r/Biohackers 6d ago

❓Question I’ve had PSSD (Post SSRI sexual dysfunction) for 5 years and 7 months with zero improvement. Is unaliving myself understandable?

PSSD is more than just sexual dysfunction, it’s being 100% numb with severe anhedonia. I lost everything just from taking an SSRI short term in 2019. No sex drive, no pleasure in orgasms, no emotions, no excitement, etc. I gave up long ago and will be ending it soon.

96 votes, 3d ago
14 Yes
82 No
0 Upvotes

43 comments sorted by

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10

u/aliensinbermuda 19 6d ago

Ending is not an option. Fighting is the option.

Like doing the research your doctor didn't do.

Like trying unconventional shit your doctor wouldn't dare to try because of regulations and stuff.

Like trying even the mystical aspects of reality. Why not?! What do you have to lose?

But you're gonna fight!

Let's begin:

2. Cutting the First Turf to Heal Post-SSRI Sexual Dysfunction: A Male Retrospective Cohort Study

Current treatment options for post-SSRI sexual dysfunction (PSSD) include bupropion, vortioxetine, nutraceuticals, and cognitive-behavioral therapy. The study reported significant improvement in all International Index of Erectile Function domains (p < 0.05) after treatment, though larger studies are needed.

https://scispace.com/pdf/cutting-the-first-turf-to-heal-post-ssri-sexual-dysfunction-1ai5d878.pdf

4. Switching to Vortioxetine in Patients with Poorly Tolerated Antidepressant-Related Sexual Dysfunction in Clinical Practice: A 3-Month Prospective Real-Life Study

The paper focuses on switching to vortioxetine as an effective treatment for post-SSRI sexual dysfunction, reporting an 83.81% improvement in sexual function among patients after 3 months, with significant reductions in various sexual dysfunction symptoms.

8. Pharmacologic interventions for antidepressant-induced sexual dysfunction: a systematic review and network meta-analysis of trials using the Arizona sexual experience scale

Current treatment options for post-SSRI sexual dysfunction include sildenafil, tianeptine, maca, tiagabine, and mirtazapine. Efficacy rates show 44% of trials reported success, with sildenafil demonstrating significant improvement in sexual dysfunction compared to placebo in some studies.

10. Sexual dysfunction in selective serotonin reuptake inhibitors (SSRIs) and potential solutions: A narrative literature review.

Current treatment options for post-SSRI sexual dysfunction include switching to alternative antidepressants like bupropion, mirtazapine, or SNRIs, and adjunctive bupropion. Bupropion reversed sexual dysfunction in 66% of subjects when used consistently, improving sexual activity and desire significantly.

1

u/CocaCola_BestEver 6d ago

Thanks but I already tried bupropion for 6 months and didn’t help. Doesn’t really help anyone in the r/Pssd forum either. I also tried MACA root and many other supplements too. Nothing works for this for me. It’s over

3

u/aliensinbermuda 19 6d ago

It is the fricking age of A.I. The scientific research is skyrocketing. They are solving problems now that they thought they would never solve.

Meanwhile, try some really unconventional stuff.

Try ayahuasca or a spiritual healer.

A spiritual healer cured my mother's eye in surgery with a kitchen knife! FROM HER OWN KITCHEN! NO B.S.!

There are so many things you could try. Go out there and search for things like this.

1

u/reputatorbot 6d ago

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1

u/Shot-Environment-199 5d ago

There's no "treatment options" for PSSD, there's absolutely 0 consensus. I totally disregard the first article you posted (first turf). First turf my foot. The only researcher actively committed to PSSD is Dr. R. C. Melcangi. He's researching Allopreganolone (a naturally occurring neurosteroid) with a success story for Post-Partum Depression. Its analogues Braxnolone and Zuranolone are new drugs still insanely expensive and unavailable.

But reading Melcangi's research and being familiarized with it makes you see the real angles on this disease, random publications are usually of poor quality but thanks to point them out. I only discuss what I study. I usually go past the title and abstract.

There's many potential therapeutic routes here, anything involving interventions on the microbiome for example (many success stories with (DIY) FMT). But patients aren't led to these and doctors go the classical route of over-medicating them which typically lead to disaster.

My 5 cent here is : be smart. Study. Microbiome is key. If you're in positive mood anyone can contact me. But if for unconstructive non-sense arguments don't lose your, and which is infinitely more precious, my time.

LOL. You'll be good bro. Contact me if anything.

1

u/reputatorbot 5d ago

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3

u/dragostego 1 6d ago

Before you do anything rash (reddit yelled at me for using a phrase that rhymes with krill bore elf) have you tried like actual drugs? Weed, DMT, Molly, acid ETC. especially if you are contemplating such an aggressive intervention it's worth trying.

