SSRI-induced sexual dysfunction

Like 60% of SSRI users, I suffer from SSRI-induced sexual dysfunction. There are several types. Some problems have to do with physical functioning, some with cognitive sexual functioning, and some with both. Some people have problems while on SSRIs and get it back. Some have problems while on SSRIs, and never get it back, even when they discontinue. Strangely, some people have few/no problems while on SSRIs, only to have problems manifest once they discontinue.

Without getting into the details of my 2.5 decades of SSRI use, back in 2012, I stopped taking 30mg of Prozac cold turkey. It wasn't my intention to discontinue, I simply forgot due to tremendous pressure. I was also suffering a marked uptic in IBS symptoms at around this time also. My discontinuation, as is often the case with SSRIs, was asymptomatic for the first month. Thereafter, I experienced absolute hell. My body could not regulate temperature properly, I had severe sleeping problems, etc., etc. My sexual function, physical and cognitive, went to nothing. In about a year, I fully regained physical sexual functioning (I'm a male, BTW). However, ever since the withdrawal, I have been left with some cognitive issues. It took several years before I could think properly. I have nowhere near the appreciation for aesthetics that I once had. I don't ever drink alcohol, simply because it no longer has any sort of euphoric effect on me. Most troubling, I have almost no libido. It's not just that I'm "not in the mood". I am (was?) attracted to women. Now, a woman's body isn't even slightly arousing. Looking at a woman's body is like looking at a fancy car: I can appreciate the beauty of the form, but am not sexually attracted to it. Furthermore, all physical interaction means little to nothing. Hugging a loved one means little. I used to have a pet. I would pet the pet for his benefit, not for mine. I no longer got much out of the experience.

When I started experiencing the withdrawal, I immediately went back up to 20 mg/day under a doctor's supervision. Over years, I've been able to decrease to my current dose of 10mg/day. The only way I can taper off of the medication is to be in a calm place in life, and to get physical exercise. Otherwise, the anxiety is overwhelming. Even so, I have historically decreased my dosage by about 0.4 mg/month (a very slow taper). Going any faster causes problems. I am very much dependent on the SSRI, and can't stop at this point.

It seems pretty common among SSRI users, to have a "loss of sexual desire", as it's often phrased. Though I've never done any sort of psychedelic drug, I've looked to the experiences of LSD users to find some answers (since SSRI meds and LSD are chemically similar, and act on the same receptors). There are lots of LSD users that claim cognitive problems decades after use also. Online, sufferers of "PSSD" (Post SSRI Sexual Dysfunction, i.e., sexual dysfunction that persists after having discontinued SSRIs) claim almost no improvement. Yes, there are many that regain functioning that has been lost once the medication is discontinued. However, of those whose problems persist, recovery is vanishingly rare. In fact, online cases of recovery (of which I've found three after quite a bit of searching seemed dubious or incomplete.

Now to the TMS part...

I have read that those that also have fibromyalgia (i.e., extreme TMS) often exhibit sensitivity toward medication. I hold out some hope regarding my condition, as I am still on the SSRI. My sexual desire was a large part of my life. Looking at this from a TMS perspective, and just from the perspective of getting on with life, I think that I need to come to terms with the fact that I might have been permanently chemically castrated. I can't seem to, though. I suppose that I have not sufficiently mourned my loss.

My problem is that if my sexuality doesn't recover, I don't have much motivation to recover from my TMS. I feel that life would be pointless without the sexual component of my being. I would like to know if these problems could be TMS. Unfortunately, they're very rare. It's not similar to someone having a bone x-rayed, being told that their fine, and then being able to focus on the emotional aspect. I have no reason to believe that this won't be permanent. My other major issue, as mentioned in another thread, is a life-long inability to concentrate. The sexuality issue and the concentration issue are together the biggest problems I have, even though I currently can hardly walk. Luckily, another user claimed to have been able to overcome concentration problems with a TMS approach. Maybe someone can help me out. Thanks.

