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Post-SSRI sexual dysfunction (PSSD)

PSSD sex libido orgasm

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#1 Altostrata

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Posted 16 March 2011 - 07:33 AM

See journal articles about PSSD in Papers about Post-SSRI Sexual Disorder (PSSD)

 

Please note that SurvivingAntidepressants is a site for tapering and recovery from withdrawal syndrome. While we see PSSD sometimes as an aspect of withdrawal syndrome (and we see gradual recovery from it as well as withdrawal syndrome), this site is not specifically for discussion of treatment of PSSD or its neurological origins (which at this time are highly speculative).

 

If you wish to discuss symptoms, theories, and treatment of PSSD, please go to these sites:

 

PSSDforum http://www.pssdforum.com/

 

Yahoo group SSRIsex (log in to http://Yahoo.com to join)

 

Various pages on Rxisk.org


Edited by Altostrata, 04 November 2015 - 11:59 AM.
added pointers to PSSD sites

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#2 branyan

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Posted 27 March 2011 - 09:22 AM

Hey all. New here. Since coming off Lexapro (after being on from Mid 2007 to March 2010) I have experience a slow decline in my sexual function which platuead in about Febuary. Generally speaking I feel unaware of my penis and sexual realm. I feel that has something to do with the pudendal nerve. Even when I can achieve an erection it is mostly numb. I cannot get visually aroused 98% of the time, and would be unable to have sex or feel intimacy at this point. This after enjoying 2 very good sexual relationships while on Lexapro. Keep in mind that the sex declined as the years went on on Lexapro. And I am only 23! Interestingly enough, the only facet of my sexual function that is somewhat intact is the actual orgasm which still feels really good. Anyway. I have been over to the YAHOO PSSD group and seen the despair over there. It sounds like this is a permanent deal, although I have had many people try to convince me otherwise. Any success stories out there>

Edited by surviving, 27 March 2011 - 09:58 AM.
merged with existing topic

2000 Lamictal 

Zoloft 
2001-2003 Still Zoloft
2004 Neurotin, LexaproSeroquel 
2005 OFF MEDS ENTIRELY
2006 -2009 Lexapro
March 2010 Off Lexapro on Zyprexa 
November 2010 off Zyprexa
Off ALL MEDICATION -Jan 22nd 2011

 

 

 


#3 Claudius

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Posted 29 March 2011 - 10:51 AM

I am not sure, but I have a feeling that PSSD is just one of the energetic distortions that occurs due to SSRI damage. For my my system was so distorted that I did not even think about sex. I work now with a kinesiologist who tries to bring those energies back in balance. And while I am still in protracted WD, this is a long and arduous road. But sometimes I feel energy and libido returning. I think that massage- and other body oriented therapy is the key to many levels of healing. And though my seks drive is srely not what it should be, I hope that it will get back finally. But I have to admit that my libido had already diminished before going on Paxil... while it used to be enormous. Therefore I think that my body energie flows were already out of sync due to other reasons, and this gave the problems that the "doctor" diagnosed as "depression"...

10 mg Paxil/Seroxat since 2002
several attempts to quit since 2004
Quit c/t again Oktober 2007, in protracted w/d since then
after 3.5 years slight improvement but still on the road

after 6 years pretty much recovered but still some nasty residual sypmtons
We are not lost even though it may feel that way. We are in transition.


#4 strawberry17

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Posted 18 June 2011 - 09:45 AM

Sexual dysfunction was a huge issue for me on SSRI's which is one of the main reasons I was so determined to get off them. I have been lucky in that normal sexual functioning has been restored since I have been tapering.

*** Please note this is not medical advice,discuss any decisions about your medical care with a knowledgeable medical practitioner***





http://prozacwithdrawal.blogspot.com/

Original drug was sertraline/Zoloft, switched to Prozac in 2007.

Tapering from 5mls liquid prozac since Feb 2008, got down to 0.85ml 23/09/2012, reinstated back to 1ml(4mg) 07/11/2012, didn't appear to work, upped to 1.05ml 17/11/2012, back down to 1ml 12/12/2012 didn't work, up to 1.30ml 16/3/2013 didn't work, bumped up to 2ml (8mg) 4/4/2013 didn't work, reinstated Sertraline (Zoloft) 50mg, feeling better now. Been on the antidepressant merry go round since November 1998.


