Can someone please educate me with some technical info? I don't want to make another mistake

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Gonzo
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Can someone please educate me with some technical info? I don't want to make another mistake

Unread post by Gonzo »

I would appreciate if someone could educate me a bit with some technical aspects about PSSD, as biology and chemistry is not my strong point and I don't ever want to make another mistake like I did with my last crash, ever again.

I got a SEVERE case of PSSD in 2004. After discovering the original forum, I tried a lot of pro sex drugs occasionally (cabergoline, bromocriptine, ropinirole, trazodone - yes, it is beneficial in my case) and I did a lot of PERMANENT improvements. I'm extremely sensitive to meds, either for good or bad, and this drugs reactivated my dopaminergic system to a considerable degree. My libido was very strong again but far from cured. Still other symptoms heavily persisted, altrought I was doing better in some aspects and achieved tremendous improvements is some aspects ( but still a bad case of pssd). This, until I took an antihistaminic, chlorphenamine which sent me back to square one. I researched the antihistaminic and I discovered it was actually a real SSRI, not marketed as such. Its been 2 years since this incident, and I'm doing progress again with the ocassional use of some of the mentioned drugs, plus gingko, but still can't get back to baseline.

The point of this post is that something like this should NEVER happen to me again. I made my condition permanently worse with an antihistaminic SSRI, it was very stupid. even though I know it was an SSRI, I'm now traumatized to take any new drugs. If you take the wrong drug, it may fuck you up and it will take you YEARS to get slight improvements again.

So, I need to understand this condition as much as possible. I would appreciate if someone can explain me the following:

Is the problem basically with drugs that falls into the category of SSRI'S? Are serotonin agonists dangerous too? or the mechanism of action is completely different? I'm very confused about it. Natural herbs like valerian root are serotonin agonist, or even buspirone, which is supposed to be benefitial for PSSD. Are they dangerous for our condition?

What about dopamine ANTAGONISTS? They use them as anti vomiting drugs post general anesthesia, and I'm going for a surgery soon.

Can benzos and Z drugs be considered safe for PSSD? I know they can cause their own sexual disfunction but I'm asking specifically about PSSD. I'm going through a difficult period in my life I will need to take them very occasionally. But I can't even take this without feeling fear of making things worse again!

Please someone help me to clarify this points!

There's a post called "worse offenders for PSSD", and there is a list of meds there,which in my opinion is highly exaggerated by the OP. it basically names every existing drug. which is very useless and non practical (like fluconazol, aspirin, and other things that won't make your condition permanently worse), and is actually missing some drugs that are really dangerous for PSSD.

Thanks in advance.
Thomas
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Re: Can someone please educate me with some technical info? I don't want to make another mistake

Unread post by Thomas »

Well, this is the issue, anything (including water) can cause worsening because of nocebo effect (https://en.wikipedia.org/wiki/Nocebo)
That's why I proposed to discard anecdotal reports and focus on drugs where any scientific study could back up the reports. Moreover, there is a scale for scientific studies: double blind > ... > human reports > ... > rats > ... > in vitro > ... > theory.

To my knowledge, we don't have any double blind study. PSSD is documented with human and rat evidences with serotonin reuptake inhibitors. Thus I would say it is basic prudence to avoid at least any drug inhibiting serotonin reuptakes. And 5ari, because some similar syndrom (PFS) is documented with 5-alpha reductase inhibitors.
But as we don't know the mechanism, root cause could come from something else... So extended prudence could lead to avoid lots of things. Most of the drugs are reported only on a theoretical point of view.
Escitalopram, 10mg/day, Jan-May 2019. Fluoxetine, May-Sept 2019. Mirtazapine 7,5mg/day, November 2019-January 2020. Escitalopram, 5mg/day, Feb-May 2020.
Symptoms: sexual & emotional numbness
sovietxrobot
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Re: Can someone please educate me with some technical info? I don't want to make another mistake

Unread post by sovietxrobot »

Gonzo wrote: Mon Apr 12, 2021 5:07 am Is the problem basically with drugs that falls into the category of SSRI'S? Are serotonin agonists dangerous too? or the mechanism of action is completely different? I'm very confused about it. Natural herbs like valerian root are serotonin agonist, or even buspirone, which is supposed to be benefitial for PSSD. Are they dangerous for our condition?
With PSSD, there are no guarantees. There are at least two subtypes- one with that appears androgenic in nature and another that is likely caused by disruption in dopamine signaling. They could have an entirely different set of dangerous/beneficial drugs. Buspar has a published history of treating SSRI-induced sexual dysfunction, its more likely than not to be beneficial. SSRIs are unclear, some people are helped by reinstatement, others are harmed, some observe no effect. Nothing is free of risk.
What about dopamine ANTAGONISTS? They use them as anti vomiting drugs post general anesthesia, and I'm going for a surgery soon.
Dopamine antagonists can caused neuroleptic induced deficit syndrome which is quite similar to the cognitive and affective symptoms of PSSD (anhedonia, avolition, etc), they will probably not help.
Can benzos and Z drugs be considered safe for PSSD? I know they can cause their own sexual disfunction but I'm asking specifically about PSSD. I'm going through a difficult period in my life I will need to take them very occasionally. But I can't even take this without feeling fear of making things worse again!
Same thing, no way to say for sure. Benzos dont appear to interact with any of the likely PSSD culprits.
There's a post called "worse offenders for PSSD", and there is a list of meds there,which in my opinion is highly exaggerated by the OP. it basically names every existing drug. which is very useless and non practical (like fluconazol, aspirin, and other things that won't make your condition permanently worse), and is actually missing some drugs that are really dangerous for PSSD.
I agree that it is exaggerated and excludes potentially beneficial treatments.
Last edited by sovietxrobot on Mon Apr 12, 2021 4:03 pm, edited 1 time in total.
sovietxrobot
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Re: Can someone please educate me with some technical info? I don't want to make another mistake