 

this is my experience with various medicines:

For many years I took allergy medicines and when I've stopped I've have had a lot of lethargy, no more red eyes, lacrimation,sneezing but a lot of lethargy, tiredness and asthma... now everything back to normal ..every year the doctor gave me a lot of antihistamine...as a cure..now I only take them if is really necessary..I had too much and without good reason and they were giving me ..other problems. now stop!!!
For SSRI same speech...the second I realized there are a lot of side effects I preferred anxiety..I would also like to say that a variety of studies shows how antidepressant don't work. I got them for my vulvodynia among other things and I've felt worse after I stopped them... you're not permanently chemically castrated.believe me...you 're only asleep...It takes a long time to go out.. especially if you took them for many years...so you need to choose.. drugs or yourself and your sexual desire..if you choose option 2 you need to do a lot of hard work to solve your anxiety..and just let your body and your brain return to normal.
you must be patient.

I f you want to know more ask me a specific question

 

I agree with Mary.

STOP reading stories online; plenty of people have recovered, they just don’t always post about it online. Those drug and withdrawal forums are the absolute WORST.

I have also been on antidepressants, and many of my friends (whom I know in person, not just in a forum where anyone can say anything) have as well.

As with anything, anxiety stimulates your nervous system, which can disrupt the repairs that occur after SSRI/SNRI withdrawal. Anxiety also affects your neurotransmitters and hormones. Additionally, withdrawal can cause central sensitization where you’re experiencing sensations even after the body as healed itself. The body naturally heals itself. Relax and disregard what you’ve read. I don’t care what anyone says on this topic - NOTHING IN LIFE HAS TO BE PERMANENT. Believe this 100%.

Perhaps you could request genetic testing that sees how you respond to SSRIs and SNRIs for further insight.

Relax and work on your anxiety. And stay off forums, and forget about the horror stories you’ve read. You have no idea what else is going on their lives to contribute to what they’re experiencing. Plenty of people have recovered from taking Prozac, even if it took some extra time.

 

Also, it’s clear Prozac is no longer making you happy, which is often the case with long-term anti-depressant use (ever heard of “Prozac poop out”?), and it’s not ideal for any doctor to just continue prescribing it to you without considering other options that may be more beneficial. You can recover, and you can choose to work with someone who helps you facilitate this recovery. Staying on Prozac and doing nothing else when it’s already not working for you is creating a loop of the same results over and over again. It sounds like Prozac stopped working for you after the withdrawal, which is not uncommon (lots of people are unable to achieve success with an anti-depressant they stopped taking once before), and it’s not going to restore your inner balance at this point.

What I’m basically saying is, your brain is not broken from Prozac - you just need to help it start creating neurotransmitters again (and don’t listen to anyone who says anything is permanent).

Poor memory and focus, apathy, and low libido are mentioned in related literature.

 

Thanks Mary and Caulfield. I'd like nothing better than to get off of the meds, but given my present circumstances, it would simply be too anxiety provoking. I'll check out the amino acid literature that you cited. It could help quite a bit. You've both set my mind at ease, somewhat. It will take a little while for me to process this. Best of luck with your journeys!

 

I'm sorry I would just ask you. . .
Do you know what a panic attack is and why does it happen?

 

Wow, thanks a bunch regarding the heads up with the amino acid supplements. You might have saved me from a real disaster.

 

I've reached a point where I'm trying to see a positive future for myself, and go for it. This means either realizing that certain things that I think are broken in my life actually aren't, or accepting those things that are. The SSRI related issues might be TMS. I recently came across a post, after having avoided the withdrawal forums since this thread, regarding someone that recovered by dealing with their trauma. Maybe this really is the answer.

