Safe treatment for anxiety/depression

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Charles36
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Safe treatment for anxiety/depression

Unread post by Charles36 »

Hello everyone,

I suffer from anxiety/depression with the following symptoms :

1) lack of libido & desire
2) lack of motivation
3) strong anxiety
4) bad self-confidence
5) lack of emotions
6) sadness
7) weak orgasms
8) low penis sensation

I try to be rational and think that these symptoms are only linked to my anxiety/depression and not a PSSD caused by my discontinuation of Paroxetine in 2019.
I believe this because from my memories I had a quite happy life during one big year after discontinuation then problems above arrived gradually with work stress (except during my temporary 3 month PSSD, see my signature).

I would like to treat my desease (suicidal thoughts never so far) because I can no longer move forward in life but I'm clearly phobic of PSSD.
So, after many readings, I elaborate what I consider to be the safiest schema in France (in order of priority) :

Tianeptine ==> Moclobemide ==> Mianserin ==> Agomelatine ==> Mirtazapine ==> Vortioxetine

These 6 antidepressants are those which induce the least sexual side effects and the least risk of appearance of PSSD (in France). But for 4 of them, there is a very little risk (orange) / little risk (red).

Do you have any comments/additions ? Safe supplements ? Other ADs ?
01/2019 - 04/2019 ==> 10mg/day Paroxetine for GAD + OCD
04/2019 - 06/2019 ==> PSSD (premature ejaculator)
06/2020 - TODAY ==> GAD + MDD (libido -) searching unrisky treatment
02/2022 - 03/2022 ==> Buspirone 15mg/day (GAD - but MDD +)
Jaxx
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Re: Safe treatment for anxiety/depression

Unread post by Jaxx »

I dont think vortioxetine has low risk, there are plenty reports on the forum it can make things worse (for some). Literature about fewer sexual side effects compared to other ssri’s are not giving a good reference for pssd cases necessarily.

Not sure why miaserin and mitazapine have a different color, they are almost the same as far as i know…
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Charles36
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Re: Safe treatment for anxiety/depression

Unread post by Charles36 »

Well, don't remember why but you are quite right and this is confirmed by page 13 of http://www.cercle-d-excellence-psy.org/ ... s_2017.pdf

Maybe better to say :

Tianeptine ==> Moclobemide ==> Agomelatine ==> Mianserin ==> Mirtazapine ==> Vortioxetine

Does anyone have any other ideas ?
01/2019 - 04/2019 ==> 10mg/day Paroxetine for GAD + OCD
04/2019 - 06/2019 ==> PSSD (premature ejaculator)
06/2020 - TODAY ==> GAD + MDD (libido -) searching unrisky treatment
02/2022 - 03/2022 ==> Buspirone 15mg/day (GAD - but MDD +)
Extremaduro
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Re: Safe treatment for anxiety/depression

Unread post by Extremaduro »

Non of them are equal to an ssri. Unfortunately.
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Charles36
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Re: Safe treatment for anxiety/depression

Unread post by Charles36 »

Extremaduro wrote: Thu Mar 31, 2022 5:51 pm Non of them are equal to an ssri. Unfortunately.
None in terms of what ? Efficacity to treat depression or risk to develop PPSD ?

I am quite sad to see that this forum offers almost no solution to treat depression/anxiety without risking PSSD.
Morality of posts similar to mine : stay depressed all your life because safe tries doesn't exist.
01/2019 - 04/2019 ==> 10mg/day Paroxetine for GAD + OCD
04/2019 - 06/2019 ==> PSSD (premature ejaculator)
06/2020 - TODAY ==> GAD + MDD (libido -) searching unrisky treatment
02/2022 - 03/2022 ==> Buspirone 15mg/day (GAD - but MDD +)
arahant
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Joined: Tue Nov 26, 2019 11:54 am
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Re: Safe treatment for anxiety/depression

Unread post by arahant »

Charles36 wrote: Fri Apr 01, 2022 11:01 am
Extremaduro wrote: Thu Mar 31, 2022 5:51 pm Non of them are equal to an ssri. Unfortunately.
None in terms of what ? Efficacity to treat depression or risk to develop PPSD ?

