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Old 06-08-2011, 09:33 AM   #1
Paxhell
 
Join Date: Dec 2007
Posts: 176
Pure speculation and guessing about PSSD

I want to write a post about what I have learned about PSSd after researching it since 2007 and recently found a doctor who took paxil and sufferes from PSSD. He told me why quitting paxil might make you worsh off than being on the drug. And remember I am only talking about the sexual sides, I am not addressing all the other problems of withdrawl.

First. When you take an SSRI you are not only increasing serotonin but you are downlegulating dopamine. How does this happen? Well, SSRIs alters the activity of Serotonin receptors, that leads to dopamine transporters to transport more dopamine to where it can be used for re-uptake. This leads to less dopamine being available for dopamine receptors to use. Not only do you have less dopamine but SSRIs seem to "trick" dopamine transporters into producing serotonin signals, resulting in more serotonin. Dopamine receptors increase as the brain tries to make up for less dopamine. This will make the dopamine receptors supersenzitive, especially the D2 and D3 receptors. In some rare cases SSRI's can increase the dopamine receptors so much that people become hypersexual when on SSRI's, usually that is not the case though. When one stops taking the SSRI, there is less activity in the dopamine transporters, leading to less dopamine being used for re-uptake, this leads to increase in dopamine that the receptors bind to. This is the reason for the increase in sex drive when you first quit the SSRI. With time, the brain stabilizes the increase in dopamine so you are yet again left with less dopamine, but the worst part is, you are not taking the SSRI anymore so there is less dopamine receptors activity. You are left with less dopamine and less activity from the dopamine receptors resulting in persistant sexual dysfunction. Though SSRIs don't have a direct dopamine antagonist effect, quitting the drug seriously effects those receptors. Dopamine also inhibits prolactin, and as we know prolactin is a libido killer. When men have an orgasm normally, dopamine decreases, this will cause a rise in prolactin, that is the reason men are not "horny" right after having sex. PSSD sufferes often have elivated Prolactin, do to too little dopamine activity. That's why they are not in the mood for days sometimes after having sex.

Now what can be done. There are 3 options, waiting till you recover. That can for some take a long time, many years even. 2, you can find a way to increase dopamine without another drug. Light excercise has been shown to increase dopamine but regular light exercise have shown to increase the activity of dopamine receptors. b-6 vitamin has shown to increase the enzime that converts L-Dopa to dopamine. This was proven many a long time ago when reseasrching cures for Parkinson's. You have to take up to 40-50mg of b6 though to see any difference. b-6 has been shown to decrease prolactin too. Taking Zinc will increases testosteron by decreasing estogen. The increase in testosteron is only temporary though, unfortunately. There are some food that increase dopamine. Stay away from caffein and alcohol, or at least consume less of it.

If you have waited years and no improvement and the natural approach doesn't make any difference, there is another way. There are medication that will increase dopamine and dopamine receptors. I know the people here are against all drugs of any kind, the truth is in some cases medication is the only way to restore sexual function in PSSD sufferes. I agree with the good people here that the best way is to wait, in most cases things will restore themselved. Unfortunately some people don't recover, and that's the horrid truth. Medication should only be used for PSSD if everything else has failed. There are many who have commited suicide over their PSSD. Should they have used medication first to see if things improved, YES, of course. I am not recommending these drugs at all, but they should be used if things don't improve after years of being off the SSRI. Let's not forget that quality of life is important and sex is part of that. I know the mods will be so mad at me for even suggesting another drug. This post is not meant to influence people to become dependent on another drug but it's only to give PSSD sufferers information.

What medication can be used.
Wellbutrin is a dopamine re-uptake inhabitor, as well as being a norepinephrine inhabitor. Wellbutrin binds to the dopamine transporters, leaving less dopamine to be used for re-uptake. Many doctors have used Wellbutrin as a way to combat SSRI sexual dysfunction and done so successfully. I have tried Wellbutrin and it did elivate my sex drive alot. I quit taking it though because I wanted to try the natural way. I walked an hour a day and used Zinc and b-6 and that made a huge differense. The increase in sex drive from Wellbutrin was more intense though. I did not mention Wellbutrin in earlyer post because I so want people to try the natural way first. I am prove that it makes a difference. The downside to using Wellbutrin is you might have to increase ther dosage with time and your sex drive will be totally dependant on the drug. You wouldn't want to ever quit it. Wellbutrin might also incrase anxiety in some people and cause mania.