#5 Altostrata

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Posted 18 June 2011 - 09:59 AM

Me, too, strawberry, though it took several years. Claudius, I do think you're right -- body work can help the body heal. For what it's worth, that's how my PSSD seemed to resolve -- some very faint glimmers at first, then more and more.
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#6 Razzle

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Posted 18 June 2011 - 04:05 PM

I gave a call to a old colleague researcher at a Primate Research Center today. I know they have been working on epigenetics related to psyche drugs and he said they are interested in protracted sexual dysfunction from SSRi use. While they are in very early stages he said preliminary suggestions are inhibition of dopaminergic neurotransmission resulting in described persistent sexual dysfunction. If this turns out to be true there are a host of dopaminergic drugs that could be tried. We also know that hard aerobic exercise increases dopamine while stress, alcohol, cigarettes, caffeine, and sugar seem to decrease it. I think this is far from hopeless - dopamine receptors and brain production of dopamine can regenerate. Looking at stimulant addicts we see this potential

#7 Altostrata

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Posted 19 June 2011 - 07:17 AM

Razzle, I do not believe you are going in the right direction with your thinking about PSSD. It is not caused by stress or neuromuscular issues. It is related to the sexual dysfunction caused by SSRIs in general, a recognized and extremely common side effect, and emotional blunting, thought to be due to serotonergic downregulation. As for dopamine dysregulation, it's probably not that simple. PSSD is probably caused by a wider-ranging hormonal imbalance caused by the dysregulated serotonergic component. Sexual arousal and orgasm depend on a complex, delicately timed interplay of many hormones. It is unclear whether SSRIs cause an increase in dopamine or decrease. It is unlikely a dopamine-increasing pill is going to be the silver bullet for this. What it the name of the Primate Research Center doing this research?
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#8 cinephile

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Posted 19 June 2011 - 10:27 AM

Has anyone heard about inositol? I've read on other forums that some people with PSSD have had some success with it. Supposedly it helps resensitize 5ht-2 receptors (serotonin receptors) which are downregulated (desensitized) with SSRIs. In a crude analogy, it almost seems like a (partial) antidote to SSRIs.

I'm intensely interested in this as I currently suffer from bad emotional blunting and sexual sides from the f***ing Effexor I took nearly five years ago. Even getting off the Effexor almost four years ago (I was only on it for a year) hasn't helped remit my symptoms at all. I'm just hoping that getting off the Lexapro I'm currently on will help these symptoms as they are often nearly unbearable. They just make everything 1000x tougher than they need to be.

HOWEVER, my sex drive and anhedonia can occasionally remit, either spontaneously or by meditation or exercise. I'll never forget a few days last fall where for some reason, my symptoms completely remitted! I stepped outside a restaurant and the crisp breeze felt better than it had IN YEARS. And my sexual fantasies, genital sensitivity and libido were BACK. But it was all bittersweet as it only lasted a few days, and then it was all back to square zero. The only thing I can think of as to why that happened was I was exercising regularly (actually, the exercise was from moving into my new apartment and with all the heavy lifting of boxes and such).

Also, one time while exercising on the elliptical machine at the gym my penis became completely sensitized, so much so that I nearly had an orgasm! I actually had to get off the machine it was so intense! I honestly have never had that happen and it was just strange. To this day I don't know what happened.

I have also had one isolated incident of hypersexuality brought on by vigorous exercise where for a few days my sex drive was the highest it ever was, almost to the point where it was bothersome! I literally couldn't stop craving sex and my orgasms were overpoweringly good.

Also, meditation has sporadically induced similar awakenings of my old self. A couple of meditation sessions have brought about profound reversals of my emotional blunting and libido issues, but I honestly don't know why the vast majority of my meditation sessions don't have this effect. Usually they just bring about a slight calming feeling.

In addition to these incidents, my libido and emotions can spontaneously spring back, seemingly for no reason. This happens every 2-3 months and can last for either a day or up to five days.

So where the hell does this all leave me? Who knows. All I do know for sure is that 90% of the time I feel like a shell of my former self, and nothing works reliably to ease my symptoms. I'm just so incredibly angry and scared that PSSD is still not even remotely acknowledged by psychiatry. But I do know of people who recover and at least realize it's ridiculous to think my life is over at such a young age. It's just really tough some days.
Been on SSRIs since 1998:
1998-2005: Paxil in varying doses
2005-present: Lexapro.
2006-early '08: Effexor AND Lexapro! Good thing I got off the Effexor rather quickly (within a year).

**PSYCHIATRY: TAKE YOUR CHEMICAL IMBALANCE AND CHOKE ON IT!
APA=FUBAR
FDA=SNAFU
NIMH=LMFAO

Currently tapering Lexapro ~10% every month:

STARTING: 15 mg
11/7/10: 13.5 mg
12/7/10: 12.2 mg
1/6/11: 10.9 mg
2/3/11: 9.8 mg
3/3/11: 8.8 mg
4/1/11: 7.8 mg
4/29/11: 7 mg
5/27/11: 6.4 mg
6/24/11: 5.7 mg
7/22/11: 5 mg
8/18/11: 4.5 mg
9/14/11: 4 mg
10/13/11: 3.6 mg
11/9/11: 3.2 mg
12/7/11: 2.6 mg
1/3/12: 2.1 mg
2/2/12: 1.8 mg

#9 Altostrata

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Posted 19 June 2011 - 12:55 PM

cine, those are good signs that your nervous system is recovering.

I would take that information about inositol reversing serotonergic downregulation with a grain of salt. Here's a 1997 study Controlled trials of inositol in psychiatry that may be the source of the information. Note that it was done during at the dawn of the SSRI era, when everything was attributed to serotonin and serotonin receptors.

