Truskawa intro

[Truskawa]

Hello,

I've been reading the forum for around three months now, but decided not to post as long as I get some significant, stable relief and have something valuable to share with you. Didn't happen so far.
English is not my native language, I am from Poland.
I am writing this having hope that @Mesolimbo could possibly help me. My mental condition is very bad. At the same time I would be glad if my report turns out to be helpful to any of you in any way.

1- What is your gender?

Male, aged 22

2- Why did you take antidepressants in the first place? and for how long were you on them? which med?

I had been taking Aposerta (sertraline) for six months, I quit it almost a year ago from now. First it was 25mg, then 50mg (one pill), then again 25mg.
The reason for that was anxiety and depression, which I would consider moderate. This led to cognitive issues and my inability to focus on studying because of all the sadness. I also had a problem with drugs, smoking lots of marihuana and occasionally taking MDMA pills, which only worsened the problem and made me seek help in the first place. Now I don't take any of these drugs anymore.

3- How was your sexual and emotional function before antidepressant intake?

My sexual function was good the entire time. I never had any issues, even during the SSRI treatment. It all began suddenly about a month after getting off sertraline.
My emotions were getting bad before sertraline, which led me to the doctor. No emotional blunting however.

4- What are your symptoms exactly and when did they start? sexual dyfunction alone, or cognitive/emotional/hedonistic as well? which symptom is bothering you the most?

My sympotms are erectile dysfunction and lack of libido. It is impossible for me to get an erection with visual stimulation only, hard to get one at all. When it happens, it rarely a full erection and doesn't last very long. I have a beautiful girlfriend, but I find it hard to get aroused around her or anything else, which makes me really frustrated and depressed. ED is the worst thing out of all.
We have sexual life, but it is not easy to maintain it and we don't have sex as often as I would like due to my lack of libido. Last time we had a week without sex, only a period of few days make me want it in a degree that is big enough. So my libido and response to stimuli seems to be blunted. My paranoia around my PSSD also affects our relationship.
I also experience mild emotional blunting, but I think I can cope with that. Don't remember the last time I had goosebumps for example.

5- What meds/suppplements have you tried so far?

Moclobemide, rhodiola rosea, SJW, inositol, deanol, tribulus, fanugreek, ginkgo biloba, zinc
Everything had maybe 10-20% percent temporary effect, which is hard to distinguish from placebo.
Except for moclobemide, ginkgo and SJW, they gave me a window of 60-70% relief that lasted a few days.
Please note that most of these I tried for no longer than 1 week. I wasn't very patient.

6- Do you have access to meds without prescription (buy online), or would strictly require a prescription for meds to try?
No access, I need a prescription. I have instant access to SSRI, baclofen and memantine. For something else, I could try to get a prescription, though.

7- Can you tolerate galicky foods? what about proteins?
I experienced no food related problems so far.

8- Have you done any blood testing? what were the results?

Yes, I have.
I have very normal prolactin level.
However, three months ago I had my sex steroids level rested, and the results seem interesting to me. I upload them in attachment. Looks like my testosterone is fine, but I have low estrogen.

What should I do? I am thinking what to do next. Would baclofen or memantine have any impact on my sexuality?

[Snake]

It's so sad that there are so many countrymen of mine here

[Truskawa]

No wonder why, doctors here in Poland prescribe SSRIs like crazy, many of my friends took it at some point of their lifes. I don't know if it's the same degree of paranoia in other countries.
BTW I forgot to mention that Sildenafil works for me

[Meso]

Did you take MDMA again after quitting Sertraline? How do you react to MDMA after PSSD?

[Truskawa]

Yes, I did it once. It worked like it should, but I had no opportunity to 'test' it in terms of sexuality.
My baseline isn't the same all the time. My PSSD peaked around 3 months after quitting sertraline. Now I have windows of like 20% improvement and also I got my 'morning wood' back. The problem is that I often mixed supplements and I have no idea which of them helped me and which made it even worse.
It is slightly easier for me to have sex in the morning, maybe it has something to do with cortisol and sex hormones balance? I have no idea, but I would love to have my old myself back!

[Meso]

Morning cortisol raises glutamate release. Maybe that's why you benefit in the morning, as glutamate would activate NMDA receptors and increase male sex hormone synthesis. Would you be willing to try SJW + glycine agonist?

[Truskawa]

Yes, sure! I am willing to try anything.
How much SJW and how often? What would you recommend?
And also what kind of glycine agonist would that be for example?
I can take SJW today and report the effects. If SJW turns out to be helpful, should the effects be instant and fade over time or maybe not present after all at the beginning?

[Meso]

Before we proceed, are you interested in a permanent cure or a symptomatic relief?

[Truskawa]

I'd go for symptomatic relief untill my mental condition gets better and I see some light, also right now it would be hard for me to go through any severe adaptation phase since I have my college going on.
I think that if my symptoms turn out to be even partially gone, it would be clear for you and me what causes my PSSD.

[Meso]

I'd go for symptomatic relief untill my mental condition gets better and I see some light, also right now it would be hard for me to go through any severe adaptation phase since I have my college going on.
I think that if my symptoms turn out to be even partially gone, it would be clear for you and me what causes my PSSD.

Alright. SJW will show us if there's any postsynaptic 5HT1A downregulation induced by the SSRI and the MDMA If you react positively to it. Alternatively, you can try Baclofen. For a glycine agonist, I prefer that you try milder ones first such as supplementing Taurine and drinking diet coke.