Taking multiple meds - Now have stinging ejaculation

[CMT23]

About 5 weeks ago I started taking Uroxatral 10mg at night. Then 3 weeks ago I started taking Imipramine (Tofranil) 25mg for first week, then 50mg, and now 75mg before sleep. Three weeks ago I also started taking Deanxit for anxiety as the doc thought it would be useful.

Last week I was thrilled to have 4 days in a row of almost feeling completely symptom free! That was followed with 2 days of having symptoms again, but not extremely bad. Anyway, I am 9 months into the Wise Anderson Protocol also so I don't know if this result was from that or the meds. My plan was to just keep doing everything. BUT I noticed 2 weeks ago that ejaculation was almost not at all pleasurable with a stinging sensation in the tip of the penis. In 16 years I have never had this symptom. Usually I just feel a sensation of needing to urinate AFTER ejaculation, but ejaculation itself feels more or less normal.

I have read today that Imipramine can cause painful ejaculation and that this goes away after stopping the med or switching to another antidepressant. So I am thinking to stop taking it for a week and see what happens. I'm wondering if anyone else has had a similar experience or if Uroxatral or Deanxit could cause this stinging during ejaculation.

It's really bittersweet as I was becoming convinced that finally something I was doing/taking was working and now I have to admit that this major discomfort during ejaculation is a problem that can't be ignored. I'm really, really hoping that when I stop the Imipramine and Deanxit that within a few days the ejaculation will feel normal and I will find that my symptoms are still feeling good by way of the Uroxatral/Protocol.

Thank you for any comments.

[webslave]

Deanxit is a mixture of Flupentixol and Melitracen.

• Melitracen is similar to amitriptyline (Elavil)
• Flupentixol is a antipsychotic/antidepressant drug and a weak anticholinergic.

Unfortunately, imipramine possesses anticholinergic properties as well. So the combined anticholinergic activity of imipramine + Deanxit is probably causing this problem, just as the anticholinergic activity of first-generation antihistamines does for our patient group (there are threads on the antihistamine hydroxyzine discussing this side effect).

Try to get the Deanxit changed to amitriptyline, and step down the dose of imipramine, is all I can suggest (but ask your doctor first).

[CMT23]

Thanks very much for this. I really felt that the Imipramine might be helping (since I took in 1998 and made a note to myself then that it felt better and since I just had the 3 or 4 days of feeling awesome) so I was discouraged to find this side effect. It's really been freaking me out - making me think that maybe I have developed another seemingly permanent symptom!

I'm happy that it may be the combination of Deanxit and Imipramine together. I am seeing my doctor in a few days and will see what she thinks. I will stop the Deanxit for now - it is not supposed to be used for more than a few months anyway.

Is combining Imipramine and Amitriptyline a normal treatment plan?

Thanks again. This forum is a godsend. Stinging on ejaculation is not a subject matter that you can discuss with many people!

[webslave]

Is combining Imipramine and amitriptyline a normal treatment plan?

No, not really. An even better plan would be to cut the Deanxit and step down the Imipramine to 50mg and see how you go, for starters. These drugs all do more or less the same thing, so best not to double up. Only add amitriptyline if advised by doctor.

[CMT23]

Okay, will do this and report back in a few days. I hope I am able to tolerate the 50mg Imipramine on it's own and that that gives me the same mental lift that I am experiencing now. Somehow feeling a little happier seems to help the intensity of the symptoms to reduce.

The doctor is a psychologist and basically will prescribe what I think I need within reason. I'd rather take one thing at a time so as to be able to reliably measure the side effects.

[CMT23]

Just wanted to post a quick update. After stopping Deanxit and dropping to 50mg Tofranil, ejaculation feels 85% or so normal. So that's a big relief. Unfortunately I now don't feel the same boost in mood or the same improvement in symptoms that I was feeling when I was on 75mg Tofranil and Deanxit 2 x daily. So I have gone up to 75mg Tofranil and we will see what that does after another week or so.

My doc said that any antidepressant in higher doses can cause the stinging ejaculation. Webslave, is that your experience? You seem to have been saying that some do not have this effect. My doc will basically work with me - like most she has no clue about this and is willing to prescribe within reason to see what helps.

Still taking Xatral each night. Another 6 weeks to go before I reach 3 months. And still do the protocol religiously. Ultimately I think that is what will bring a big reduction in symptoms, but if pills can bring some relief along the way, then I am all for it.

[webslave]

My doc said that any antidepressant in higher doses can cause the stinging ejaculation. Webslave, is that your experience? You seem to have been saying that some do not have this effect.

Yes, it's true what he says. Look up the drug on the internet and check for the words "anticholinergic", "antimuscarinic" and "difficulty urinating".

[CMT23]

My doc said that any antidepressant in higher doses can cause the stinging ejaculation. Webslave, is that your experience? You seem to have been saying that some do not have this effect.

