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PSSD Post SSRI sexual dysfunction.

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music321   
music321

On occasion, I have been on high doses of SSRI. I would notice a loss of sexual function, and back the dose down. Sexual function returned in a day or two. Recently, I underwent a withdrawal from 20mg prozac. about 10 days into the withdrawal, I started taking 20mg again. but it was too late. over a period of a few days, sexual function diminished, and finally vanished saturday afternoon. now, I started taking 10 mg on thurs and fri, and went back to 20 on sat, and have been on 20 since. I have no libido and am impotent.

 

At what point should i really start to worry about this? i would have thought that function would have started to return today.

 

It seems that PSSD as a result of discontinuing is a different phenomenon than PSSD as a result of taking SSRI. does this carry a different standard of recovery?

My gut feeling is that I've already begun to live the rest of my life as a Eunuch, but i still have some hope.

 

what sucks is that because of a back injury, i've been without sex for years already, and I was feeling that within six months i might finally be able to engage. but now i don't know...

 

I wish my parents had never sent me to a witch doctor psychiatrist when i was a teen. SSRIs have ruined my life in so many ways.

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Altostrata   
Altostrata

music321, I attached your post to this existing topic. The information above may be of interest to you.

 

Psychiatric drugs affect the autonomic nervous system and general hormonal balance. Sexual response is a finely calibrated interplay of autonomic and hormonal factors. Going on and off medications may affect this.

 

As you found, earlier success is no guarantee you will continue to be able to go on and off or lower the dose to bring back sexual functioning. Going on and off or going up and down in dose changes the nervous system in dynamic and unpredictable ways. It's not elastic -- it doesn't go back to the way it was.

 

It's impossible to tell how long this will affect you. Your entire hormonal situation is now in a different balance.

 

You may find sexual function returns while you're on Prozac, or you may now be susceptible to the very common adverse effect of sexual dysfunction. Going off Prozac may help, or it may not. It's possible that some time after you go off, your sexual functioning will return.

 

It's unknown whether PSSD on psychiatric drugs is a separate phenomenon from PSSD after quitting.

 

After only a few days, it's impossible to tell what will happen.

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music321   
music321

Thanks. i had no idea i was playing with fire by taking SSRIs. my psychiatrist claims to be ignorant of lasting sexual side effects. i wonder if this is the case, or if these people simply look the other way. if they are ignorant, there is no excuse. there's enough literature out there.

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Altostrata   
Altostrata

Correct, they just don't want to know.

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music321   
music321

I'm wondering if anyone has lost libido + become impotent while discontinuing ssris, only to regain it a short time later. I lost my sexuality 3 weeks ago. I really wonder if I fall into the category of "PSSD" yet, or if I'm experiencing something "normal".

 

Thanks.

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Altostrata   
Altostrata

Probably most people recover functioning fairly quickly. It's unpredictable.

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shriraj   
shriraj

took nexito 5mg for only few days....it took about a month for my physical symptoms to finally dissapear(includes vomiting, indigestion,dizzyness) there are still few mental symptoms...lyk mood swing, depersonalization etc..which i think is getting better.....but the only thing which worries me is my libido...but yah i think there is some improvement..so my question ...is this improvement in sex drive is a sign of full recovery or is it going to reach a particular point and become permanent....if any onr wana know what has brought this improvement can ask me ..m here to help u

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Altostrata   
Altostrata

If you've seen improvement, that's a good sign, shriraj.

 

You need to take care of yourself and be patient.

 

You don't need to keep repeating your history -- post a link to your Intro topic instead.

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Catalyzt   
Catalyzt

I know this is an old thread, but I will throw my hat into the ring.

 

My history with SSRIs was very brief. I took Paxil for about 10 or 12 days, started feeling weird, and stopped immediately.