Unread post by sovietxrobot »

Thomas wrote: Mon Apr 12, 2021 5:55 am Well, this is the issue, anything (including water) can cause worsening because of nocebo effect (https://en.wikipedia.org/wiki/Nocebo)
That's why I proposed to discard anecdotal reports and focus on drugs where any scientific study could back up the reports. Moreover, there is a scale for scientific studies: double blind > ... > human reports > ... > rats > ... > in vitro > ... > theory.
Given how rare PSSD is, and that it is largely unrecognized, anecdotal reports are basically all we have. I agree that some of these individual reports ("I got PSSD from drinking water") are useless, but a lot of people have posted detailed logs, and there are some identifiable trends. For example, many people report being highly anxious and hyper sexual prior to developing PSSD- could suggest overly active 5ht2a as a risk factor. More formalized survey data is one of the few realistic routes for research, at this point.
To my knowledge, we don't have any double blind study. PSSD is documented with human and rat evidences with serotonin reuptake inhibitors. Thus I would say it is basic prudence to avoid at least any drug inhibiting serotonin reuptakes. And 5ari, because some similar syndrom (PFS) is documented with 5-alpha reductase inhibitors.
It may be even more specific than that. I think the main issue is abrupt discontinuation/dose reduction from SSRI (as opposed to just taking it at all), at least in some subset.
Gonzo
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Re: Can someone please educate me with some technical info? I don't want to make another mistake

Unread post by Gonzo »

So I think we could conclude that benzos and Z drugs are the safest psych drugs for pssd?
Gonzo
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Re: Can someone please educate me with some technical info? I don't want to make another mistake

Unread post by Gonzo »

Thomas wrote: Mon Apr 12, 2021 5:55 am Thus I would say it is basic prudence to avoid at least any drug inhibiting serotonin reuptakes.
I guess a serotonin agonist doesn't fall in to this category? Not because it increases serotonin it means that is dangerous for pssd, right?
Gonzo
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Re: Can someone please educate me with some technical info? I don't want to make another mistake

Unread post by Gonzo »

sovietxrobot wrote: Mon Apr 12, 2021 10:50 am Dopamine antagonists can caused neuroleptic induced deficit syndrome which is quite similar to the cognitive and affective symptoms of PSSD (anhedonia, avolition, etc), they will probably not help.
With dopamine agonist, I basically mean antipsychotics.
Thomas
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Re: Can someone please educate me with some technical info? I don't want to make another mistake

Unread post by Thomas »

Gonzo wrote: Tue Apr 13, 2021 1:48 am So I think we could conclude that benzos and Z drugs are the safest psych drugs for pssd?
sovietxrobot's answer was the best you would ever have:
no way to say for sure. Benzos dont appear to interact with any of the likely PSSD culprits.
Anyone claming this to be sure would be lying, but they seem safe and could be beneficial for the anxiety induced symptoms, cf. https://www.pssdforum.org/viewtopic.php?f=20&t=4265
Escitalopram, 10mg/day, Jan-May 2019. Fluoxetine, May-Sept 2019. Mirtazapine 7,5mg/day, November 2019-January 2020. Escitalopram, 5mg/day, Feb-May 2020.
Symptoms: sexual & emotional numbness
Thomas
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Re: Can someone please educate me with some technical info? I don't want to make another mistake

Unread post by Thomas »

Gonzo wrote: Tue Apr 13, 2021 1:50 am
Thomas wrote: Mon Apr 12, 2021 5:55 am Thus I would say it is basic prudence to avoid at least any drug inhibiting serotonin reuptakes.
I guess a serotonin agonist doesn't fall in to this category? Not because it increases serotonin it means that is dangerous for pssd, right?
It is a completely different mechanism but it would interact with main PSSD culprits, so it is less safe, in theory.
Escitalopram, 10mg/day, Jan-May 2019. Fluoxetine, May-Sept 2019. Mirtazapine 7,5mg/day, November 2019-January 2020. Escitalopram, 5mg/day, Feb-May 2020.
Symptoms: sexual & emotional numbness
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