Buspar for Libido - Proper Dose?

[DaveK22]

My Primary has agreed to let me try Buspirone (Buspar) for no libido as a result of Accutane's version of PFS.

Can anyone (Dr. Saya maybe?) suggest a good starting dose? Only other med I'm currently taking is enclomiphene mono for secondary hypo (also as aresult of 'tane)

My Primary is very open minded & has been educated by me on PFS (and Accutan'es version which is near identical). He wrote script for 10 mg 2x day.

 

[captain]

I think I read it was once or twice a week or it stops working for this if you take it everyday. It was a low dose as well. I don't remember exactly what it was.

 

[Dr Justin Saya MD]

Yes you don't want to take it every day or it will boost serotonin and consequently reduce dopamine over time. This is counterproductive for libido.

The opposite can occur if used less frequently. I generally would start at 7.5 mg twice a day on an every other day or every third day basis. However 10 mg twice per day on the same basis would be okay.

 

[ERO]

I have read that the libido boosting effect is basically a side effect rather than a sure thing and that it seems to work better for women in this regard. That is all bro science, but I would be curious to find out more.

Since I have had nothing but low to zero libido on TRT since day one, I tried it a few years ago and found it to give me anxiety instead of a libido boost. Which seems weird as it is drug FOR anxiety.

 

[Dr Justin Saya MD]

I have read that the libido boosting effect is basically a side effect rather than a sure thing and that it seems to work better for women in this regard. That is all bro science, but I would be curious to find out more.

Since I have had nothing but low to zero libido on TRT since day one, I tried it a few years ago and found it to give me anxiety instead of a libido boost. Which seems weird as it is drug FOR anxiety.

Yeah that's definitely a paradoxical reaction. Ironically, that may hint at a possible root to the ongoing and frustrating lack of response to TRT for you...perhaps some "whacky" (for lack of a better term) neurotransmitter physiology going on.

Buspar isn't the best approach for libido enhancement in general, but for very select patients who suffer from anxiety (which can inhibit libido itself), the buspar has the *chance* to be a win-win.

 

[ERO]

I am running out of neurotransmitter supplements to try. I have tried all of the following without noticing anything.

Acetyl-L-Carnitine
Choline
Phosphatidylserine
GABA
Inositol
5-HTP

 

[DaveK22]

Yes you don't want to take it every day or it will boost serotonin and consequently reduce dopamine over time. This is counterproductive for libido.

The opposite can occur if used less frequently. I generally would start at 7.5 mg twice a day on an every other day or every third day basis. However 10 mg twice per day on the same basis would be okay.

Dr. Saya- Thank you for your valuable input. Would you see any problem starting with every day dosing for 1 week, then switch over to EOD or E3D? Almost a "loading" type concept?

 

[Dr Justin Saya MD]

Dr. Saya- Thank you for your valuable input. Would you see any problem starting with every day dosing for 1 week, then switch over to EOD or E3D? Almost a "loading" type concept?

I would stick to E2D or E3D...the whole point is that you DON'T want a "loading dose" as you don't want the full physiologic impact of bupropion (increase in serotonin = decrease in dopamine). When used intermittently it can (not always) have the opposite impact (lower serotonin, raise dopamine).

 

[Dr Justin Saya MD]

I am running out of neurotransmitter supplements to try. I have tried all of the following without noticing anything.

Acetyl-L-Carnitine
Choline
Phosphatidylserine
GABA
Inositol
5-HTP

I know ERO, frustrating.

If memory serves (without your records in front of me), you've tried provigil or nuvigil with poor response as well? What about modafinil? Have seen some success with that...problem is the response to these type of meds is so darn individualistic.

 

[ERO]

Hello Dr. Saya-

I have tried both provigil and nuvigil. They both make me feel like I took a stimulant, but they certainly had no effect on my lack of libido. Just curious - has anyone ever had either of those drugs help with libido? I mean, they are for folks with narcolepsy or folks that work rotating shifts and need to stay alert/awake, etc...and I can see how they would do that quite easily.

 

[Dr Justin Saya MD]

Hello Dr. Saya-

I have tried both provigil and nuvigil. They both make me feel like I took a stimulant, but they certainly had no effect on my lack of libido. Just curious - has anyone ever had either of those drugs help with libido? I mean, they are for folks with narcolepsy or folks that work rotating shifts and need to stay alert/awake, etc...and I can see how they would do that quite easily.

I have seen them improve libido several times. Interestingly, from my own experience I've seen generic modafinil work better than brand name provigil...though I'm sure it's likely coincidental and/or circumstantial specific to the cases I've seen. The guys who experience better libido with those meds may be due to dopamine enhancement (blocks re-uptake) or perhaps simply due to better energy from the stimulant effect. Libido is so multifactorial that it's a difficult nut to crack for some. Having a partner with a healthy libido goes a long way too.

 

[Tommy Wall]

I don´t follow you very well. Buspirone (Buspar) and Bupropion are different. Bupropion can conteract the side effect of SSRI such libido problems (though Buspar in not a SSRI). Bupropion acts as an norepinephrine-dopamine reuptake inhibitor (NDRI)

 

[Dr Justin Saya MD]

I don´t follow you very well. Buspirone (Buspar) and Bupropion are different. Bupropion can conteract the side effect of SSRI such libido problems (though Buspar in not a SSRI). Bupropion acts as an norepinephrine-dopamine reuptake inhibitor (NDRI)

Read about the MOA of Lybridos (testosterone + buspirone) for female HSDD (hypoactive sexual desire disorder). Granted OP isn't a female, but proposed MOA is valid for males as well.