 

During the last days I was taking the paroxetine, I noticed a bizarre arousal disorder. No problem with anything mechanical, response to visual stimuli was okay, but... something was missing. I am a heterosexual man, and if I saw an attractive woman, she was attractive... kind of like sculpture. The electricity wasn't there. I could get aroused looking at porn, but fantasies that used to turn me on suddenly didn't. Sex was possible, it was just oddly unidimensional-- in a way that was very subtle, but extremely profound. And when that dimension was missing, I was just generally less interested in sex. It's as if you were listening to music, and an entire frequency range disappeared. You're at the symphony, and there's no string section and some of the percussion is gone... something like that.

 

Talked to a friend of mine who had been on a different SSRI. We have totally different histories and sex lives (he's ***) and our symptoms were different-- (his ran more towards anorgasmia) but again, there was the sense that some part of arousal just went completely missing. Abruptly, in a way that felt absolutely organic.

 

My psychiatrist urged me to try a dopaminergic, but I just had a really bad feeling about it. It was immediately obvious to me that this doctor-- who I still respect and see, because he's a very talented therapist-- had no idea what he was playing at. That we really had no idea how these drugs work. He also doubted my symptoms were related to paroxetine, but... how can I explain? I just knew, even though this was 2004 and I didn't have access to academic databases. It was a new problem, and completely unlike any drug side effect I'd ever read about for antidepressants-- I'd heard some guys were impotent, but never anything weird like this. And the symptoms went on for years.

 

What helped? Group therapy in my psych program. With lots of women. Looking deep into someone's eyes, just letting go. What it felt like... and this is nothing but wild speculation... was that I was flooded with oxytocin, then some testosterone cut in, and then other neurotransmitters started firing, and suddenly everything fell into the right configuration. The door slammed open. I was wildly attracted to many of my classmates.

 

As many have described here, the door sometimes slams shut. If I want it to open again, I have to spend quality time with my wife, other people I care about, face to face. Eye contact in particular was very important. Really wanting to know what someone else was feeling and thinking, going for deep empathy with women I knew very well.

 

If I'm sad, spend too much time on the computer? I go right back to that place I was in after stopping the Paxil. It's not like just being a bit depressed and not being horny. It's a totally different thing.

 

I am so glad I stopped when I did. It seems quite likely that if I had continued, the symptoms would have been worse. When I was young and stupid, I tried about every drug from LSD to mandrake root, and I had some pretty horrific experiences... but all of them resolved in a few days, a week or two at most. The effects of 10 doses of Paxil were far, far worse than any other drug I have ever used either recreationally or by prescription.

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Altostrata   
Altostrata

Thanks, Catalyzt. Very astute of you to realize what the problem was. Doctors convince a lot of people to stay on these drugs for years and, as you guessed, sexual dysfunction gets worse.

 

These drugs are hormonal disruptors, affecting the complex orchestra of hormones involved in sexual arousal, response, and orgasm. The incidence of sexual dysfunction on antidepressants is quite high and may affect the majority of people who take them.

 

However, over time, the nervous system tends to repair itself, even if it takes years. Sounds like this happened to you -- very important for people with PSSD to realize.

 

It also sounds like you found another dimension to sexuality within yourself and in your relationships, learning from the injury, and this helped you to cope and have a sex life while your nervous system was healing.

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Catalyzt   
Catalyzt

Thanks, Allostrata. Mostly, I do feel healed... but if I am down, or isolated, I can go right back to that place. I wish I never knew that place existed.

 

It is very frustrating because I work as a mental health intern, and clients who use SSRIs symptoms like these all the time. Scope of practice limits what I can say because I am not a doctor. My scope of practice limits me to providing information, not giving advice, and it's a very fine line. I can say things like, "That sounds like it could be a drug side effect, and you should report that to your doctor." Or I can say, "There are many different protocols for using SSRIs. Some doctors suggest using them for only a short period of time and then tapering off them very gradually." I can suggest people get a second opinion. I can also follow up with psychiatrists and say, "Gee, did you ever follow up with that client about the side effects they were experiencing?" But if the psychiatrist claims it's not a side effect, or suggests adding a dopaminergic, there is nothing I can do.