As near as I can tell, inositol contributes to the maintenance of cell membranes. It has the reputation to be calming. I took it for a while. I also took lecithin, phosphatidylserine (Seriphos), and niacinamide. I made a note that lecithin was calming. (Maybe I'll try it again.)


Razzle -- if you cannot give traceable citations, please do not post vague information about how some authority thinks something, especially alarming or misleading information.

As for the relationship between serotonin, dopamine, and sexual response -- SSRIs affect dozens and probably hundreds of neurotransmitters, neurohormones, hormones, etc., not just the Big Three serotonin, dopamine, and norepinephrine. Many important neurotransmitters and feedback loops haven't even been identified.

SSRIs affect dopamine, true, but that doesn't mean their effect on dopamine has anything whatsoever to do with PSSD. It is more likely some other hormone or group of hormones or feedback loop or timing of hormone release is implicated in PSSD.

The folk wisdom about dopamine is that it is the feel-good hormone, therefore associated with sexual pleasure. This is as true as serotonin being the cheerful hormone.

I would hate that anyone try a dopaminergic, which can cause serious movement disorders, in a misinformed attempt to treat PSSD.
This is not medical advice. Discuss any decisions about your medical care with a knowledgeable medical practitioner.

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#10 Patience

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Posted 19 June 2011 - 07:54 PM

My libido has been mostly absent, but it returned for a few days last month. I got off Celexa primarily because my libido was low, but I didn't count on it becoming non-existent after I got off it. I've been off for three years. My low/non-existent libido has been pretty challenging for my husband. I thought it was permanent, too, but I was watching TV last month and found myself noticing things about some men on the show we were watching that attracted me. Then it became a strong desire to, well, you know what. This gives me hope that it come can back. My thinking is that there are so many functions in the body that need healing that the sex drive comes last. Think about it from an evolutionary standpoint. If we are too sick to take care of a baby, much less carry it to term (for females), then it would make sense for the body to shut off the libido until we are healthy enough to procreate. Just my two cents worth. I'd stay away from that Yahoo group. They are pretty negative that and can leave you feeling doomed.
1989 to 2008: Prozac then Paxil then Celexa.
Numerous attempts to quit.
Then I got off the SSRI poop-out merry-go-round.
11-12 week taper.


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If you're going through hell, keep walking
The only way out is through

#11 Phil

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Posted 08 November 2011 - 01:49 AM

I wasn't sure where to post this, apologies if it's not appropriate here.
I came across this on the Dr Bob forums. They are discussing Tianeptine withdrawal but the mentions of SSRIs and gene expression caught my eye.
I'd appreciate others thoughts on this. I mean changes in gene expression is quite "big", isn't it?
I can't help but wonder...what if SSRIs actually change the way the brain "take in" serotonin, so that when they are removed, the brain is left with this change intact, but without the means of taking up serotonin from the body?

I know there is the other theory that SSRIs cause the brain to reduce its number of receptors. But I suppose this also makes logical sense.

Is there anyone out there who is actually knowledgeable about these things and studying it? Or are we just left with theories?


http://www.dr-bob.or...sgs/939916.html

There is a support group on Yahoo named "SSRI Sex" for those with what appears to be either long-term or permanent sexual dysfunction related to past SSRI use. They are of the thinking that long-term SSRI use may cause changes in gene expression. I'm not sure that it is permanent. It might just take some months or years to come back.

It's also possible that the body just gets used to SSRIs increasing the amount of serotonin that when withdrawn, the body doesn't immediately respond by producing enough serotonin again. Low serotonin levels can also cause sexual dysfunction, although I do know that SSRIs increase by up to 50% the number of dopamine transporters after 4 weeks of use. Dopamine then drops and that will definitely cause sexual dysfunction, apathy, emotional blunting, weight gain and lack of motivation.

I hope tianeptine doesn't do this too. It's said to not do that. In fact, if I take more tianeptine than usual, my libido sometimes increases briefly, but over the long term it seems that my libido keeps dropping. It is almost nonexistent now and I'm not even 40 years of age yet.

Maybe it is my age? I have also read that low cholesterol levels can be problematic since cholesterol is involved in the synthesis of sex hormones. Low cholesterol is also linked with depression and even aggression. Someone told me that cholesterol is a precursor to Vitamin D and most folks just don't get enough Vitamin D.

I should probably have my Vitamin D, cholesterol, prolactin and testosterone levels checked.

The members of the SSRI Sex group have often reported having low testosterone lab results or high prolactin.


Off Lexapro since 3rd November 2011.

#12 Altostrata

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Posted 08 November 2011 - 08:40 AM

Hi, Phil. Thanks for posting this. Yes, SSRIsex has been around for a very long time. (Sorry if my topic categories seem arbitrary. You don't have to apologize when you post. I moved this to Symptoms because sexual dysfunction can be a symptom in withdrawal.)
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#13 Maybe

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Posted 08 November 2011 - 08:57 AM

As far as I understand the topic of gene expression, it is not permanent. I think it happens all the time, because the body is adapting to it's environment. Nutrition for example can change the expression of genes. If the influence of SSRIs was permanent, there weren't that many people who recovered from withdrawl.