I have lingering doubts though, for the following reason: Rat studies have shown that rats exposed to SSRI while in utero, or as adolescents have decreased sexual functioning throughout their lives. I have a hard time believing that these rats are just suffering from TMS. I realize that you aren't doctors, and even if you were, this is uncharted medical territory. I wonder if anyone can speak to this, though. Thanks.

 

I agree with Mary And Dorado who have given you good advice. I've been on and off Prozac since 1991 and it's just one tool in the toolbox. I think you are making a way bigger deal out of the Prozac than it it really is and you are overthinking the whole thing. Stay away from scientific articles about rat studies and forums filled with horror stories. I can guarantee you, everything you are attributing to the Prozac, has nothing to do with the Prozac. It's just another distraction and something to obsess over. I hope this is not coming across as harsh because it's meant in the nicest way...I've been down all these roads so I know what it's like. Sexual libido is something that begins in the MIND and has everything to do with emotions and your feelings for another person. I could easily attribute lack of libido to menopause or declining hormones for ex.....but I think it's it's a very tiny part of the equation. It always comes down to mindset.

 

Stop porn and masturbation; you have to keep your semen inside. Its your lifeforce. Protect it. It will protect you. Depression and anxiety wont be part of your reality anymore afterwards.

You ll litterally feel like james bond once you get the hang of it

Same for women, no touching, erotica, etc and you ll feel like wonderwoman

 

I don't think you understand. I haven't had any desire to view porn or to masturbate in years.

 

@music321, as someone who has spent time researching various studies on rats and mice out of my own interest, I want to note that there's a reason we've cured these animals of Alzheimer's, Lou Gehrig's, HIV/AIDS, the most difficult cancers, standard aging (examples = increasing their lifespan by three times, reversing wrinkles and hair loss, etc.), and countless other conditions over and over again, yet those cures don't work in human trials the vast majority of the time: rats and mice are very different from humans, and the studies on them frequently do not apply to us! Researchers study rats and mice instead of species that are closer to us for ethical reasons (although people can debate that experiments on rats and mice are still unethical). This is why I never get overly excited when I see anything about rat and mouse studies, even when my Facebook friends post about curing them of cancer.

Did you know that animals can get CRPS, too? That's a major reason why people frequently don't believe CRPS can be a mind-body process (TMS), but it is in humans. So we are not directly comparable to animals. Your brain is not the same as a rat or mouse brain - it is way more complex.

I will be honest: I can't directly speak to this issue. After I quit taking Cymbalta (an SNRI, which is more powerful than most SSRIs), I actually felt hypersexual and had pretty bizarre mood swings. I think it's because the medication "numbed" me emotionally, and coming off it way too quickly made everything feel incredibly intense and raw. I'm not bipolar and I didn't experience mania, but I mean it when I say it was intense. I'd go from one extreme to the next, feeling like I could cry tears of joy walking down the street while grabbing lunch and then being super annoyed by minor issues, such as the sound of my colleague's computer mouse clicking once I got back to the office. I've written about this experience before. You said you no longer feel sexually aroused when looking at women, but I was overly excited by men and women, to the point that my sleep was interrupted and I would wake up in the middle of the night.

However, it went away over time, and so did the other symptoms people often cite as potentially becoming permanent - brain zaps, headaches, the aforementioned mood swings, sleep paralysis, severe panic attacks and depersonalization, etc. Now I have a normal and healthy sex drive without any problems. My intention in sharing this information is to be as transparent as possible about my experience so as not to mislead anyone who directly asks me about sexual side effects of antidepressant withdrawal. We're all different. Some people get erectile dysfunction, others spontaneous orgasms, I dealt with hypersexuality, etc. Actually, I just googled "Cymbalta hypersexuality," and there are some case studies about people who felt hypersexual like I did.

That said, I have heard of people recovering over time. I recall reading about this on Reddit and elsewhere. These animal studies do not mean you will experience permanent side effects and do not necessarily apply to humans, per my first paragraph. People think all kinds of antidepressant withdrawal symptoms can be permanent, but they most certainly do not have to be. This is a symptom that people often find highly distressing, and that alone can get them "stuck" in a circle.