 

Really, I am only in the very early phases of learning about these drugs. I have a lot of research to do... and I'm very glad I found this site. I look forward to exploring many of the links.

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starlitegirlx   
starlitegirlx

I too have noticed some level of PSSD, but I don't know if it has to do with peri menopausal stuff, withdrawal stuff, life stuff making sex irrelevant in terms of what's' more important to me - that I can do simple and basic tasks like unload the dishwasher, walk more than 100 ft. easily as I once did or weather I have a libido particularly when I don't have a partner. But I understand how horrible this is for people because before having to go off my AD and now the benzo, I had libido issues due to another illness I had and that illness included the likeliness of never having sex again due to possible complications. It was the most devastating possibility to me at the time. And I'd never really been sexual as in having sex regularly due to lack of relationships, etc, but it was like it stole the hope for me ever having one. I am just sorry to see that these drugs are causing these kinds of issues because I remember the sense of loss I went through with my health issue. It was devastating to feel like I would never have a relationship because I couldn't have sex. It saddens me that people have to go through this because of meds they were given under the guise of good when really it was all about big pharma and money.

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Barbarannamated   
Barbarannamated

 

What helped? Group therapy in my psych program. With lots of women. Looking deep into someone's eyes, just letting go. What it felt like... and this is nothing but wild speculation... was that I was flooded with oxytocin, then some testosterone cut in, and then other neurotransmitters started firing, and suddenly everything fell into the right configuration. The door slammed open. I was wildly attracted to many of my classmates.

 

As many have described here, the door sometimes slams shut. If I want it to open again, I have to spend quality time with my wife, other people I care about, face to face. Eye contact in particular was very important. Really wanting to know what someone else was feeling and thinking, going for deep empathy with women I knew very well.

 

Catalyzt,

 

This is fascinating! I've wondered how oxytocin plays into this whole picture and the general detachment caused by SSRIs. I have read that eye contact (in addition to other activities) stimulates oxytocin release and bonding.

 

Thanks for sharing your experience. You will be a great asset to the field!

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starlitegirlx   
starlitegirlx

 

 

What helped? Group therapy in my psych program. With lots of women. Looking deep into someone's eyes, just letting go. What it felt like... and this is nothing but wild speculation... was that I was flooded with oxytocin, then some testosterone cut in, and then other neurotransmitters started firing, and suddenly everything fell into the right configuration. The door slammed open. I was wildly attracted to many of my classmates.

 

As many have described here, the door sometimes slams shut. If I want it to open again, I have to spend quality time with my wife, other people I care about, face to face. Eye contact in particular was very important. Really wanting to know what someone else was feeling and thinking, going for deep empathy with women I knew very well.

 

Catalyzt,

 

This is fascinating! I've wondered how oxytocin plays into this whole picture and the general detachment caused by SSRIs. I have read that eye contact (in addition to other activities) stimulates oxytocin release and bonding.

 

Thanks for sharing your experience. You will be a great asset to the field!

 

Very fascinating indeed! I wonder if that bonding factor is the key. When you are detached, you don't bond and I would suspect that as the detachment continues you withdraw more and more until things start shutting down due to the detachment factor. If your detached from people and not socializing or experiencing normal ranges of emotions in response to them it seems to me that would have some impact on sexual drive and ability to have sex. Kind of like a system shut down. There's no stimuli to trigger any response so the system doesn't respond until there is some form of contact.

 

I think there have been studies on how viewing porn has ruined relationships because the men who view it regularly tend toward losing interest in their partners. I actually have read about this though when and where I cannot remember. But I wonder if it's due to that lack of actual connection. The SSRIs, in this case, keep one from making those connections because of the detachment, and now you're in a catch 22 as long as the SSRIs are there and continuing to prohibit connections from being made. Oxytocin is key in the process. If you aren't connecting then there is no oxytocin. I would guess that could shut down libidos. It might even be some kind of biological imperative (just a theory here) because having a high libido or any level of libido without any kind of connections to people would be counterproductive.