End of 2008: Remeron 15mg for around 2 months. Unorthodox taper, no problems.
End of August 2009: Lexapro 10mg for only 4 days. Panic attack after 3 pills. Severe gastro problems in the morning for 3 days after last pill. 2 weeks later strong w/d symptoms set in.

Acute WD lasted around 3.5 years. I am feeling much better today, 5.5 years out, but still have some symptoms left.


#14 Altostrata

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Posted 08 November 2011 - 10:20 AM

PSSD is not permanent. I had it for several years and recovered from it.
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#15 Altostrata

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Posted 19 November 2011 - 10:53 AM

I had absolute PSSD for about 3 years, then it started to go away. Lately, I'm definitely having signs of more libido -- and I'm a post-menopausal woman. Here's a young man who believes acupuncture helped him recover from PSSD in about a year: http://ssrisexdysfun...n.blogspot.com/
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#16 alexjuice

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Posted 19 November 2011 - 05:10 PM

questions? answers?


So many, sadly, to the first.

So few, sadly, to the second.

When I feel better and am financially stable I want to make PSSD my cause more seriously. For me, the PSSD is maybe the worst thing. I dunno. There are a lot of bad things.

When I think of what I can do someday to help with psych drug aftermath, I always think of this.

In my case, most of my issues are erectile. I've had other problems but the ED has been a fixture. I developed prostate inflammation in w/d. I have altered seminal volume and testicular reaction. Interestingly, I have the torture of sometimeshigh libido without ability to function sexually. Very very upsetting.

Also, I can not take erectile dysfunction medication (pde5 inhibitors) due to the fragile nature of my brain + the construction of the elements of my eyeball. I temporarily lost 90% of my vision and damaged my left eye after taking Cialis and am at risk of permanent blindness should I have another episode.

I have heard about the Yahoo group and I won't be visiting it.

It does seem that exercise may help, from what I've read here and elsewhere. My issues are generally improving, though if a typical guy woke up with my problems he'd place his life on hold while searching for solution. I don't plan to take any drugs or compounds to assist at this point. I will see where I am in another year.... Another year, jeez, how long does it go on?

Alex

"Well my ship's been split to splinters and it's sinking fast
I'm drowning in the poison, got no future, got no past
But my heart is not weary, it's light and it's free
I've got nothing but affection for all those who sailed with me.

Everybody's moving, if they ain't already there
Everybody's got to move somewhere
Stick with me baby, stick with me anyhow
Things should start to get interesting right about now."

- Zimmerman


#17 Absent_damnnardil_*

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Posted 07 December 2011 - 12:50 AM

Any guys out there having the same problem as I am? The first time I was on my anti depressant, I was able to have sex, just not as often as if I were not taking an anti depressant. This second time though, I can't really do anything, although I am still on a very high dose. Does this go away and also does it go away as you decrease the medicine or do you have to wait until you're off of it completely or almost completely? I am worried this time. Thanks. John

#18 Altostrata

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Posted 07 December 2011 - 11:23 AM

dn, I added your post to this topic. What you are describing is PSSD. Yes, people do recover from it. Like all withdrawal symptoms, it can take time.
This is not medical advice. Discuss any decisions about your medical care with a knowledgeable medical practitioner.

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#19 Altostrata

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Posted 07 December 2011 - 11:27 AM

I also want to point out that although the members of SSRIsex have tried for years to find medical treatment for their PSSD, no one has come up with anything that works, and many have further injured themselves by taking various hormones and medications. Most of them also have withdrawal symptoms, although they may not recognize their situation as prolonged withdrawal syndrome. However, members do report resolution of PSSD given time -- like other withdrawal symptoms.
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#20 Altostrata

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Posted 04 February 2012 - 10:56 AM

In response to a request for more detail about my PSSD:

I had the absolute genital anesthesia at first for quite a while, then that slowly went away, and sexual response gradually returned. This took several years. It's still improving.

I'm a menopausal woman. My hormonal situation may not be the same as yours. I got a little benefit from microdoses of DHEA (an unpredictable prohormone thought to turn into testosterone in women) but it gave me whiskers so I stopped it. I got a little more benefit from microdoses of estrogen in the Menostar patch, but it also helped other symptoms, such as sleep and hot flushes, which may have had something to do with sexual function recovery as well.

If you are younger, I suspect your recovery may be faster.

I would caution everyone, however, from experimenting with drugs to push PSSD recovery along. They may make other withdrawal symptoms worse.

PSSD is only one manifestation of withdrawal syndrome, which is basically autonomic dysregulation. Trying various drugs for PSSD can interfere with your body's attempt to correct its autonomic functioning. This will make recovering from PSSD and the rest of withdrawal syndrome more difficult and take longer.

To recover from PSSD and withdrawal syndrome, do your best to improve your sleep (if you have withdrawal insomnia) and calm your nervous system with stress-reduction techniques, healthy diet, and a positive attitude.

