S/x on Dr/gs Reference
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Clinical + experiential evidence

Dopaminergics (apomorphine, cabergoline)

Off-label treatment·Sexual-dysfunction treatments

Effect across the cycle

DesireFacilitatory: Dopaminergic tone raises desire.
ArousalFacilitatory: Apomorphine acts on central pro-erectile pathways.
PerformanceFacilitatory: Pro-erectile effect studied for erectile dysfunction.
ClimaxMixed: Variable; prolactin-lowering can restore function.
ExperienceFacilitatory: Restored reward and function.
MemoryNeutral: Not a memory factor.

Mechanism

Apomorphine (D1/D2 agonist) acts on hypothalamic pro-erectile pathways. Cabergoline and bromocriptine (D2 agonists) treat hyperprolactinemia-related dysfunction by lowering prolactin. Dopaminergic tone facilitates desire, arousal and genital reflexes.

Pharmacokinetics
Apomorphine sublingual, fast-acting; cabergoline long-acting.
Reversibility
Prolactin-lowering effect reverses hyperprolactinemic dysfunction.

Sex differences & notes

Cabergoline can rarely cause priapism via alpha-1 antagonism.

Key sources

  • Wiley — dopaminergic modulation of ED (Simonsen 2016)