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Altostrata   
Altostrata

Being with friendly, trustworthy humans (and animals) is good for the nervous system.

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SlimNm   
SlimNm

http://mindandmuscle.net/forum/showthread.php?t=48481

 

I believe I may have discovered the cure to PSSD (with the help of a few others).

 

So far, 3-4 other people, PLUS MYSELF, have been cured of PSSD by taking licorice root 450mg every early morning.

 

TOTALLY WORTH LOOKING INTO AT LEAST!

 

I hope I don't get banned and this post deleted because this is potentially VERY USEFUL information.

 

I can't contain my excitement, because I thought that dude on dr-bob.org was full of it when he made that big post about being cured by licorice root... but I found other similar stories.. and now... ME! :D

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SlimNm   
SlimNm

I'd like to add that licorice root has helped several people, including myself, get RID of PSSD.  I made this detailed thread on the discovery at the mind and muscle site:

 

http://mindandmuscle.net/forum/showthread.php?t=48481

 

It would be great if it helps other people.

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Altostrata   
Altostrata

I would be very, very cautious about taking licorice when suffering from withdrawal syndrome. Licorice root affects adrenal functioning, increasing cortisol production. In general, people suffering from withdrawal syndrome want to REDUCE rather than increase cortisol production.

 

It can cause a host of serious health problems, including electrolyte imbalances leading to blood pressure elevation and potassium loss.

 

https://en.wikipedia.org/wiki/Liquorice

Liquorice affects the body's endocrine system as it contains isoflavones (phytoestrogens). It might lower the amount of serum testosterone slightly,%5B20%5D but whether it affects the amount of free testosterone is unclear. Consuming liquorice may prevent the development of hyperkalemia in persons on hemodialysis.%5B21%5D Large doses of glycyrrhizinic acid and glycyrrhetinic acid in liquorice extract can lead to hypokalemia and serious increases in blood pressure, a syndrome known as apparent mineralocorticoid excess. These side effects stem from the inhibition of the enzyme 11β-hydroxysteroid dehydrogenase (type 2) and subsequent increase in activity of cortisol on the kidney. 11β-hydroxysteroid dehydrogenase normally inactivates cortisol in the kidney; thus, liquorice's inhibition of this enzyme makes the concentration of cortisol appear to increase. Cortisol acts at the same receptor as the hormone aldosterone in the kidney and the effects mimic aldosterone excess, although aldosterone remains low or normal during liquorice overdose. To decrease the chances of these serious side effects, deglycyrrhizinated liquorice preparations are available.

 

http://www.livestrong.com/article/522282-licorice-cortisol/

 

http://www.livestrong.com/article/506254-the-effect-of-licorice-on-hypothyroidism/

 

http://drholly.typepad.com/licorice/

....It isn’t aldosterone that licorice increases, but cortisol, which looks like aldosterone to your kidneys. At first scientists postulated that licorice simply mimicked the hormone aldosterone, which certainly seemed reasonable, because aldosterone is a steroid, and licorice contains steroid mimics....If left active, cortisol works on the kidney just like aldosterone, binding to aldosterone’s receptor and triggering the same effects as aldosterone: potassium wasting through the urine, sodium retention, water retention, and hypertension. The problem with cortisol acting just like aldosterone in your kidney is that cortisol is several times more concentrated than aldosterone in your plasma, and if cortisol remains unchecked at your kidney, it will appear as though your kidney is flooded with aldosterone when it is actually cortisol doing all of this....

 

....Licorice may not be the most romantic treat for your male partner. If you are male, recent evidence suggests licorice could have a downside for your love life. In some small studies it decreased testosterone levels of both male and female volunteers, and because of this it was suggested as a possible culprit in male sexual dysfunction....