We are all victims of medical error, but we can take charge of our recoveries. Unpatient yourself and take care of yourself to support your recovery.
This is not medical advice. Discuss any decisions about your medical care with a knowledgeable medical practitioner.

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#21 missworldoxo

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Posted 04 June 2012 - 09:03 PM


Hi there,

I'm new to the group and have a couple of questions.

I was diagnosed with a panic disorder at 11 years old and put on Clomipramine soon after. Years later when I started having sex, I noticed that I was unable to orgasm but I just assumed that I was one of the many many women who just couldn't. Sex still felt good, and no finale was the only problem.

When I turned 18 my medication was changed from Clomipramine to Sertraline. There was no change in my sex drive or ability to orgasm with the change in medication. Now, at 24 years old, my psychiatrist recommended that since I've been on meds for so long that I try and see how life is without them given the fact that I've been doing so well. My original dose was 75 mgs, which was reduced to 50 mgs with little to no problems a few months ago. I was moody for a couple of days and extra anxious for a week and then it tapered off to me feeling normal again.

This past week after a trip to the psychiatrist I went from 50 mgs to 25 mgs. There has been a major increase in my anxiety level, but that's not whats worrying me the most as I have become accustomed to dealing with these panicky feelings. I have always enjoyed sex, and since the last decrease in my medication there has been problems with me staying adequetly lubricated. This has never been a problem for me and it has been extremely frustrating for both me and my boyfriend. I was hopeful that decreasing my medication would increase my pleasure and possibly allow me to orgasm, rather than make sex frustrating and feeling as if my body isn't working properly.

It's only been a week, so I will give it more time and see if it straightens itself out, but my questions are as follows: Is this Post SSRI Sexual Dysfunction or just a withdrawal symptom? Why didn't this occur when my medication was originally changed to Sertraline or when the dose was changed from 75 mgs to 50 mgs? Is my inability to orgasm part of this dysfunction or am I just one of those women who can't? I think I'd rather be stuck on meds that I possibly don't need than to think about living with these kinds of sexual problems.

Any comments, insights, or advice would be much appreciated!

#22 Altostrata

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Posted 05 June 2012 - 05:33 PM

Welcome, missworldoxo.

It sounds to me like you have been having a classic adverse effect of antidepressants, inability to orgasm.

My guess is you are not "one of those women" who can't! It sounds like you have a lot of interest in sex even through the drug effects.

If you are still taking an antidepressant, by definition, you don't have Post-SSRI Sexual Dysfunction (PSSD). That is sexual dysfunction that doesn't recover after you are completely off the medication for a significant amount of time.

Little is known about how antidepressants interfere with sexual functioning, or why some people get this and others don't. The incidence is quite high, maybe as much as 50%.

One thing is clear from antidepressant-induced sexual dysfunctioning: These drugs are hormonal disruptors.

Since you decreased in dosage, the drug is disrupting your hormones in a different way. You may wish to use a lubricant temporarily. Restoring the drug dosage may or may not restore your own lubrication. Hopefully, once you're off the medication, your nervous system and hormonal systems will soon re-set to normal settings.

I'm concerned about those panicky feelings. These sound like withdrawal symptoms. They're a red flag you're reducing too quickly. Please consider slowing down so as not to put additional stress on your nervous system.
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#23 Barbarannamated

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Posted 05 June 2012 - 06:16 PM

Hi Missworldxo, Welcome to the group. The first part of your post is a topic that's near and not-so-dear to my heart as one of those "many women" (49yo). You perfectly describe the stages of interest and arousal, then no follow-thru. You are young and sound very in tune with your feelings and your partner, so it may just take time and getting off of drugs. However, if it doesn't resolve, I encourage you to have reproductive hormones and other endocrine function checked. I've struggled with this before drugs and throughout life and I don't have an answer for you (or myself). I always thought it would resolve itself when the situation was right/partner was right/I relaxed, etc. I'm now almost 50 and, well, it's on my bucket list. I learned a few months ago that I've had many endocrine disorders including premature ovarian failure and I don't know if that has played in. It's difficult to go through life and many relationships wondering what that experience is like and if it might be better in another situation, etc. The pleasure is there to a point, as you describe. It also can get very physically uncomfortable to have buildup and no release. I hope this is helpful in some way.
Pristiq tapered over 8 months ending Spring 2011 after 18 years of polydrugging that began w/Zoloft for fatigue/general malaise (not mood). CURRENT: 1mg Klonopin qhs (SSRI bruxism), 75mg trazodone qhs, various hormonesLitigation for 11 years for Work-related injury, settled 2004. Involuntary medical retirement in 2001 (age 39). 2012 - brain MRI showing diffuse, chronic cerebrovascular damage/demyelination possibly vasculitis/cerebritis. Dx w/autoimmune polyendocrine failure.<p>2013 - Dx w/CNS Sjogren's Lupus (FANA antibodies first appeared in 1997 but missed by doc).