Dopamine agonist can be used to treat PSSD. Doctors have used them with good success. There is also an ongoing clinical trial to test the effectiveness of the dopamine agonist Requip (ropinirole) in reversing the symptoms of SSRI-induced sexual dysfunction and Post-SSRI sexual dysfunction. The drugs that can be used are Mirapex and Requip. Only small doses should be used as big doses might give you horrible side effects including hallicination and compulsive behaviors. These drugs are used for Restless legs syndome and in big doses for Parkinsons. People should be warned that dopamine agonist have caused hypersexuality, compulsive shopping and gambling and ruined many peoples lives. In those cases, big doses were usully involved. Mirapex and Reqiup work well on the D3 receptors and D3 receptors control behaviour and sexual pleasure. Dopamine agonist have shown to inhibit prolactin too.

Again, I urge every one to try EVERYTHING else before thinking about medication. The brain has a funny way of fixing itself, it just takes alot of time and you have to be VERY patient. The psychological part plays a big part in PSSD to I know that myself. In fact PSSD is a combinition of chemical imbalance and incresed anxiety over the sexual dysfunction. I often found out years ago that when I was drunk, I was less afraid to attempt sex and things worked much better. That only proves that anxiety plays a part. Having a positive attitude maked all the difference. Negativity will only make things worsh. And remember to do light exercise every day. I hope this post will help someone. There is always hope and a way to have a better quality of life.
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Old 06-21-2011, 05:20 PM   #2
rnm85
 
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Re: The reason for PSSD and how it may be eliminated

Thanks for the tips. I'm afraid I have PSSD and I'm 25. It's been over a month since I quit Zoloft and I seem to have lost the sensitivity in my penis. It takes forever to orgasm, and it's doesn't even feel good when I do. It's very hard to keep an erection without stimulation as well. I don't get the pleasure feeling in my brain like I did before I took Zoloft after orgasm, it just feels like a thud. I think I may have a dopamine problem now because sex just doesn't feel like it used to. I've been taking zinc to see if I can see some improvement.
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Old 06-21-2011, 07:50 PM   #3
brunyan
 
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Re: The reason for PSSD and how it may be eliminated

I can speak for myself and say that after about 16 months I have seen massive improvement.

Going from not being able to get it up at all or have ANY sexual feelings (but always a decent orgasm, interestingly, just nothing before it) to being able to have sex more often than not and enjoying it.

One thing that has NOT improved at all is the amount of ejaculate. I remember within a week after CTing move ejaculate went from normal to VERY sparse. I fear my endocrine system is permanently screwed. but this remains to be seen.

I would like to know how to get my testosterone system back to normal without medical intervention. The dopamine is coming back, I can feel all of that. I just want the rest back.

Im thinking about taking that zinc supplement again.

Btw what brand do you take? Dont link to a commercial site, just tell me if you can.


-Ben
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2000 Lamictal
Zoloft
2001-2003 Still Zoloft
2004 Neurotin
Lexapro
Seroquel
2005 OFF MEDS ENTIRELY
2006 -2009 Lexapro
March 2010 Off Lexapro on Zyprexa
November 2010 off Zyprexa

Off ALL MEDICATION -Jan 22nd

Symptoms: Sexual Dysfunction while on Lexapro during 2009. Bad PSSD after coming off in March 2010Cognitive Problems, Sensitivities to food (especially sugar/caffeine/alcohol)
NOVEMBER 8th 2011 almost ALL symptoms of PSSD and withdrawal are gone
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Old 06-22-2011, 08:54 PM   #4
rnm85
 
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Re: The reason for PSSD and how it may be eliminated

The zinc question probably isn't to me, but I am taking GNC Zinc 60 mg per day.
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Old 07-04-2011, 04:50 PM   #5
worrriedsick
 
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Re: The reason for PSSD and how it may be eliminated

