosterone: 201.87 ng/dl
Serum Prolactin: 73.58 ng/ml
Follicle Stimulating Hormone: 1.37 mIU/ml
Lutenizing Hormone: 0.75 mIU/ml
These are from last year:
Vit B12: 493 Pg/ml
Vit D: 14.2 ng/ml (currently on weekly dose of tayo 600, started recently)
Blood Sugar: 86 mg/dl (glucose random)
I have been advised Bupron-SR in the past, not sure if it is the same drug as you are mentioning. This was about 7-8 years ago, and I do not recall it having any significant effect at that time, though now my symptoms have worsened.
Your views are appreciated.
Thank you for your response.
I have had a Depressive Disorder with psychosomatic symptoms - for the last 10 years
Symptoms include fatigue, weakness, uneasiness and nausea, IBS, constipation, hemorrhoids, headaches, low concentration, brain fog, diplopia, muscle tension, nasal heaviness and post nasal drip, irritability and anger issues, apart from the ones mentioned above.
My recent blood reports show the following values:
Serum Testosterone: 201.87 ng/dl
Serum Prolactin: 73.58 ng/ml
Follicle Stimulating Hormone: 1.37 mIU/ml
Lutenizing Hormone: 0.75 mIU/ml
These are from last year:
Vit B12: 493 Pg/ml
Vit D: 14.2 ng/ml (currently on weekly dose of tayo 600, started recently)
Blood Sugar: 86 mg/dl (glucose random)
I have been advised Bupron-SR in the past, not sure if it is the same drug as you are mentioning. This was about 7-8 years ago, and I do not recall it having any significant effect at that time, though now my symptoms have worsened.
Your views are appreciated.
Brief Answer:
I think duloxetine should be considered
Detailed Answer:
Dear XXXXX,
Thanks for reverting back to me.
The medication I advised is same as bupron XL which was advised to you few years ago.
Considering the above information I feel the SNRI group of medication should be the primary medicine rather than escitalopram. The escitalopram have little role in somatic symptoms and this needs SNRI such as duloxetine. In addition the fatigue is sometime increased by escitalopram although there is help with use of SNRI. Brain fog also responds better to SNRI than that escitalopram.
Having said this I feel there is great potential for nutritional supplements such as vitamin B12, Vitamin D3. Since you already started taking vitamin D3 please ask your doctor to add vitamin B12 in treatment. It comes with name neurobion or neurokind gold. Ensure intake of 1500 microgram per day.
I hope this helps you further.
Thanks and regards.
I think duloxetine should be considered
Detailed Answer:
Dear XXXXX,
Thanks for reverting back to me.
The medication I advised is same as bupron XL which was advised to you few years ago.
Considering the above information I feel the SNRI group of medication should be the primary medicine rather than escitalopram. The escitalopram have little role in somatic symptoms and this needs SNRI such as duloxetine. In addition the fatigue is sometime increased by escitalopram although there is help with use of SNRI. Brain fog also responds better to SNRI than that escitalopram.
Having said this I feel there is great potential for nutritional supplements such as vitamin B12, Vitamin D3. Since you already started taking vitamin D3 please ask your doctor to add vitamin B12 in treatment. It comes with name neurobion or neurokind gold. Ensure intake of 1500 microgram per day.
I hope this helps you further.
Thanks and regards.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Thanks a lot for your reply doctor.
Is surbex gold a good enough vitamin supplement? I have been taking that for the past year or so.
I will consider duloxetine after consultation with my doctor, thanks.
Lastly, an advise for the phimosis would be appreciated.
Is surbex gold a good enough vitamin supplement? I have been taking that for the past year or so.
I will consider duloxetine after consultation with my doctor, thanks.
Lastly, an advise for the phimosis would be appreciated.
Brief Answer:
I am sorry for missing phimosis part
Detailed Answer:
Dear XXXXX,
Thanks for reverting back to me.
I am glad to know that the information was useful for you and you decided to discuss the option of duloxetine with your psychiatrist.
Regarding surbex gold I am sorry to inform you that vitamin B12 content is very low and not enough to meet demands of the body. Fortunately it contains many of the vitamins and minerals but the vitamin b12 content is less than the requirement.
Regarding phimosis if you are XXXXXXX to retract the king back to glans keep it doing with use of some lubricant as much as possible. Avoid excessive stimulation to prevent erection while retracting skin.
In case you are not able to retract in my opinion seek an opinion of surgeon. It can be corrected with a simple surgical procedure.
I do not mean that it is absolutely necessary to undergo surgery but it the best treatment available for phimosis.
I hope this helps you further.
Thanks and regards.
I am sorry for missing phimosis part
Detailed Answer:
Dear XXXXX,
Thanks for reverting back to me.
I am glad to know that the information was useful for you and you decided to discuss the option of duloxetine with your psychiatrist.
Regarding surbex gold I am sorry to inform you that vitamin B12 content is very low and not enough to meet demands of the body. Fortunately it contains many of the vitamins and minerals but the vitamin b12 content is less than the requirement.
Regarding phimosis if you are XXXXXXX to retract the king back to glans keep it doing with use of some lubricant as much as possible. Avoid excessive stimulation to prevent erection while retracting skin.
In case you are not able to retract in my opinion seek an opinion of surgeon. It can be corrected with a simple surgical procedure.
I do not mean that it is absolutely necessary to undergo surgery but it the best treatment available for phimosis.
I hope this helps you further.
Thanks and regards.
Note: For further guidance on mental health, Click here.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Answered by
Get personalised answers from verified doctor in minutes across 80+ specialties