I am quite sad to see that this forum offers almost no solution to treat depression/anxiety without risking PSSD.
Morality of posts similar to mine : stay depressed all your life because safe tries doesn't exist.
The paradox of mental health is: "You may need a medication to treat your most exaggerated fears and intrusive thoughts, but those fears make you avoid it, and the doom cycle continues..."

This forum is not responsible for your health. You are the one responsible for deciding it.
Wellbutrin (2007 - 2018)
Wellbutrin + Sertraline (2015)
Wellbutrin + Ritalin (2016 - 2018)
Wellbutrin + Ritalin + Sertraline (3 months in 2018)
Buspirone (Feb 2019 - Today)
Ritalin + Buspirone (Nov 2019 - today)
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Charles36
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Re: Safe treatment for anxiety/depression

Unread post by Charles36 »

I agree with you about my personnal case, I just notice that there are more posts explaining what to avoid rather than what can be tried without PSSD's risk.
01/2019 - 04/2019 ==> 10mg/day Paroxetine for GAD + OCD
04/2019 - 06/2019 ==> PSSD (premature ejaculator)
06/2020 - TODAY ==> GAD + MDD (libido -) searching unrisky treatment
02/2022 - 03/2022 ==> Buspirone 15mg/day (GAD - but MDD +)
npiccio
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Re: Safe treatment for anxiety/depression

Unread post by npiccio »

I am very interested in this topic, I am also looking for it.

Do you think the drugs you highlighted in green are completely safe for PSSD?
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Charles36
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Re: Safe treatment for anxiety/depression

Unread post by Charles36 »

Hello npiccio,

All the followings are my conclusions and need to be taken with precaution. I created this post to confirm with others members. For the moment, no one answered my message in a detailed way.

I need to specify that I'm searching a good treatment (France) for OCD/GAD/MDD without riskling PSSD or sexual side effects, how to say it's a difficult mission !!! And my priority is GAD/MDD and not OCD which i'm used to live with...

To my undestanding, most popular PSSD triggers are on SSRI/SSNRI/AP. These tryings (in safe order) are only my beliefs after many researchs :

1) Tianeptine : SSRE
2) Moclobemide : MAOI


For me, Tianeptine & Moclobemide are the safest.

You can experience sexual side effect on Moclobemide because it increases prolactin levels but it's unusual (3,9% : https://www.revmed.ch/revue-medicale-su ... raitements) and for me it's reversible.
If you are worried you can do a test level of prolactin and see if you level is already high or not. If it's already high you could have sexual side effects with treatment but remind that (to my comprehension and readings) it's unusual (some people don't have prolactin augmentation) and reversible.

I see that you have OCD like me, I read on Internet that Tianeptine could cure or worsen this disease, it seems to depends how your OCD is linked to anxiety. For me it's 100% linked with anxiety and when I chill I don't have OCD so Tianeptine could help but for others who have complex OCD, it could get worse.

3) Agomelatine : "OTHERS" in France
4) Mianserine : "OTHERS" in France
5) Mirtazapine : "OTHERS" in France


For the 3 "OTHERS", there are some reports of PSSD but when you see they are reports of getting PSSD taking Zinc, you tried to be rationnal and it is sure that it is safer than SSRI/SNRI or AP...

6) Vortioxetine : SSRI

Vortioxetine is quite similar than Vilazodone. They are known to be SSRI with low chance to have sexual side effects. For PSSD, I don't really know. They are young AD so there is little hindsight on it.
To me, if I was forced to take an SSRI to get better, I will do Vortioxetine/Vilazodone ==> Fluvoxamine. But I pray that I will get better on Tianeptine or maximum Moclobemide (lol).

I didn't talked about Trazodone because what you can see on Internet is too much contradictory.

Sorry if my english is not so good, I'm french so..

Charles36
01/2019 - 04/2019 ==> 10mg/day Paroxetine for GAD + OCD
04/2019 - 06/2019 ==> PSSD (premature ejaculator)
06/2020 - TODAY ==> GAD + MDD (libido -) searching unrisky treatment
02/2022 - 03/2022 ==> Buspirone 15mg/day (GAD - but MDD +)
tonyareias
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Re: Safe treatment for anxiety/depression

Unread post by tonyareias »

If you don’t have problems with Paroxetine, take low / micro Paroxetine dosing.
For me work great for anxiety and sex.
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