I agree with a lot of what you are saying paxhell, but what do you mean by "light exercise"? I have noticed that exercise helps, but I don't know what type of exercising I should be doing more of, weights or running? There has been a couple (rare) times when I lifted weights real hard and I feel like my sex drive is back in full force. This effect is only there for a short while and then things go back to lack of libido. I think the anxiety attacks the feeling a little bit. I too am more willing to have sex when I am drinking alcohol, but after the effects of alcohol wear off I feel depressed and ****ty. Should I stay away from alcohol? I am in college and alcohol is a big part of what is going on around me, I also feel like it will help me meet more girls.
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Old 07-10-2011, 11:35 PM   #6
ScubaDoobyDoo
 
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Re: The reason for PSSD and how it may be eliminated

Hi WorriedSick.

I also have PSSD. I have found that exercise helps but you have to be dedicated to it. The best I have found at least is to do some sort of aerobic weight training. Running can actually decrease testosterone. Drinking alcohol definitely does as well as turning on your depressive system.

Anyhow my libido increase from doing serious weight training.

The main problem I have left from PSSD is soft glans syndrome. I cannot get the head of my penis hard for the life of me, but things aren't as bad as they were prior to exercise. I have had PSSD for almost 3 years now, and a year and a half of dysfunction while on SSRIs. Best of luck to you.

I personally haven't tried wellbutrin. I honestly am afraid to take any more drugs. Besides I don't really know how that would help with the soft glans problem.

I took zoloft and effexor. I never had sexual dysfunction prior to these drugs, not even at the greatest depth of my depression.
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Old 07-11-2011, 11:52 AM   #7
rnm85
 
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Re: The reason for PSSD and how it may be eliminated

I have the soft glands problem too. Before Zoloft the head of my penis would swell and fill with blood, now it doesn't do that anymore. I have gotten comments from women "I love your head. It's soft." Ugh, I'm not sure if she was serious or just trying to make me feel better, but I don't like it one bit.
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Old 07-28-2011, 09:10 AM   #8
zebass
 
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Re: The reason for PSSD and how it may be eliminated

Those medications sound hopefull in a way...but the side effects do not seem without risk!
Is there anyone who has experience with either the parkinson medicine Requip/Mirapex or either Wellburtin?
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Old 07-28-2011, 09:21 AM   #9
brunyan
 
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Re: The reason for PSSD and how it may be eliminated

I would HIGHLY suggest against them.

I did try these medications back in Feb and I got some short term results. BUT. They are short term and could be damaging you more. If anything it gave me a window into what I would be sometime around right now, which is much better.

-Ben
__________________
2000 Lamictal
Zoloft
2001-2003 Still Zoloft
2004 Neurotin
Lexapro
Seroquel
2005 OFF MEDS ENTIRELY
2006 -2009 Lexapro
March 2010 Off Lexapro on Zyprexa
November 2010 off Zyprexa

Off ALL MEDICATION -Jan 22nd

Symptoms: Sexual Dysfunction while on Lexapro during 2009. Bad PSSD after coming off in March 2010Cognitive Problems, Sensitivities to food (especially sugar/caffeine/alcohol)
NOVEMBER 8th 2011 almost ALL symptoms of PSSD and withdrawal are gone
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Old 12-18-2011, 01:26 PM   #10
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Re: The reason for PSSD and how it may be eliminated

