Can I take Pramipexole in the long-term to relieve my anxiety and improve sexual problems caused by Effexor?

Q. Can Pramipexole be taken to relieve anxiety and improve sexual side effects caused by Effexor?

Answered by
Dr. Seikhoo Bishnui
and medically reviewed by iCliniq medical review team.
This is a premium question & answer published on Mar 02, 2023

Hello doctor,

I have been taking medication for chronic anxiety and GAD to control my anxiety and prevent relapse for the past few years. I now take Effexor XR 150 milligrams daily in the morning and Crestor 10 milligrams daily in the morning (for controlling the lipid profile), and recently the doctor has added Telmisartan 80 milligrams daily in the morning (because of high blood pressure).

I have used nearly all types of SSRIs for the past few years, but none of the medicines were able to control my anxiety completely. However, the medicine Effexor benefitted me. It treated my anxiety completely and controlled the whole case with the least side effects regarding weight gain and fatigue. Overall, Effexor was very nice unless for the sexual aspects.

I am doing pretty well on Effexor XR 150 milligrams in controlling the whole case of anxiety. I do not think about changing or stopping it or even decreasing this dose. Still, I have had a few continued symptoms since I started Effexor a few months ago. These are erectile dysfunction, low libido, anorgasmia, and little semen volume during ejaculation. I feel like a machine, not a human, without any feelings during sexual intercourse. There is no pleasure in ejaculation. Also, I have abnormal sleeping during the night, waking up many times during the night, and insomnia.

I also tried Buspar 30 milligrams daily divided into three doses, but it did not help much regarding those symptoms of sexual side effects. My doctor suggested another drug called low dose dopamine agonist (Pramipexole) before bedtime along with Cialis or Viagra on demand.

I wanted to ask a few questions.

1) What do you think about these suggestions as an add-on to resolve these sexual problems?

2) Can they be taken in the long term?

3) Is it true Pramipexole can harm valves and the heart?

4) Can Pramipexole or Buspar lead to dementia in the long term?

Please help.



Welcome to

I went through your query and understood your concern.

1) If we consider mood symptoms, then you are doing good. You have reported improved anxiety symptoms and depression with Effexor (serotonin and norepinephrine reuptake inhibitors). The addition of Buspirone (anxiolytic) can help to control your anxiety. But you have anxiety controlled even with Effexor. But to some extent, that can positively affect sexual side effects. Relief of anxiety also improves libido. Pramipax (dopamine agonist) can also help with persistent depressive symptoms. It will not cause many benefits in sexual side effects. So, I suggest Pramipax and also Buspirone are overall safe to use. Weight gain and metabolic side effects, too, are very less.

2) Yes, these can be taken in the long term. I suggest there is no significant effect on cardiac valves. Both Buspirone and Pramipax are safe to use. The risk of cognitive decline can occur with Pramipax, but the risk is low. With Buspirone, the risk is almost nil.

3) For depression, I suggest you take a tablet of Pramipax 0.5 milligrams.

4) I also suggest taking a Trazodone tablet (serotonin modulator). The drug is safe to use. Even safe for people more than 65 years of age. The drug helps a lot with sleep and should also help you. Also, it causes slight improvement in sexual functions. This drug should benefit you more than Pramipax or Buspirone as long as sexual issues are considered. Pramipax helps mainly with depression symptoms.

Kindly consult a specialist doctor, talk with them, and take medicines with their consent.

I hope this has helped you.

Thanks and regards.

Hello doctor,

Thank you for your reply.

Which is better and safe with the least side effects: Pramipax or Ropinirole?

Please help.



Welcome back to

I prefer Pramipax. It has been in use for a few years in depressive episodes. I am using this drug with my patients, and they respond to this drug. In terms of tolerance, Pramipax is better. However, nausea and vomiting are seen in most individuals who start this drug. This can be minimized by taking this drug with antacids like Pantoprazole (antacid).

Kindly consult a specialist doctor, talk with them, and take medicines with their consent.

I hope this has helped you.

Thanks and regards.

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