#24 missworldoxo

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Posted 05 June 2012 - 07:50 PM

Thanks so much for your fast responses! Altostrata: Thanks so much for clarifying PSSD for me. Some of the articles left me a little bit confused as to whether it means sexual dysfunction that starts when you come off SSRI's or sexual dysfunction caused by SSRI's that don't go away when the medication is no longer present in your system. I do feel withdrawal symptoms such as nausea, dizziness, and the excess anxiety and panic but they don't seem to be interfering with my day-to-day activities, and I'm able to handle it when it occurs. Whether I'm on the meds or not, anxiety and panic are something that I'm always going to have to deal with. I'm being weaned of the medication slowly and under the supervision of my psychiatrist and don't plan on reducing any further for at least a couple of months (if all goes well this time). I'm just at a point in my life that I really want to give life a try without relying on medication, especially given the fact that I really can't remember what it's like not to be medicated. Hope I haven't given you any cause for worry :) Barbarannamated: Your comments are very helpful! After talking to both my psychiatrist and my pharmacist today my next step will be going to see my family doctor and taking any tests that she may recommend. I wish you luck as well!! I'll keep you updated on my progress, and it helps to know that I'm not the only one going through these types of things.

#25 Altostrata

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Posted 06 June 2012 - 09:53 AM

If you don't mind, missworld, may I move this to the Intro section as your Intro and Updates topic? If you have any withdrawal symptoms that do not go away in a few days, that is a sign your nervous system has been stressed by your taper. You are wise to hold on your tapering until the symptoms go away. If I were you, I'd go very, very slowly with the tapering, probably slower than your doctor recommends.
This is not medical advice. Discuss any decisions about your medical care with a knowledgeable medical practitioner.

"It has become appallingly obvious that our technology has surpassed our humanity." -- Albert Einstein

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#26 enufodat

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Posted 30 June 2012 - 10:37 AM

Anyone out there have a handle on the possibility that PSSD may be not (or not simply) neurotransmitter or hormone-related, but tied to changes in genetic expression? (Genes are not nearly as determinative as the current conventional wisdom would have it, they can "express" (act) differently when triggered by a chemical "switch," and these changes can be persistent or permanent.) Here is one article suggesting it as a possiBILity. http://www.sciencedi...306987709002916 I've also seen elsewhere an article that found empirical evidence for it, but it was a while ago and I don't have the reference. Relatedly, how common is it for sexual dysfunction to actually worsen post-withdrawal? I thought mine was improving a bit but it seems to have slid backwards markedly in the past month or two. Tx, E

1994-2009 50-100 mg Zoloft (plus tried Effexor, Lexapro, Wellbutrin at times)
5/'09-7/'09 taper off Zoloft
7/'09-12/'09 no zoloft, rough times after ~ 2 mos.
1/'10-6/'10 50 mg zoloft
6/'10-1/'11 slow taper
2/'11-7/'11 off entirely, ok for 2-3 mos., then rough
7/'11-9/'11 50 mg
9/15/'11 - 11/15/'11 taper off
11/15/'11 - 2/'11 clean, doing well but with some PSSD
2/'11 - 6/'11 depression creeps back, fairly significant by May.

6/'14 (long time...!)  life is good, full recovery, at least in terms of SSRI addiction.  Still digging out from the social and professional hole that it all left me in, but despite the loss of far too many years to this business I'm basically doing pretty well.  Still some depression at times, even severe on occasion, but clearly related to past trauma and current circumstances, all things that I am continuing to work through and work on.  I'd say it took at least six months and perhaps a year to fully get back to normal (neuro-psychologically and sexually) after the last dose in 2011.


#27 Altostrata

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Posted 30 June 2012 - 10:49 AM

Everything is tied to genetic expression. Everything you do, eat, ingest, sense etc. affects you epigenetically as your nervous system adapts to stimulation. "Epigenetics" is yet another piece of meaningless jargon used to explain the basis of psychiatric treatment. Here's a discussion http://www.madinamer...ppen-all-along/ Of course, response to drugs and iatrogenic damage is at least partially determined by genetic makeup, but nobody knows anything to predict such effects. You will experience waves and windows in PSSD, like all withdrawal symptoms, as your nervous system repairs itself.
This is not medical advice. Discuss any decisions about your medical care with a knowledgeable medical practitioner.

"It has become appallingly obvious that our technology has surpassed our humanity." -- Albert Einstein

All postings © copyrighted.

#28 Barbarannamated

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Posted 30 June 2012 - 10:50 AM

I couldn't get to full text, but interesting topic. I believe in the premise of epigenetics as I understand it (not well). I believe drugs have the potential to alter gene expression. I think research is going in a direction of looking at blaming genetics for alterations/harm done by drugs (in water, in utero, etc). They will, of course, have a "cure" for. Autism is one example. I apologize if this resonse is unrelated to content of article! I think many "symptoms" can be worse during withdrawal.
Pristiq tapered over 8 months ending Spring 2011 after 18 years of polydrugging that began w/Zoloft for fatigue/general malaise (not mood). CURRENT: 1mg Klonopin qhs (SSRI bruxism), 75mg trazodone qhs, various hormonesLitigation for 11 years for Work-related injury, settled 2004. Involuntary medical retirement in 2001 (age 39). 2012 - brain MRI showing diffuse, chronic cerebrovascular damage/demyelination possibly vasculitis/cerebritis. Dx w/autoimmune polyendocrine failure.<p>2013 - Dx w/CNS Sjogren's Lupus (FANA antibodies first appeared in 1997 but missed by doc).