 

 

It is possible someone might accidentally find licorice compensates for an unrecognized endocrinological issue and taking it improves PSSD or another symptom. This is the weakness of anecdotal reports -- they may not apply to a larger population.

 

Please note that there is a deglycyrrhizinized licorice that does not contain the active ingredient, glycyrrhizin, and does not have its effects on endocrine functioning, positive or negative.

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alex   
alex

I'd like to add that licorice root has helped several people, including myself, get RID of PSSD.  I made this detailed thread on the discovery at the mind and muscle site:

 

http://mindandmuscle.net/forum/showthread.php?t=48481

 

It would be great if it helps other people.

SlimNm, may I ask what your symptoms are and how long you have been in w/d?

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theelt712   
theelt712

I have seen licorice root treat a few people with anhedonia/PSSD, but I'm quite worried about it after doing some research, mainly because it could increase blood pressure and lower potassium levels. I'm trying to gather research before I decide to do anything with supplements, has anyone here tried it? It has been recommended to me.

 

-theelt712-

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theelt712   
theelt712

I will.

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theelt712   
theelt712

Hey, I'm dealing with PSSD and anhedonia from 2 months use of Zoloft and I've heard that licorice root may possibly help. I'm looking into Omega-3 as well but I'm nervous that I may react badly to supplements. Bearing in mind that I'm 15 and have been off meds for 2 months, could licorice root help? I'm trying to be cautious, I've heard licorice root help multiple people.

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alex   
alex

Again,give it time T, unless your symptoms are unbareable, I would stay with the least supplements possible.

Time, time is the key here.

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theelt712   
theelt712

This is true...thank you for the advice, alex. :)

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Altostrata   
Altostrata

I would be very, very careful with licorice root. Such as, don't try it.

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theelt712   
theelt712

Thank you Alto, after hearing about some effects of taking too much [mainly heart attack], I decided against it.

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SlimNm   
SlimNm

I would be very, very careful with licorice root. Such as, don't try it.

This is horrible advice.  Why would you discourage someone from trying something that may help them?  If their symptoms are unbearable, they should give it a go.  Of course, start off with the smallest dosage, and at the first sign of unwanted side-effects, just stop.  Licorice Root's side effects are well described in scientific studies, and they clearly state that side effects of prolonged use go away with discontinuation.

 

To get a heart attack from licorice root would require more than the recommended dosage.  ANYTHING (almost) can give you a heart attack in the right dose.

 

Hey theelt712, you are from paxilprogress.org right?

 

Just an update:

 

My overall sense of well being has taken a HUGE lift the past couple of days, ever since starting 6 pills per day, as recommended on the bottle.  Every symptom associated with my withdrawal has diminished.  I only hope that my progress continues, and doesn't revert upon discontinuation of the licorice.

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SlimNm   
SlimNm

 

I'd like to add that licorice root has helped several people, including myself, get RID of PSSD.  I made this detailed thread on the discovery at the mind and muscle site:

 

http://mindandmuscle.net/forum/showthread.php?t=48481

 

It would be great if it helps other people.

SlimNm, may I ask what your symptoms are and how long you have been in w/d?

 

 

Symptoms:

 

Brain fog

Anhedonia

PSSD

Absent libido

Impossible to find any sense of well being / contentment no matter what I do.

 

All of these have been massively diminished since starting my licorice root regimen a week or so ago, and my symptoms continue to improve in leaps and bounds.

 

The only side effect I get from licorice is irritibility whenever I increase the dosage, but this side effect to increased dosages wears off after a couple days.

 

I recommend anyone who tries this to take only 1 pill for a few days, see how it goes, then if they want, increase by 1 pill per a few days until they hit the recommended dosage as it states on the bottle.

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cymbaltawithdrawal5600   
cymbaltawithdrawal5600

From the above linked website:

 

 

In this thread I intend on posting all the most useful anecdotal evidence of what is known so far about PSSD. I will try to find common denominators among sufferers. I hope to do this in such a fashion as has never been seen before on the internet.