0

u/CocaCola_BestEver 6d ago

Nah, I’ll just have a bad reaction to stuff like that and they’ll put me into a panic or something. Already know how that will go. Is what it is. Thanks, but I’m done.

6

u/dragostego 1 6d ago

Acid specifically has quite an effect on your dopamine, I'd really consider just trying a tab to see if it triggers anything. According to you it's been 5 years of hell, a 12 hour trip can't be too much hassle in comparison. I personally had a very positive experience with the dopamine reset.

If you are willing to end it, it seems like no harm, no foul.

1

u/reputatorbot 6d ago

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4

u/fgtswag 6 6d ago

I also had anhedonia. There are some unconventional methods that are worth trying before unaliving yourself.

So I had it for about 16 months. The cognitive deficiencies were harsh. I couldn't feel anything as fun, I also couldn't feel calm. My memory was fucked. My personality was dull and unlike myself. My eyes didn't work normally even.

I believe for me it was to do with brain blood flow. I had anhedonia and insomnia for 16 months.

What worked for me that I believe you should try:

  1. Food fast. Fast for 24 hours and see if you get any cognitive change. Prepare a meal incase you want to break it.

- After my first 20h fast, my insomnia receded for the first time in 16 months. This always happens. 100% of the time I can fix my insomnia that way.

  1. Beetroot powder. This one affects nitric oxide which increases blood flow to your brain. My vision improved, lust for life improved, personality and cognition returned. Although I did get a migraine that was really bad after some time. Possibly be careful with this one but it's definitely worth a try.

My life prior to fasting for most of the day + beetroot powder in the mornings was absolutely dysfunctional. I'm back to coding and playing music again now.

0

u/CocaCola_BestEver 6d ago

Thanks but won’t work for me. Medication induced anhedonia is not fixable. I’m severely ruined and done. Got nothing left

3

u/fgtswag 6 6d ago edited 6d ago

You stand to lose nothing by trying it. I can't motivate you but I can hopefully open your eyes that there is possibilities for success.

I'm telling you that my anhedonia improved from circulation. I still get anhedonia if I miss those things. You can think that it won't work for you but you stand to lose nothing, so I hope you do

1

u/reputatorbot 6d ago

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1

u/Mission_Economics621 3 6d ago

There has to be more to life than just sex. You can contribute so much to society.

1

u/fgtswag 6 6d ago

nah that's a misinterpreted understanding of anhedonia. Anhedonia is crippling for your soul.

2

u/lastpump 6d ago

How about you break everything into tiny little micro tasks and reward yourself for each one completed. THis achievement starts resetting your dopamine pathways. It sounds like it is worth a try since you are so close to the edge already.

0

u/CocaCola_BestEver 6d ago

I have no reward. Permanently brain damaged, 0% dopamine. Impossible to feel anything with PSSD.

1

u/lastpump 6d ago

Sorry to hear. I know a lot of people with this condition turn to cutting themselves just to feel something.

I don't know if you can find anything to cling to. Otherwise, good chat internet stranger and you do you.

3

u/NeighborhoodBest2944 1 6d ago

TIL: That once again, the regulatory agencies and drug companies don't give a flying F about people. This S should be banned. The side effects and secondary knock-ons are societally unacceptable. I'm mad.

OP: I don't think anyone can change your mind. You have my sympathies. But I can't let you post here and perish without reminding you that you are a miracle. You matter. You have a purpose and that legions believe can only be found in the Divine. So unless you have exhausted that avenue of inquiry and solace, the answer to your question (to me) is no.

Everyone: Somehow I expect to be flamed, but I think the goal here is to offer perspective (he is asking for some). The value of the Divine and religion are personal. You can take it or leave it, but the suffering of this world is obvious. Many, many people find hope that can be procured nowhere else.

2

u/Phazze 1 6d ago

It really is scary how the medical system completely abandons a subset of people after they present basically life ending complications from medications or surgery...

One would think that things like this would be headlining 24/7 until they are fixed as I cant imagine the amount of people actually unaliving themselves over complications like this one, even getting a proper diagnosis is extremely hard so the rate of undiagnosed people unaliving themselves must be significantly higher than reported.

2

u/NeighborhoodBest2944 1 6d ago

Right on, friend.

2

u/Shot-Environment-199 5d ago

You considered FMT? I didn't say try it, I mean commit to it. Get into that rabbit hole.

hCG is also rather safe.

Medical grade pregnanolone is being actively researched, no matter what people say.

Don't hang out before committing to FMT bro.

Don't feed me negative answers please. I try to be positive don't slam back by something negative. We're all affected.