#29 Altostrata

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Posted 30 June 2012 - 10:54 AM

Csoka, lead author of that paper, has written quite a bit about PSSD.
This is not medical advice. Discuss any decisions about your medical care with a knowledgeable medical practitioner.

"It has become appallingly obvious that our technology has surpassed our humanity." -- Albert Einstein

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#30 enufodat

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Posted 30 June 2012 - 11:14 AM

Well, I certainly agree it's a lousy basis for treatment of depression, but I do believe it's a little more than jargon. It does, of course, influence everything, which is why knowing about it helps to break down the current mythology regarding genetic determinism--whether regarding the psyche or anything else. But the particular concern here, at least from my limited understanding, is that epigenetic changes have more potential to be permanent. I hope perhaps I am wrong about that, or alternatively that it is simply not behind PSSD!

1994-2009 50-100 mg Zoloft (plus tried Effexor, Lexapro, Wellbutrin at times)
5/'09-7/'09 taper off Zoloft
7/'09-12/'09 no zoloft, rough times after ~ 2 mos.
1/'10-6/'10 50 mg zoloft
6/'10-1/'11 slow taper
2/'11-7/'11 off entirely, ok for 2-3 mos., then rough
7/'11-9/'11 50 mg
9/15/'11 - 11/15/'11 taper off
11/15/'11 - 2/'11 clean, doing well but with some PSSD
2/'11 - 6/'11 depression creeps back, fairly significant by May.

6/'14 (long time...!)  life is good, full recovery, at least in terms of SSRI addiction.  Still digging out from the social and professional hole that it all left me in, but despite the loss of far too many years to this business I'm basically doing pretty well.  Still some depression at times, even severe on occasion, but clearly related to past trauma and current circumstances, all things that I am continuing to work through and work on.  I'd say it took at least six months and perhaps a year to fully get back to normal (neuro-psychologically and sexually) after the last dose in 2011.


#31 Altostrata

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Posted 30 June 2012 - 12:07 PM

I've had some correspondence with Dr. Csoka about this. A complex interplay of hormones is involved in sexual response. Hormonal dysregulation from withdrawal syndrome is widespread, variable from individual to individual, and expresses itself in different ways. My belief is that the cause of PSSD cannot be isolated to any one cause, hormone, or genetic composition. "Epigenetic" as applied to a complex situation such as this one is not going to be helpful. It's like saying the dysfunction is "physical." Furthermore, the nervous system and hormonal balance is plastic and dynamic. Research often starts with questions like this one and often turns up interesting if not conclusive information.
This is not medical advice. Discuss any decisions about your medical care with a knowledgeable medical practitioner.

"It has become appallingly obvious that our technology has surpassed our humanity." -- Albert Einstein

All postings © copyrighted.

#32 alexjuice

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Posted 30 June 2012 - 11:38 PM

Well, I certainly agree it's a lousy basis for treatment of depression, but I do believe it's a little more than jargon. It does, of course, influence everything, which is why knowing about it helps to break down the current mythology regarding genetic determinism--whether regarding the psyche or anything else. But the particular concern here, at least from my limited understanding, is that epigenetic changes have more potential to be permanent. I hope perhaps I am wrong about that, or alternatively that it is simply not behind PSSD!

Hey enufodat,

Great name by the way.

PSSD is a terror. I've endured it as well as SSD. I didn't have to get off the meds to have functioning problems, they just got worse afterwards.

I personally know how horrifying and terrible the idea of living life as a sexually incapable human. As far as epigenetics, I am not a geneticist.

Thinking a thing to be permanent, especially hen it is unlikely (unless you are 75 or something) to be so.

I try not to worry about the cause or the permanence of my sex function. I'd just try to practice and practice acceptance. And value myself a lot higher than I did.

I'm not sure that all makes sense.

I'm really sorry to hear that you're dealing with this. It stinks. I know.

"Well my ship's been split to splinters and it's sinking fast
I'm drowning in the poison, got no future, got no past
But my heart is not weary, it's light and it's free
I've got nothing but affection for all those who sailed with me.

Everybody's moving, if they ain't already there
Everybody's got to move somewhere
Stick with me baby, stick with me anyhow
Things should start to get interesting right about now."

- Zimmerman


#33 enufodat

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Posted 01 July 2012 - 05:41 AM


H I'd just try to practice and practice acceptance.


Thanks, I think that is precisely right. Also, and perhaps relatedly, I think tantric practice holds a lot of potential, taking the emphasis off of, ahem, completion...and really practicing bodily awareness in a wider sense.

