Cyproheptadine treatment of ED induced by SRis

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I could give this a try. I read a bit about it, it’s said to make you sleepy, so at least it might help me sleep if nothing else.


Got very hard erections after taking it one day.
I really doubt the problem is 5AR related.


Did you get any side effect from it?


No. But it can screw neurotransmitter balance as its been trialed as antipsychotic and it depletes your serotonin and other neurotrasmitters. And of course there are other possible side effects. And it’s sedative, only take it before going to sleep.


Are ypu going to keep taking it?


I am still taking it, and its a huge breakthrough for me in terms of erection quality. Erections are back 80-100%. Some improvements in libido , but its still lacking. It could be serotonin and E2 balance thats playing a role. Serotonin is also dependant on E2 levels, which I have above normal. The fact is at the moment the strength of erections are pre PAS. But still no morning wood. I have occasional morning wood when it feels like i want to urinate, but its doesnt feel natural like pre pas. Besides that, sensation feels normal. Cyproheptadine is antagonist of 5HT2A, 5HT2C and 5HT2B. Some theory sugggests its only 5HT2C thats responsible for possible sexual dysfunction. So it might be better to try selective inverse agonist of 5HT2C instead of bombarding all receptors.


Little update. Done some more research. I can tell that my erection was very hard while on cyproheptadine and I could maintain it longer than pre PAS, even without physical stimulation. I stopped the med and the effect is diminishing unfortunately. But I will try more selective drug in the near future, because cypro bombarding too many unnecessary receptors. There is also evidence isotretinoin is upregulating 5HT1A, which has a negative effect on Sexual behaviour.
I am interested particularly in 5HT1A and 5HT2C due to following reasons:

Downregulation of 5HT1A revereses ED.

The present study demonstrates that adjunctive treatment with a 5-HT1A antagonist not only can reverse SSRI-induced sexual dysfunction, but may also prevent these side-effects when co-administered with a SSRI.

Upregulation of 5HT2C induces erection.

Activation of 5-HT2C receptor subtype has been reported to mediate numerous effects, such as penile erection.[42][43] Based on multiple studies, results show that several 5-HT2C receptor agonists, including mCPP and YM348 induce penile erections in rats,[44] but mCPP seems to mimic both vasodilation and vasoconstriction. The vasodilator action is mediated by 5-HT1D receptors, whereas the vasoconstriction effect involves 5-HT2 receptor activation…