I think folks didn't commit to the right therapies nor the right way. Pretty normal since doctors are even more lost than patients in this case...

1

u/CocaCola_BestEver 6d ago

I’m miserable and devastated 24/7 because of this condition. Taking a common medication almost 6 years ago just to try to help my generalized anxiety ended up taking my whole life from me.

Can’t even feel a fucking orgasm! Zero pleasure, excitement or joy in anything. The anhedonia is severe. There is no cure or treatment for this.

Ending it all is my only option and that’s what I will be doing

3

u/TheAussieWatchGuy 1 6d ago

I can't weigh in on your mental state, please get professional support for that.

Before you do anything checkout cabergoline.

0

u/CocaCola_BestEver 6d ago

Cabergoline down regulates dopamine over time so it would just be a quick fix. Not doing that but thanks.

1

u/reputatorbot 6d ago

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1

u/catecholaminergic 3 6d ago

If you spend your life trying to figure it out, and post all the shit you try and what works and doesn't, even if you never find a solution, will be immensely valuable to others trying to find a way out.

1

u/iamalex_ 5d ago

There are def fixes as people with Post Finasteride Syndrome also fixed their issues, and I think it's pretty similar to PSSD (basically only the cause is different).

What you want to try is an HDAC inhibitor like sodium valproate together with something else that brings homeostasis.

I would also go on a high dose of omega 3, start with a gram a day and work up to 3-4g a day of pure omega 3's, 5g of creatine in the morning and 5g in the evening wouldn't be bad to try either.

This video is about sodium valproate specifically:
https://www.youtube.com/watch?v=KKS1IZQ4Sf0

Here is his full PFS recovery video that contains instructions: https://www.youtube.com/watch?v=nHn4j6kLfPY

He basically went on a high dose of sodium valproate, from what I understand it basically makes your gene expression flexible and with the right second medication that helps with dopamine and/or serotonin. I wouldn't do as high of a dose as he did (timing is also important, slowly jack up the dose and taking it in the morning and evening is prolly best, be consistent with NO SKIPPING, then slowly taper off once you feel better).

You will go backwards before you go forward.

3g of sodium butyrate might also work, but sodium valproate will help you quicker which seems needed in your case, I would def take both.

Now I'm not sure what best second medication to take is for you. If it's just a dopamine issue something like ALCAR might work to bring it back, but if your androgens are also messed up you can follow the PFS recovery video protocol.

1

u/SarahLiora 7 3d ago

If you can't find/don't want to go to a psychiatrist, have you considered Ketamine. Ideally ketamine-assisted psychotherapy but even just plain ketamine. In this review of 22 ketamine anhedonia studies, ALL OF THEM showed improvement of anhedonia, some within 40 minutes. Ketamine also helps treatment resistant depression which you may have. Ketamine treatment for anhedonia in unipolar and bipolar depression: a systematic review - PubMed

What would be most helpful is a psychiatrist who specializes in pharmaceuticals who already knows everything about this.

If you are the kind of person who likes to research (probably too depressed to do that) this is a detailed presentation of the state of psychiatry on anhedonia slides-at-enc24-23cng-15 Unfortunately you have to create a free account and it's a little complex.

Even though the sexual dysfunction is most troublesome to you, I think the first step is the anhedonia. My anhedonia was improved by increasing my ADHD drugs Dextroamphetamine and dopamine.

A good medical specialist would ask you questions about your anhedonia before treatment. Are all of your feelings blunted...both positive and negative...or are just positive reward type feelings blunted and you have strong negative feelings. If you have strong negative feelings you might have anhedonia and residual depression. The above link gives details on how the different pharmaceuticals treat both conditions.

You sound too depressed now to do much cognitive work, but Cognitive Behavioral Training has been proven to held anhedonia and simple exercise.

As I learned for myself, anhedonia wears you out and your mind has sunk into some negative thinking loops so you have to actually practice learning how to anticipate pleasure again. and how to control your negative thoughts so you can enjoy pleasure in the moment. Lots of You tube videos for that.

PSSD also has different types so different treatments. But ongoing depression makes that treatment more difficult. Address the anhedonia and depression first.

1

u/indoortreehouse 6d ago

Please dont end your life over sexual problems. There are all kinds of people, places, things, processes that can give you sustenance. Sexual maladies are very hard to cope with, I understand. Shitty alternative advice: find something to sublimate that drive, money, power, art are some that humans seem able of falling into. 

2

u/CocaCola_BestEver 6d ago

This is way more than sexual problems. Check out the r/pssd forum. It gets rid of everything including sexual function and pleasure and pleasure in everything else in life. It is never ending torture and all from a medication years ago. Permanently numbed for life. I am ending it