Well, that approach can also apply to the larger withdrawal problem, too. As you can see, I sometimes get caught up in wanting to know specific causes, predictability, endpoints, etc...whereas it's a "journey" (excuse the kind of woo-woo term!), albeit not an easy one, that will go....where it goes.

E

1994-2009 50-100 mg Zoloft (plus tried Effexor, Lexapro, Wellbutrin at times)
5/'09-7/'09 taper off Zoloft
7/'09-12/'09 no zoloft, rough times after ~ 2 mos.
1/'10-6/'10 50 mg zoloft
6/'10-1/'11 slow taper
2/'11-7/'11 off entirely, ok for 2-3 mos., then rough
7/'11-9/'11 50 mg
9/15/'11 - 11/15/'11 taper off
11/15/'11 - 2/'11 clean, doing well but with some PSSD
2/'11 - 6/'11 depression creeps back, fairly significant by May.

6/'14 (long time...!)  life is good, full recovery, at least in terms of SSRI addiction.  Still digging out from the social and professional hole that it all left me in, but despite the loss of far too many years to this business I'm basically doing pretty well.  Still some depression at times, even severe on occasion, but clearly related to past trauma and current circumstances, all things that I am continuing to work through and work on.  I'd say it took at least six months and perhaps a year to fully get back to normal (neuro-psychologically and sexually) after the last dose in 2011.


#34 Maybe

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Posted 01 July 2012 - 06:19 AM

In my opinion SSRI withdrawal might to a larger extent be a direct cause of changed gene expression. Maybe this explains why people often start to feel bad after months of stopping the drugs: The drugs could induce epigenetical changes which take time to effect the body on such a level that it is possible to experience it via "symptoms". On the other hand, as I understand it, epigenetic changes are never permanent. As Alto stated the expression of our genes is influenced by our daily life. So if certain expressions are changed there are possibilities to change them back by a special behavior or even absence of the drug. Only problem is, we do not know what behavior (exercise, food etc) that might be and how long it might take. Regarding PSSD, even though I am not affected and so cannot talk about my own experience, I have read about a lot of people who have regained their "sexuality" by a 100%. Even if it took them months and years. No idea if anything I wrote made sense, but I wanted to share my opinion :)

End of 2008: Remeron 15mg for around 2 months. Unorthodox taper, no problems.
End of August 2009: Lexapro 10mg for only 4 days. Panic attack after 3 pills. Severe gastro problems in the morning for 3 days after last pill. 2 weeks later strong w/d symptoms set in.

Acute WD lasted around 3.5 years. I am feeling much better today, 5.5 years out, but still have some symptoms left.


#35 enufodat

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Posted 07 July 2012 - 06:55 AM

Yes, Silver, makes a lot of sense--thanks! My happy update is that, after becoming fearful in the past few weeks that either the PSSD was just not going to go away or that I was just aging into a non-sexual being....something switched suddenly and all functions normal! Of course, I suspect it may come and go, as others have suggested, but very encouraging. I also had gotten more comfortable with non-orgasmic sex, just enjoying it for what it was in a new relationshp...and maybe, in fact, that is part of what's changed, just being easy about the whole thing and letting it take it's own course. Anyway, a little update that may be encouraging for others. Cheers, D

1994-2009 50-100 mg Zoloft (plus tried Effexor, Lexapro, Wellbutrin at times)
5/'09-7/'09 taper off Zoloft
7/'09-12/'09 no zoloft, rough times after ~ 2 mos.
1/'10-6/'10 50 mg zoloft
6/'10-1/'11 slow taper
2/'11-7/'11 off entirely, ok for 2-3 mos., then rough
7/'11-9/'11 50 mg
9/15/'11 - 11/15/'11 taper off
11/15/'11 - 2/'11 clean, doing well but with some PSSD
2/'11 - 6/'11 depression creeps back, fairly significant by May.

6/'14 (long time...!)  life is good, full recovery, at least in terms of SSRI addiction.  Still digging out from the social and professional hole that it all left me in, but despite the loss of far too many years to this business I'm basically doing pretty well.  Still some depression at times, even severe on occasion, but clearly related to past trauma and current circumstances, all things that I am continuing to work through and work on.  I'd say it took at least six months and perhaps a year to fully get back to normal (neuro-psychologically and sexually) after the last dose in 2011.


#36 alexjuice

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Posted 07 July 2012 - 11:17 AM

Terrific news. Thanks for sharing, I've had some good moments but ultimately always slipped back. But the good moments have definitely helped me keep a positive attitude because I know it is possible that things may work again. Hopefully you've reached a point of sustained function. If not, the interlude can only help with the mental aspect, fears that things will never be the same or are gone for good. But it's very good news for you and others suffering who struggle with fears that their sex lives may be ruined. Thanks

"Well my ship's been split to splinters and it's sinking fast
I'm drowning in the poison, got no future, got no past
But my heart is not weary, it's light and it's free
I've got nothing but affection for all those who sailed with me.

Everybody's moving, if they ain't already there
Everybody's got to move somewhere
Stick with me baby, stick with me anyhow
Things should start to get interesting right about now."

- Zimmerman






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