I've been off SSRIs for around 4 months now and things with sexual dysfunction are getting only worse for me. I heard that it tends to happen. So I did a little research on my own on how my 'cure' this thing or atleast make it better.
There are few natural remedies for it, few vitamins.
Firstly Ginseng. I have no experience with it, but I heard that it does help out some people. Its 100% natural, it gives you energy, its worth a try.
Then ginkgo biloba seems to boost up the sex drive.
Macca powder (which I am using right now) seems to do the trick for some people. There has been research done with it and it seems that it tends to help post ssri sexual dysfunctions. I've been using it for uhmm.... 2-3 weeks now, I have increased energy which is perfect, I have slightly increased libido now, but still unable to reach orgasm normally. You have to take it for 4 weeks to have it fully 'work' on you. So far I can say that it isn't a life saver, but it sure doesn't make things worse so its worth a try.
Then there are herbal pills. These work just on women. They are called Shatavari. I got completely no idea what is the success rate of women using them, but yet again I think its worth a try. Its natural and inexpensive.
Horny goat weed is also a natural remedy, but so far I haven't found actual proof that it works. Its most likely just like a placebo.
There are pills called 'Hersolution' for women. Manufacturers say that they are all natural ingredients. There seem to be many positive feedbacks on the pills. But yet again no actual scientific research, so in my opinion its best to avoid these.
The only pills/vitamins/dietary supplement that has been scientifically researched is called ArginMax. They are made for both men and women. I heard very positive feedback about them and tempted to try it myself.
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Old 12-18-2011, 04:02 PM   #11
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Re: The reason for PSSD and how it may be eliminated

Just a quick observation here as someone who is very knowledgeable about supplements (and needs some for medical reasons) and also has read on this site for many years.

We have found that supplements frequently advised or used for certain conditions often have very different, and often very negative, effects when the problem being addressed is caused by meds or withdrawal.

Some people in withdrawal can take supplements with no problem, but most find they have sensitivities to things like supplements (and many meds) that can take quite some time in many cases to resolve even after finishing tapering.

I had to stop taking the supplements that were helping many of my pre-existing medical problems, once I went into withdrawal, because I realized that many (possibly all) were aggravating severe withdrawal symptoms. It was only after years off paxil that I tried some supplements again, and even then I had to introduce them very slowly (starting with just tiny fractions of tablets or capsules of supplements I used to take with no problem), and after brief adjustments am now able to take as large doses as necessary (within safe limits, and under the guidance of an M.D.). But my doctor took me seriously that earlier in w/d my body was in such an altered state I couldn't tolerate even the supplements that normally benefited me.

Also, though I'm not knowledgeable about PSSD specifically (beyond what I read here), conditions caused by withdrawal - and which can last for a time beyond that last pill! - are caused by the changes made by the meds and which need to heal, and are not caused by the other things that can cause such problems, even if the problems seem the same.

If one can tolerate supplements and wants to try them, fine - though I do urge everyone using supplements in w/d for any reason, to introduce them very slowly. Tiny amounts at first and increasing by another tiny amount every 4-7 days, no sooner. (I had to introduce some supplements, such as the vitamin D blood tests showed I was very deficient in, by 1/10 of a capsule's contents at first! But that way I was able to tolerate it and worked up to a full therapeutic dosage with no problems. Easy does it!)

A special concern too about L-arginine, which is in ArginMax and many other supplements. My doctor suggested I try it for my stubborn high blood pressure and said it has no side effects he's aware of. Well, usually not, but I had such bad side effects I couldn't take it. I have read of other people having more severe reactions to arginine (maybe they didn't start with the low doses I did). Although it's helped many people and they've been able to avoid medications (for circulatory system problems) that have bad side effects, the desired effect of increasing nitric oxide can be horrible when one's body is sensitized following SSRI (and some other meds) w/d.

Lecithin is a natural food product and probably would not be a problem for most people, but even then I'd suggest introducing it very slowly if you choose to try it.

I only have "book knowledge" of horny goat weed and maca etc., but I'd be very careful with them because the hormone and other systems affected by these meds and the subsequent healing process are in a huge state of flux as they are healing and the body is working hard at restoring natural homeostasis, and what one "needs" at any given time can change frequently during this healing process.
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Old 03-02-2012, 10:46 AM   #12
Schwinn57
 
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Re: The reason for PSSD and how it may be eliminated

Wellbutrin does not always work as a way to fix PSSD.

I took Wellbutrin for a year after taking Paxil for 2 months and it has had absolutely no effect on my very severe form of PSSD.
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Old 04-14-2012, 03:56 PM   #13
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Re: The reason for PSSD and how it may be eliminated

If you are looking for a natural alternative to Wellbutrin, I used L-Tyrosine.

I had w/d problems with Wellbutrin, (nothing like Paxil, but still present) which is not supposed to happen.... Anyway, L-Tyrosine seemed to be a good inbetween step for me.

