Worst offenders for PSSD and things to avoid taking
Posted: Wed Dec 30, 2020 4:10 pm
Here's a list of the worst offenders when it comes to PSSD.
Antibiotics:
Avoid a class of antibiotics called fluoroquinolones. They can trigger a chronic syndrome (google 'floxed antibiotics') of neurotoxicity and can loosen up your tendons (seriously, they can even injure your achilles tendon).
It's a generally good idea to avoid antibiotics that can trigger neurotoxicity unless necessary. Here's a list of them:
Antifungals:
Avoid Ketoconazole since it has hormonal side effects. Itraconazole, Nystatin, and Flucoconazole are possible alternatives (with required caution). Topical antifungals are OK.
Pain-killers:
Avoid Paracetamol/Acetaminophen as there are a few reports of it causing a crash. It inhibits neurosteroid synthesis and it's an endocannabinoid 'facilitator' for a lack of a better term. Opt for NSAIDs instead, but avoid Indomethacin since it may have endocannabinoid effects.
Avoid mu receptor agonists unless absolutely necessary to control pain. MOR agonists are known to give you limp dick. You can use low doses of Tramadol. It isn't a strong MOR agonist so it's safe to use in low doses.
Anesthetics:
Although there are no reports of crashing from these, I'll use this chance to tell you to opt for Ketamine if possible since it can help with both depression and PSSD for a short duration after it's out of the body due to neurogenesis and a NMDA receptor rebound activation facilitating erectile functions.
Cannabis, nicotine, alcohol, and caffeine:
Cannabis: The main active constituent is THC, which acts as a partial agonist at CB1 receptor. I've written an entire thread on why I think cannabis is the worst offender for PSSD here:
https://www.pssdforum.org/viewtopic.php ... 2&s#p38352
Nicotine: It can have potent vasoconstrictive effects in many people and can impair your erectile function when used chronically. Better avoid it.
Alcohol: It's OK in moderation when it comes to PSSD. Avoid excessive chronic intake though as it can downregulate your endocannabinoid receptors, same as what cannabis does, since it increases your endocannabinoid production (anandamide & 2-AG).
Caffeine: Adenosine antagonism is a potent endocannabinoid potentiator. Avoid mixing it with THC.
Antidepressants:
It goes without saying to avoid any antidepressant that inhibits SERT function (i.e. Certain tricyclic antidepressants, SSRIs, Trazodone, Vortioxetine ... etc) or messes with neurosteroids (i.e. Mirtazapine). There are reports of post-AD syndromes similar to PSSD from that.
NMDA antagonists like Ketamine and Ketamine analogues (intranasal Esketamine) are excellent alternatives. There are some countries and states that allow psychedelic treatment for depression, this is also an excellent option.
Herbal antidepressants like 'Chai-hu' or 'Xiao Chai Hu Pian' are readily available options. Rhodiola rosea is a good option.
Please avoid curcumin extracts since it messes with testosterone. (weak evidence though).
Please avoid experimenting with Ashwagandha since there are a couple of crash reports from it. It downregulates 5HT1A autoreceptors, maybe that's why idk.
Ginger has worsened some people's PSSD temporarily and there's a report of permanent crashing. Better to avoid.
MAO-inhibitors can cause sexual dysfunction but there are no reports that they can trigger a syndrome similar to PSSD as of yet. Be cautious.
Avoid 5-HTP as it crashed a couple of people here.
Methy-donors:
There are a few reports that methyl-donors (i.e. supplements containing two or more methyl molecules) can cause a terrible crash. Please avoid SAM-e and Betaine/trimethylglycine.
5-alpha reductase inhibitors:
This goes without saying to avoid a similar post-drug syndrome (PFS). There are some supplements that can be weak 5ARI, those are fine and don't cause a crash as people tried them. Avoid the "big ones" basically, like Finasteride and Saw Palmetto.
Panax ginseng can also be a potent 5-alpha reductase inhibitor but this is limited to extracts that use the rhizome part of the herb. Most, if not all, supplements use the root's extract so they are safe. Make sure it's a root extract.
Hormonal disruptors:
Androgen receptor antagonists or things that lower testosterone or dihydrotestosterone can cause worsening of PSSD (i.e. Minoxidil). Xenoestrogens (i.e. many plastic types) and phytoestrogens (i.e. Berberine, soy products). Please avoid these hormonal disruptors.
Vitamin A and its derivatives:
Those can cause a post-drug syndrome similar to PSSD and can cause PSSD patients to crash (i.e. vitamin A supplements, Isotretinoin, etc.).
Hyperbaric oxygen therapy (HBOT):
There are few reports of people crashing from HBOT permanently. Please take antioxidants while doing HBOT or avoid altogether.
hCG:
Although many patients use it without a problem, there are a couple of reports of PSSD crashing severely after hCG use. Tread carefully here.