I know you want hope that life can be fulfilling. For what it's worth, I was physically intimate with someone who experienced some sexual dysfunction right after coming off an ADHD medication. They didn't have much time to heal at that point. The libido was there, but my friend's body wasn't fully aligned with their thoughts. We later lost contact due to a move, but it wasn't stopping us back then, and I believe this individual will totally fine because they weren't hung up on it. This is the only person I've spoken about this issue face to face, but there are stories out there of recovery in both men and women!

Additionally, I do recall hearing about Moclobemide (available outside of the US) helping, but I don't know enough about it and haven't really researched it because sexual dysfunction wasn't something I experienced. Bupropion is another one. I strongly believe your future is going to be fulfilling!

 

Okay, @music321, I've done some research on this topic. Here are some stories from both men and women of all different ages that you might find interesting. To me, this totally points to dysfunction that some people just can't seem to get out of due to emotions and fear - same as the fear of other antidepressant withdrawal symptoms such as brain zaps. Also note that there are many references to healing naturally.

Some people did say it took a few years to heal, but it probably would've been faster had they known about the mind-body connection and truly understood it (as was my own personal experience with general antidepressant withdrawal). For that reason alone, I normally steer away from stories that reference longer healing periods (people sometimes panic and don't understand that the mind-body connection plays a major role in the timeframe), but I feel it may be helpful since people tend to think that means something is permanent, which is not true. Hope is not lost for you!

My belief is that very few things in life are permanent. Steve Ozanich taught me that the body is designed to heal, and if you aren't healing, you need to consider the mind-body connection (TMS). I even saw a few doctors claim that healing from tardive dyskinesia after antidepressants is impossible, yet there are tons of success stories out there. Please do not believe the negative stories! One of the most hurtful things I ever read was that Cymbalta withdrawal can be permanent, and I know for a fact that isn't true.

Each quote is from a unique individual:

And honestly, this right here is definitive proof that many of these people are dealing with mind-body effects - acupuncture was their placebo and calmed them down:

 

@music321, I just found this true story that will certainly be of interest to you. This is from an individual who has been through this exact situation. Truthfully, they sound like me with all of that chitter chatter about working with the top doctors - we are the type of people who believe that there is always an answer and always a way. I never believe that anything is hopeless, and I tell myself and the people around me that there is always an answer.

As noted in the individual's words below, anxiety and depression can cause changes to the brain, but please remember that the brain is neuroplastic, and those changes do not have to be permanent - every single person on this forum who has had a success story for any symptoms (PSSD and/or the endless list of other symptoms) is living proof of this. I've been through countless other SNRI withdrawal symptoms and understand how scary it can be. I hope this gives you hope. Things really do get better in life.

My posts from last year reference all types of recommendations I would never suggest after overcoming my own struggles with withdrawal by just understanding that I was already healed, but my sympathetic nervous system was in overdrive and keeping some of the symptoms alive.

More from this individual - this is why it is absolutely critical for you to not be going on withdrawal or PSSD forums:

 

Maybe just keep stimulating it and have an ED med as a fallback option

 

I wanted to revisit this thread just to thank all of you who have written detailed responses. My primary manifestation of TMS is MECFS. Soon after I posted this topic, I became in capacitated to the point where I couldn’t use my computer very well. Hence, the lack of a reply. As an update, things regarding this topic have not improved that much. This doesn’t especially concern me however, has none of my TMS symptoms have especially improved. I’m hopeful that the rest of the symptoms resolved, as well.

 

Alan Gordon was on a good podcast about Erectile Dysfunction. Might want to check it out. https://www.timnortontherapy.com/alan-gordon-psychological-somatic-symptom-disorder-erectile-dysfunction (Erectile Dysfunction | ED | Podcasts | Hard Conversations)