TRT vs SSRI reinstatement

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Troskie
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TRT vs SSRI reinstatement

Unread post by Troskie »

I'm at the point that i'm considering re-instating SSRI's. I took celexa for about 6 months roughly 10 years ago and haven't taken anything since. I miss my sexuality, but perhaps even more i'm just sick of being anxious and having this anhedonia.

First, i'm going to try psilocybin. I recently met up with an old friend and suddenly have the opportunity. I've heard some people have good results with this, so I want to give it a try.

Along the same vein, if I don't get the relief from psilocybin i'm looking for, I'm strongly considering a series of ketamine infusions. They are expensive, but I have a couple clinics around me and i'm begrudgingly willing to pay the high cost to attempt it.

Now, if those don't work i'm torn between reinstating TRT or reinstating an SSRI.

I had ok results with when I tried TRT 8 months ago. For reference, I took it only for 6 weeks, and during that time my anxiety and anhedonia marginally improved. My erection quality without question improved, however my libido and sensation remained pretty flat. I wish I stuck with it longer, I got scared of committing to it for life at the age of 29, but reading more about it I believe I could trial it for longer and come off with hcg. If I take it longer, the thought is maybe my AR and dopamine receptors will become more sensitive over time, and eventually with a PCT I could have lasting improvement.

When I took SSRI, it did help my anxiety a great bit while I was on it. I feel sort of stuck on a fight-or-flight mode, and I think taking one will help me get this back to a baseline. Of course having taken it before and attributing many of my problems to having taken it, the thought of taking it scares the crap out of me. There's a popular thread on here of a guy taking prozac + buspar and having good results, if I go this path I may try something like that combo.

Also a thought I had was that study saying 1 dose of citalopram changes so many (~300+) of our genes through methylation / demethylation. Maybe if I try TRT first and after a while it doesn't give me the improvement I want, I would re-instate an SSRI while still on TRT, and maybe upon quitting the SSRI my my gene profile would be more favorable than what it is now.
ihatelexapro444
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Re: TRT vs SSRI reinstatement

Unread post by ihatelexapro444 »

You have had this for 10 years? There goes my hope.
JP1985
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Re: TRT vs SSRI reinstatement

Unread post by JP1985 »

ihatelexapro444 wrote: Fri Jul 09, 2021 4:26 pm You have had this for 10 years? There goes my hope.
Not everyone has it 10 years! A lot recover sooner! I feel things are improving with myself after 2 years. I’ve seen a lot of recovery stories 2-5 years. And a lot of people don’t post their stories.. they just get on with their life!
Last pill March 2019 - Citalopram for 7 years
Numbed penis and weak orgasm
Fatigue
Slightly blunted
Dizziness (this has improved a lot in the last 6 months)
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guacamo
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Re: TRT vs SSRI reinstatement

Unread post by guacamo »

SSRI reinstatement may help you at first but then something switches in your brain and it stop working and actually worsen things. At least that's what i observed. I never took TRT so i cannot comment on that, but on discord there were few comments about TRT helping with PSSD when it's being supplemented with low doses of lithium. My opinion on those is that they already were taken by many on this forum and no one who did it recovered. Atually if my memory is right there was 1 case cured by TRT, but only one. It may help as long as you take it, but there are more risks than profits, that's what i think. Taking exogenous testosterone is not candy, it will eventually lead to decrease of production of endogenous testosterone and hormonal dysfunction if you take it for a long time. There are some that recover fast from this and their testosterone level become normal after few months, and there are people who took it for years and after ending they couldn't produce their testosterone even after year and a half. They had testosterone below limit for so long. I imagine living without testosterone for so much time must really affect one mentally and phisically.
dog_lover
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Re: TRT vs SSRI reinstatement

Unread post by dog_lover »

Troskie wrote: Mon May 31, 2021 11:52 am Along the same vein, if I don't get the relief from psilocybin i'm looking for, I'm strongly considering a series of ketamine infusions. They are expensive, but I have a couple clinics around me and i'm begrudgingly willing to pay the high cost to attempt it.
Hi Troskie! If you are in the US, I’d suggest trying instead ketamine-assisted psychotherapy. The way this typically works is that the therapist (ideally a good trauma therapist) has a working relationship w a psychiatrist who prescribes the ketamine off-label, which is very cheap, to you. You then take the ketamine to the therapy session. This is legal in US, not sure about other countries.

Ketamine temporarily affects interesting parts of the brain, such as the Default Mode Network. The DMN is responsible for one’s sense of self / relation to oneself. Modulating it w ketamine allows for many insights, and for subconscious processes to come forth in therapy. It deepens the therapy work, and can bring positive healing experiences. Google Marcela Ot’alora, she is a ketamine therapist (and is also a MAPS trained MDMA therapist). Think she’s done some good podcast interviews if you want to hear more. And Will Siu MD did some interviews about it on Goop, he’s also excellent.

I would try this before a ketamine infusion clinic. One reason the price of those might be so high is that it’s actually esketamine you’re getting pumped with, which pharma has jacked the price on (they can’t make any money on ketamine). And with the infusion clinic there is no psychotherapy, so less opportunity to process anything that comes up.

One last thing - I understand that the anhedonia and emotional blunting could absolutely have been caused by SSRIs. But they are also hallmarks of a traumatised brain. It depends on your history. For many on this forum, I suspect it's a complex mix of both. The biomedical model of psychiatry (which has pseudoscientific foundations and very little explanatory power - see http://cepuk.org/unrecognised-facts/no- ... al-causes/), severely understates the fundamental role that trauma and early attachment experiences play in shaping our mental health. Just worth keeping in mind.
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