So.... if you are thinking about taking Wellbutrin for sex drive, L-Tyrosine might be a better alternative.

Does anyone else have any experience with it?
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Old 05-20-2013, 10:10 AM   #14
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Re: The reason for PSSD and how it may be eliminated

Quote:
Originally Posted by knowla View Post
If you are looking for a natural alternative to Wellbutrin, I used L-Tyrosine.

I had w/d problems with Wellbutrin, (nothing like Paxil, but still present) which is not supposed to happen.... Anyway, L-Tyrosine seemed to be a good inbetween step for me.

So.... if you are thinking about taking Wellbutrin for sex drive, L-Tyrosine might be a better alternative.

Does anyone else have any experience with it?
I have not, but one year later I still have PSSD and nothing much has gotten better.
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Old 05-25-2013, 11:30 AM   #15
tom1986
 
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Re: The reason for PSSD and how it may be eliminated

I would like to add my story to this thread as it could possibly help people. I am a 26 year old male. I took Paroxetine for 4 days in Feb 2013. I noticed that I was eating a lot more than I normally did and also I lost the sensation in the end of my penis, could not get an erection and could not ejaculate, so I decided to stop taking the medication.

I read nearly all the threads regarding sexual dysfunction and PSSD and totally freaked out. After about 3 months I would say that all of the problems that I had went away- so now I can get an erection and I can ejaculate, also I can feel the end of my penis. However the end of my penis is not as sensitive as it used to be, but now strangely when I ejaculate I have a very weak and sometimes undetectable orgasm.

I used to have very strong amazing orgasms. I noticed suddenly about 2 months before I took Paroxetine that they didn't feel as strong anymore. I was going to go to my G.P and discuss the issue, then Paroxetine came along and I didn't. Although I am 26 and have had 1 night stands I have never had a boyfriend and never regular sexual partners. I sort of attribute in my mind that my brain and body has got bored of me masturbating and wants some of the real thing, as I had sex with a guy a month ago (post peroxetine) and had a pretty good orgasm, so I am going to stay positive. If it doesn't get better when I am with someone, then I will visit my G.P and explain and will ask for blood tests for hormone levels etc.

What I would say is that a positive approach is the advisable one. At the beginning of my PSSD experience I was very depressed. I stayed in my room and read loads about it and felt awful, but I realised that this would get me nowhere so I carried on my daily life of eating reasonably healthily and going to the gym etc. I think that doing these things can help and have some idea that the human body has a good way of naturally repairing itself with time, and if in time you don't find you are getting to where you want to be, consult your doctor, talk honestly and openly and explore physical and psychological ways of getting your sexual function to be the best it can be.

Having mental health issues is bad enough. I have BDD and OCD and general anxiety without having an antidepressant take away your ability to enjoy a healthy sex life.
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Old 05-25-2013, 01:38 PM   #16
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Re: The reason for PSSD and how it may be eliminated

If you have not visited David Healys' websight Rxisk.org yet can i invite you too he is collecting details of pssd sufferers.
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Old 07-08-2014, 12:36 PM   #17
wdtony
 
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Re: Pure speculation and guessing about PSSD

Just wanted to add my personal experience. I took prozac for about 2 months when I was 21. During that time I was completely impotent and had almost no sexual desire. Prior to and after ending the Prozac I had a strong libido and no physical problems sexually.

I was terrified by the idea that this might be a permanent disability. Fortunately for me it was not. But if it had, I doubt I would have felt like life was worth living.
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Old 07-09-2014, 08:27 PM   #18
OlCrazyJack
 
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Re: Pure speculation and guessing about PSSD

I just mentioned it on another thread, about what the dopamine alteration did to me. I haven't suffered permanent impotence, but rather was left with a case of Generalised Dystonia that a neurologist considered most likely to have a permanent prognosis. I used to take the zinc supplements for it, but they caused me a lot of nausea problems- even with food or mints. They did seem to help some, though.

I'll never put another pill of medication down my throat again, though, so, the anti-Parkinsons drugs that they offered me are out of the question. I'm also not willing to gamble with herbs.

I can vouch for the zinc, though.
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