Yes, it's true what he says. Look up the drug on the internet and check for the words "anticholinergic", "antimuscarinic" and "difficulty urinating".

It's really a big let down. I felt enormous relief for four days after a few weeks of the Deanxit and Tofranil. But then I had to put up with stinging and burning ejaculation. So stopped the Deanxit and dropped to 50mg Tofranil. That relief subsided. Went up to 75mg Tofranil 5 days now and didn't feel any real relief. And today my symptoms are horrible.

I hope I can find some sort of solution where I feel some of the relief without that horrible side effect. There has got to be the right combination and dosage out there. I felt it with what I was doing, but I just don't want that side effect. Waiting for my doc to tell me if she has any ideas. Luckily it's quick and easy to see/communicate with the doctors over here. I'll post an update soon.

[webslave]

You can experiment by going back to the full dosages of all meds, then adding an alpha blocker to relax smooth muscle in the area. BUT ask your doctor first!

[CMT23]

Hi Webslave. Thanks for this. I was (and still am) actually on Xatral - about 6 weeks already. So Imipramine 75mg, Deanxit 2 x day, and Xatral seemed to do something. Certainly I hadn't had 4 days in a row where I felt almost normal for years. But stinging ejaculation is a tough trade off!

Unfortunately I don't have any doc that I feel confident in at all. I suppose they are good for telling me what not to combine and for helping to spot serious reactions to a med, but I describe my symptoms and they are perplexed. I stopped going to Urologists here as they were telling me that there simply isn't anything wrong with me and that's that. (Peeing every hour today and feel like I need to urinate constantly and there is nothing wrong with me. Thanks doc).

Anyway, I have emailed the psychologist who prescribed the Tofranil and Deanxit to see if she has any other ideas that might give similar relief without the side effects. If I go back to what was seeming to make me feel better what are the chances that the stinging ejaculation goes away on its own?

Also, she said that sensation was not the result of a physical change, but actually just a change in the brain chemicals and thus the way that orgasm is perceived. Is that your understanding?

[webslave]

Also, she said that sensation was not the result of a physical change, but actually just a change in the brain chemicals and thus the way that orgasm is perceived. Is that your understanding?

No, that's not my understanding of how anticholinergic effects work. But yes, persisting with the regimen may lead to a cessation of symptoms. There are a few drugs that operate that way, i.e. the side effects lessen with time. If I remember correctly, we have a few accounts on the forum of men who had similar symptoms subside while taking antihistamines. Certainly wouldn't hurt too much to try.

[CMT23]

Also, she said that sensation was not the result of a physical change, but actually just a change in the brain chemicals and thus the way that orgasm is perceived. Is that your understanding?

No, that's not my understanding of how anticholinergic effects work. But yes, persisting with the regimen may lead to a cessation of symptoms. There are a few drugs that operate that way, i.e. the side effects lessen with time. If I remember correctly, we have a few accounts on the forum of men who had similar symptoms subside while taking antihistamines. Certainly wouldn't hurt too much to try.

I think I will try the adding the Deanxit 2 x day back to my regiment of 75mg tofranil. It sounds like I can't damage myself i.e. the stinging ejaculation will stop when I stop taking the drugs. And maybe my body will adjust and I won't have the side effect. I was also thinking that perhaps I don't need the tofranil at all. I guess the only way to know is to see if I start to have the same relief that i experienced previously and if so, then slowly cut down the tofranil.

Thanks for the comments here. I'll update again soon.

[CMT23]

So after 3 more weeks of Deanxit, Imipramine and Xatral, ejaculation feels almost normal. A little weird sometimes for a few seconds, but that unmistakable stinging sensation is gone. As I posted in another thread, overall I feel better. (I am also doing the protocol and internal trigger point every evening). I am getting a few hours most mornings where I feel almost normal. Then in the late afternoon evening, not so good, but my body seems to be able to reset rather than go on a multi day or week flare. So that is promising.

But yesterday a new issue developed. My semen has always looked exactly the same my whole life. Yesterday before ejaculating it looked like a significant amount of some liquid leaked out and then it looked like some semen actually leaked out. Then after ejaculation, the semen had lots of white clumps. I've never seen anything like it before. It was kind of the texture of tapioca.

Since I am taking three meds, I don't know which one (if any) may be the culprit. I googled it of course and apparently it's not serious. There is no blood and no other colors present. But it just seems beyond weird and I'm prone to worry about this kind of thing.

Sometimes I really wish I just had a problem with my elbow.

I've been taking the Xatral for 2 months and planned on one more before deciding whether or not to continue. Could an Alpha Blocker have this effect on semen (after 2 months of taking it?)

Anyway, if anyone has any ideas or has experienced this, comments are welcome.

[webslave]

Could be corpora amylacea, but most probably just inspissated secretions escaping the gland (or seminal vesicles) now that the ducts are opening under the current regimen.

[CMT23]

Well 2 days later and it is back to normal. Thank God. Are the ducts opening a good sign?