Mianserin

[iggy131313]

But mianserin is an a2 antagonist too...which would mean it also is an indirect agonist of 5ht1a??

This is bad news indeed....I don't want anhedonia and I know 3 people who have severe anhedonia from mirtazapine

[ethanmatthews]

ive never heard of it causing anhedonia. one guy had stress induced anhedonia and mianserin fixed it. you would be on a low dose anyway (15mg). also, louis never got anhedonia on his long term use of mianserin.

here is a paper that explains mirtazapine actions "Differential mechanisms underlie the regulation of serotonergic transmission in the dorsal and median raphe nuclei by mirtazapine: a dual probe microdialysis study."

[iggy131313]

I'm going to put this here to add to my research of mianserin

http://www.sciencedirect.com/science/ar ... 0880901872

Luke....I believe there may be many mechanisms behind pssd...in your case and others who experienced this on stopping there are a few explanations

1 ... If it happened on stopping it could have been that the ssri was acting as an agonist at pre synaptic 5ht1a and stopping the ssri then unmasked the downregulation...rather than it becoming apparent during use

2... If the drug was an srni then the ne may have been having an effect on serotonin release, we know it does but I don't know enough yet

3.....it could be an upregulation response...different receptors such as 5ht2c upregulating in response to the drop in serotonin levels

For you..as I've said before I would guess at #1 it seems to me that when you stopped the drug serotonin flooded the brain, hence the symptoms you experienced...although if this was the case I would have expected you to also have things like akathisia, terror or severe anxiety also....once the brain flooded with serotonin it gradually compensated by down regulating down synaptic receptors...how this relates to dopamine I'm unsure,,,,it needs more work

[iggy131313]

Also you are right that the drop in Serotonin should cause a compensatory upreg.....but that's not nessisarily going to happen in the correct place..I believe, and it's only a theory that the upreg will happen at any place...so receptors that downregulate pre synaptically may well upregulate post synaptically..the way I view it is kinda like a memo comes into the brain....that says...less 5ht1a activation noticed...upregulate.....but that's all the message says, and so it upregulates but without specific instruction on where this needs to happen, it just happens anywhere pre, post synaptically god knows...

Also, you ask about doesn't everyone have downreg when they take the drug, well yes they do...but there are different factors at work...the affinity a drug has specifically for 5ht1a being one major one, we know that Prozac, Paxil and lexapro...also mirtazapine have very high potency acting on 5ht1a....much more so than citalopram.

As we see sertraline causing this often. Perhaps this also has a very high affinity for 5ht1a....the higher the affinity, the more downreg a person will get

Another factor is kindling, how many times one has gone on and off the drug, how many times downregulation has happened

Uncontrollable stress has an impact on 5ht1a receptors

And last but not least is genetics...just like how many moles we have on our body, why schizophrenia can run in families etc etc...there must be a threshold of how much downreg if 5ht1a is required to cause pssd....let's say it's 4000 receptors (I'm pulling this out of no where just to give an example) that 4000 pre synaptic receptors is required to feel emotion and not have pssd

Now it stands to reason that some people will naturally have 5000,6000,7000 others will have 4500! This will be a factor in wheather a person develops pssd...some people can handle more downreg than others before reached the threshold of problems

[EricCartmanRJ]

Iggy, I had partial responses with agomelatine (Strong libido for a few days, although not decent erections), mirtazapine (even when a add on to celexa two years ago, but didn't help at all 2 months ago). Trazodone helped a little too, but in a less extent. Do you think that, in my case, it can be only 5ht2c related ?

[iggy131313]

ericcartmen, im not the authority on this, my speciality is more about post ssri withdrawal syndrome, akathsia all that which is i belive an upregulation reaction

the question would be, what triggered the onset f your symtpoms? was it during drug use? or on cessation?

your on mianserin now right? Sonny is right, there are plenty of things left to try, zinc being a good one, but how did you pssd start?

Im more tha happy to give you my opinion on things, my views are all very receptor centric, and are only my views and opinions, but im happy to give you that, if you wish.

trazadone and mirt are both 5ht2a antagonists, to aceive the most from 5ht2a antagonists serotonin should also be raised in the synapse, perhaps thats why the mirt and citalopram combo was helpful..

let me know some details, and ill give you some speculative opinions

[iggy131313]

ethan matthews, is that the same guy who had pssd? or the one this post talks about?

stress indiced anhedonia is the same mechanism i belive as pssd, as uncontrolable stress downregulates 5ht1a

[ethanmatthews]

iggy stop talking to me. you dont even have pssd. leave me alone

[iggy131313]

ok fair enough. I DO have pssd....i have severe pgad, and THAT is a form of pssd, just because its not the same as someone elses symtpoms doesnt make it less valid. I will respect your wishes, and I hope with more manners than you had.

But I understand and wont address you in any questions. apologies for any offense

[LouisSyfer]

Hi everybody,

I wonder why this forum has been deleted and... rebuilt. Whatever I'm back, thanks Gh0st !
Never late than never.
I didn't know where to post first so I create a new topic here. Sorry if I'm mistaken.

I'm LouisSyfer a french guy who recovered from PSSD with mianserin. My Posts has disappeared so for those they know me already I'm still ok ! Over one year now, my libido is still around and I don't feel no more PSSD symptoms.

But I'm here too because I want to know if anybody else tried mianserin with success to get rid of PSSD.

I hope so.

See you soon !!