Please remember: Things to avoid doesn't mean it hasn't helped anyone, or that it will 100% cause crashes. It's not black and white. For example, inositol helped some people but crashed others.
Antibiotics:
Avoid a class of antibiotics called fluoroquinolones. They can trigger a chronic syndrome (google 'floxed antibiotics') of neurotoxicity and can loosen up your tendons (seriously, they can even injure your achilles tendon).
It's a generally good idea to avoid antibiotics that can trigger neurotoxicity unless necessary. Here's a list of them:
Antifungals:
Avoid Ketoconazole since it has hormonal side effects. Itraconazole, Nystatin, and Flucoconazole are possible alternatives (with required caution). Topical antifungals are OK.
Pain-killers:
Avoid Paracetamol/Acetaminophen as there are a few reports of it causing a crash. It inhibits neurosteroid synthesis and it's an endocannabinoid 'facilitator' for a lack of a better term. Opt for NSAIDs instead, but avoid Indomethacin since it may have endocannabinoid effects.
Avoid mu receptor agonists unless absolutely necessary to control pain. MOR agonists are known to give you limp dick. You can use low doses of Tramadol. It isn't a strong MOR agonist so it's safe to use in low doses.
Anesthetics:
Although there are no reports of crashing from these, I'll use this chance to tell you to opt for Ketamine if possible since it can help with both depression and PSSD for a short duration after it's out of the body due to neurogenesis and a NMDA receptor rebound activation facilitating erectile functions.
Cannabis, nicotine, alcohol, and caffeine:
Cannabis: The main active constituent is THC, which acts as a partial agonist at CB1 receptor. I've written an entire thread on why I think cannabis is the worst offender for PSSD here:
https://www.pssdforum.org/viewtopic.php ... 2&s#p38352
Nicotine: It can have potent vasoconstrictive effects in many people and can impair your erectile function when used chronically. Better avoid it.
Alcohol: It's OK in moderation when it comes to PSSD. Avoid excessive chronic intake though as it can downregulate your endocannabinoid receptors, same as what cannabis does, since it increases your endocannabinoid production (anandamide & 2-AG).
Caffeine: Adenosine antagonism is a potent endocannabinoid potentiator. Avoid mixing it with THC.
Antidepressants:
It goes without saying to avoid any antidepressant that inhibits SERT function (i.e. Certain tricyclic antidepressants, SSRIs, Trazodone, Vortioxetine ... etc) or messes with neurosteroids (i.e. Mirtazapine). There are reports of post-AD syndromes similar to PSSD from that.
NMDA antagonists like Ketamine and Ketamine analogues (intranasal Esketamine) are excellent alternatives. There are some countries and states that allow psychedelic treatment for depression, this is also an excellent option.
Herbal antidepressants like 'Chai-hu' or 'Xiao Chai Hu Pian' are readily available options. Rhodiola rosea is a good option.
Please avoid curcumin extracts since it messes with testosterone. (weak evidence though).
Please avoid experimenting with Ashwagandha since there are a couple of crash reports from it. It downregulates 5HT1A autoreceptors, maybe that's why idk.
Ginger has worsened some people's PSSD temporarily and there's a report of permanent crashing. Better to avoid.
MAO-inhibitors can cause sexual dysfunction but there are no reports that they can trigger a syndrome similar to PSSD as of yet. Be cautious.
Avoid 5-HTP as it crashed a couple of people here.
Methy-donors:
There are a few reports that methyl-donors (i.e. supplements containing two or more methyl molecules) can cause a terrible crash. Please avoid SAM-e and Betaine/trimethylglycine.
5-alpha reductase inhibitors:
This goes without saying to avoid a similar post-drug syndrome (PFS). There are some supplements that can be weak 5ARI, those are fine and don't cause a crash as people tried them. Avoid the "big ones" basically, like Finasteride and Saw Palmetto.
Panax ginseng can also be a potent 5-alpha reductase inhibitor but this is limited to extracts that use the rhizome part of the herb. Most, if not all, supplements use the root's extract so they are safe. Make sure it's a root extract.
Hormonal disruptors:
Androgen receptor antagonists or things that lower testosterone or dihydrotestosterone can cause worsening of PSSD (i.e. Minoxidil). Xenoestrogens (i.e. many plastic types) and phytoestrogens (i.e. Berberine, soy products). Please avoid these hormonal disruptors.
Vitamin A and its derivatives:
Those can cause a post-drug syndrome similar to PSSD and can cause PSSD patients to crash (i.e. vitamin A supplements, Isotretinoin, etc.).
Hyperbaric oxygen therapy (HBOT):
There are few reports of people crashing from HBOT permanently. Please take antioxidants while doing HBOT or avoid altogether.
hCG:
Although many patients use it without a problem, there are a couple of reports of PSSD crashing severely after hCG use. Tread carefully here.
Please remember: Things to avoid doesn't mean it hasn't helped anyone, or that it will 100% cause crashes. It's not black and white. For example, inositol helped some people but crashed others.