Dopamine agonists

By Serge Kreutz

Dopamine agonists have been around for many decades, and their pro-libido effect has been known for a long time. The assortment of dopamine agonists includes bromocriptine, cabergoline, pergolide, pramipexole, lisuride, apomorphine, and a few more.

Apomorphine (brand name: Uprima) was sold in Europe as a medication for erectile dysfunction. But it was wrong marketing. Dopamine agonists don’t work for erections like phosphodiesterase inhibitors. They work on libido, at least for some people who use them.

Uprima typically is a disappointment for men whose problems are primarily vascular. Uprima was sold as a medication for erectile dysfunction mainly because erectile dysfunction is an accepted medical condition, while low libido is not.

While sildenafil citrate and yohimbine work on erections, and while elevating testosterone levels is of an unpredictable pro-sexual nature, dopamine agonists can enhance sexual excitement, though also not reliably.

Because dopamine agonists suppress the hormone prolactin, which in turn suppresses testosterone, dopamine agonists can, in people with elevated prolactin levels, function in the same way as a testosterone replacement therapy would. This mostly happens in patients with pituitary cancer, which typically expresses itself in strongly elevated prolactin levels. Those afflicted by the disease have very low testosterone levels. Thus, for them, dopaminergic agents work as hormonal therapy. The hormonal effects are less pronounced, or totally absent, in healthy subjects.