 

Alrighty then!

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theelt712   
theelt712

 

I would be very, very careful with licorice root. Such as, don't try it.

This is horrible advice.  Why would you discourage someone from trying something that may help them?  If their symptoms are unbearable, they should give it a go.  Of course, start off with the smallest dosage, and at the first sign of unwanted side-effects, just stop.  Licorice Root's side effects are well described in scientific studies, and they clearly state that side effects of prolonged use go away with discontinuation.

 

To get a heart attack from licorice root would require more than the recommended dosage.  ANYTHING (almost) can give you a heart attack in the right dose.

 

Hey theelt712, you are from p******.org right?

 

Just an update:

 

My overall sense of well being has taken a HUGE lift the past couple of days, ever since starting 6 pills per day, as recommended on the bottle.  Every symptom associated with my withdrawal has diminished.  I only hope that my progress continues, and doesn't revert upon discontinuation of the licorice.

 

I am from PP. And I'm considering supplements. I just want to do it correctly. I am also concerned due to my age [15].

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Altostrata   
Altostrata

SlimNum, we support  a lot of people here who have taken various supplements in the hopes they might help, and gotten worse instead. People with withdrawal syndrome often have very sensitive systems. Even a small alteration in aldosterone could have serious effects.

 

Anything should be tried very cautiously, in very small amounts. If you wish to urge people to try licorice root, I hope you stay around to support those who have a bad result.

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elbillingino   
elbillingino

Currently my PSSD is terrible. I had sexual side effects on zoloft for years which were just ignored by doctors when I mentioned them. They're fairly similar to what I am experiencing now - premature ejaculation, pleasureless orgasms, anaesthesia - but not quite as bad, and I cared less about them. Strangely, erections are now far more frequent than when I was on meds - which is good, I suppose, but fairly pointless as nothing works as normal after this.

 

Like most people, I'm pretty scared the PSSD will be permanent. The only real glimmer of hope is that for the first 3 or so months after stopping zoloft - before withdrawal kicked in, in fact - my sexual functioning returned to about 80% - in fact, each decrease in dosage over my too quick 3 month taper brought a big increase in functioning.

 

I know nobody can say whether it will go away, but is the fact it did almost recover previously any kind of good sign? Or just another unpredictable aspect of the withdrawal rollercoaster?

 

(Apologies if the above is a bit explicit for some people!)

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theelt712   
theelt712

The fact that it returned to 80% at least gives you some [huge] hope that your function will return one day.

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johnson   
johnson

Currently my PSSD is terrible. I had sexual side effects on zoloft for years which were just ignored by doctors when I mentioned them. They're fairly similar to what I am experiencing now - premature ejaculation, pleasureless orgasms, anaesthesia - but not quite as bad, and I cared less about them. Strangely, erections are now far more frequent than when I was on meds - which is good, I suppose, but fairly pointless as nothing works as normal after this.

 

Like most people, I'm pretty scared the PSSD will be permanent. The only real glimmer of hope is that for the first 3 or so months after stopping zoloft - before withdrawal kicked in, in fact - my sexual functioning returned to about 80% - in fact, each decrease in dosage over my too quick 3 month taper brought a big increase in functioning.

 

I know nobody can say whether it will go away, but is the fact it did almost recover previously any kind of good sign? Or just another unpredictable aspect of the withdrawal rollercoaster?

 

(Apologies if the above is a bit explicit for some people!)

Hi,

 

I too have experienced severe PSSD. About 8 months ago I could not get an erection at all. Had major premature ejaculation issues, delayed ejaculation, major loss of sensation and pleasure less orgasms. Thankfully a lot of that has improved. However my erections still aren't hard enough for intercourse or hard enough all the time, morning erections are back but not as strong as they used to be. I am just wondering if you are still experiencing troubles with your erections, maintaining them, having one strong enough for intercourse as you mentioned your sexual function is at about 80%?

 

thanks.

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