PSSD ?

[Vercingétorix]

My situation seems very similar. I was on 10 mg lexapro, 2.5 mg paxil, 25mg zoloft, and 150 mg Wellbutrin xl for 16 years. We tried to make a change and increased the zoloft and lowered the paxil and I got aroused immediately and had the greatest orgasm ever - like I was on ecstasy or something. We ended up lowering and going off the paxil and zoloft and it’s been a year of hell.

I had no problems with erections of sex drive when on all the meds but when on the 10 mg lexapro and 150 Wellbutrin I have no sex drive, hard time maintaining erections, and my glans feels smooth or cold at times in a weird way. I just tapered off lithium which they put me on when they took me off the paxil and zoloft and I had better erections than I have now but they didn’t feel good and I hated the lithium. I don’t dream anymore, have brain fog, and am exhausted. When I tried to increase the lexapro to 12.5 I had more erections but orgasm made me feel sick.

It seems more SSRI helped my sex drive but low SSRI hurts it. I may try to add deplin next as I have homozygous mthfr mutation and if that doesn’t work I’m gonna try to go off the lexapro. I’m also flat and depressed now - how’s your mood?

It seems some men have hypersexuality when they are on ssri, and the problems starts when they stop or lower the ssri.
My mood ? Depressed. But i am not the most depressed guy in the world, and this could be caused more by my personnal situation than ssri.
Have you tried inositol or other things ?

[Vercingétorix]

Well, after about 2 month of treatement it seems that inositol is not so efficient. My erections are not as good as they were in the first weeks of the treatement.

I stop inositol for 1 ou 2 weeks, then I'll try something else. Maybe one week ON / one week OFF.

[JakeLawe]

Have you tried Buspar? What sexual symptoms you have?

Genital anesthesia?
Low semen?
Weakened orgasms?
Low libido?

Can you check any of those?

I'm curious of Buspar. Has worked with some people here.
I haven't tried it myself but would like to see the success recurrence. Of course read about all possible side effects even the not so common and on your own risk. Seems rather benign as in only dizziness, nausea and drowsiness can be common If I remember correctly.

If you do that trial please report back and if you do please report what symptoms alleviate from those and what doesn't and to what degree and after what time.

Things that I think helped me recover faster (but in retrospect I think was only time):

D-aspartic acid (for testosterone)
Fenugreek (for testosterone)
Tribulus (I feel erections are even stronger and libido too and even helps a bit with semen volume)

All of these effects wear off as soon as I quit AS ANY NORMAL drug/supplement should have btw!

But you may want to try any of those supplements too.

If you do the buspar, please check on the symptoms. I'm specially curious if it'll help with genital anesthesia and low semen. Also if you do buspar only do it on it's own I'd say.

[Vercingétorix]

Have you tried Buspar? What sexual symptoms you have?

Genital anesthesia?
Low semen?
Weakened orgasms?
Low libido?

Can you check any of those?

I'm curious of Buspar. Has worked with some people here.
I haven't tried it myself but would like to see the success recurrence. Of course read about all possible side effects even the not so common and on your own risk. Seems rather benign as in only dizziness, nausea and drowsiness can be common If I remember correctly.

If you do that trial please report back and if you do please report what symptoms alleviate from those and what doesn't and to what degree and after what time.

Things that I think helped me recover faster (but in retrospect I think was only time):

D-aspartic acid (for testosterone)
Fenugreek (for testosterone)
Tribulus (I feel erections are even stronger and libido too and even helps a bit with semen volume)

All of these effects wear off as soon as I quit AS ANY NORMAL drug/supplement should have btw!

But you may want to try any of those supplements too.

If you do the buspar, please check on the symptoms. I'm specially curious if it'll help with genital anesthesia and low semen. Also if you do buspar only do it on it's own I'd say.

My case is particular because my libido was higher on ssri, and the sexual problems started when I lowered it. I am currently still on citalopram, my libido is normal but my erections are weak. In fact I am not sure I have PSSD, maybe it is only ssri related sexual dysfunction (you can read the first message of the topic if you want more details).

I will try tribulus and aspartic acid one day, maybe in association with inositol for the next time.

I have already though of trying buspirone, but I prefer to try safer products before taking a new medicine.

[tonyareias]

Buspirone works on libido and better on woman.

Natural alternative to buspirone is ginkgo biloba.

[JakeLawe]

Buspirone works on libido and better on woman.

Natural alternative to buspirone is ginkgo biloba.

How would buspirone and gingko biloba be similar? Do they target same kind of brain areas?

[tonyareias]

Buspirone works on libido and better on woman.

Natural alternative to buspirone is ginkgo biloba.

How would buspirone and gingko biloba be similar? Do they target same kind of brain areas?

Yes, they are similar at neural targets, except blood flow (only for ginkgo)

[Vercingétorix]

bupropion- NDRI, blocks reuptake of dopamine, requires a prescription
vitamin E- reduces prolactin, which should raise dopamine. it is quite safe.
dopa mucuna/mucuna pruriens- essentially an exogenous source of dopamine, comparable to levodopa. this completely cured my cognitive and affective symptoms (anhedonia, brain fog), but didn't have as much of an impact on sex drive as I had hoped.

if you try bupropion or dopa mucuna, be careful with them- you need to dose consistently, and never stop abruptly. you always need to do a slow taper.

I started mucuna pruriens and maca one week ago, hoping it could improve my sexual function. Could you just tell me how much mucuna you took, and after how many days you started getting positive effects ?
For the moment I have no effect, I am only tired when I upper the dose.

[sovietxrobot]

They both started working very quickly for me. I have a friend (without PSSD) who gets same-day benefits from taking DM. I'm surprised you haven't seen any benefit. You may want to stop and trying some other things first, DM is not to be taken lightly. You can get prolactin levels tested as an imperfect proxy for dopamine levels. I would say switch to escitalopram first, then try adding buspar. If that doesnt help enough, you can add mirtazipine or trazodone. These two in particular target the serotonin receptors most associated with sexual dysfunction.

[Vercingétorix]

They both started working very quickly for me. I have a friend (without PSSD) who gets same-day benefits from taking DM. I'm surprised you haven't seen any benefit. You may want to stop and trying some other things first, DM is not to be taken lightly. You can get prolactin levels tested as an imperfect proxy for dopamine levels. I would say switch to escitalopram first, then try adding buspar. If that doesnt help enough, you can add mirtazipine or trazodone. These two in particular target the serotonin receptors most associated with sexual dysfunction.

In fact my libido is a little bit higher those last days, I believed it was just a natural fluctuation, but it could be an effect from mucuna/maca. I continue the treatement for 2 weeks and I will see the results. No effect on erections for the moment.
I don't want to take new medicines for now, I prefer to try first some natural suplements. I will start a new inositol cure next month (the first cure was succesful but the effects decreased after a few weeks), and try yohimbine.
Maybe I will try buspar in a few months, because it seems to be a light medicine.
About switching to escitalopram : I am only followed by a general practionner, who I already talked to about switching to another antidepressant. He doesn't want to, he told me the switching was too difficult. If I want to switch I have to see a psychiatrist.

I 'll talk to my doctor about prolactin.