A very strange case (psychodrugs)

[BenyaMarubo]

Hi everybody!
Will try to sum up shortly the nature of my problem:
- Jun'17. Big family tragedy. Got nervous, could barely sleep at night (3-4 hours daily max.), lost appetite. Used simple herbs-based anti-axiety pills to calm myself. No big impact.
- Jul'17. Nervousness continues, sleepless nights, poor appetite. Added other more potent natural pills (as I live in Germany - Neurexam). Took Stillnox (aka Zolpidem) as sleeping aid. To no avail. To calm down took 1 single pill of Laif 900 (Saint John's Wort, SJW). My anxiety paradoxically increased even further. maybe because I drank juices (which is not advisable with SJW).

As my nervousness continued went to doctor, who prescribed escitalopram 10 mg per day (in the morning). To be on the safe side, took half of the pill (i.e. 5 mg), immediately felt unwell (sweating, heart palpitations, giddiness). Took char coal to wash the pill out. As I did not know what an antidepressant is (thought it to be a sort of anti-anxiety / sleeping pill), took 2.5 mg before sleep for the next 2-3 days. My agitation got worse. In retrospect I think that I provoked a mild serotonin syndrome, given that I took escitalopram soon after taking SJW. My body was shaking, trembling, I was not able to control my hands. Neede even to call sick from work. Got strange suicidal thought which I had never had in my life. Did not know this state was provoked by pills. I somehow foolishly decided that because of my insomnia and malnutrition, my brain started to die off.

Dropped escitalopram. Got electric splashes in my head. Panicked. Did not know it was a side effect of escitalopram withdrawal. Was afraid that my brain was harmed beyond repair and decided to commit suicide by jumping from the balcony. My relative held me tight, but I somehow managed to drop him on the floor and get loose. Panicked that I harmed my relative. I called ambulance but they came not alone but with ... police (apparently neighbors called them as I shouted a lot). Was not able to understan what was going on, tried to jump off the balcony in the presence of doctors / cops. Was hospitalized in the ward involuntarily.

- Aug'17. Spent 14 days in the ward on 4 mg risperidone (aka risperdal) daily in pill form + tranquilizer (lorazepam).
After this "treatment" did not feel well. No thoughts, no emotions, personality erased. Dropped risperidone cold turkey.
Was not able to sleep for a week. Went to private psychiatrist. He reinstated risperidone at 1 mg ( I went from 1 mg daily to 0 within 1 month) + gave lerivone (mianserin) 15 mg as antidepressant for sleep.
Have been on various doses of mianserin (from 15 mg up to 45 mg and then progressively down to 0) from September to December (i.e. 3 months). Dropped the last 5 mg cold turkey.

Since Dec'17 - drug free. Though my initially poor thinking / no thoughts etc has dramatically improved (thanks God), I still suffer from a symptom which first appeared somewhere in mid November: genital numbness, loss of sexual interest, decrease in libido. I found out it is PSSD.

My questions are as follows, to which I would kindly ask to help me:

1. Why is this impotence? What is the more likely culprit: risperidone or mianserin. I ask as I have read that SSRI / SNRI are the most likely culprits of PSSD, whereas mianserin is actually used to treat it (with varying success though).

2. How can it be cured?

3. Has anyone experienced reduced eyesight (increased myopia) on antipsychotics / antidepressants and will the issue resolve itself?

Thank you very much in advance for your kind help !!!!

 

[Cheshire_Kat]

Hi Sonny.

Welcome to Bluelight.

Your post is a bit specific for the New Members Introduction forum. It's not that I mind you posting here, you are always welcome. It's more like the right eyes might never see your post here and you have less chance of a good answer. I'm going to move it to Other Drugs. I hope you find your answer

NMI to OD

 

[Scrofula]

Howdy, welcome to OD! Sadly, I have to disagree with you though. It's not personal, it's just how I make friends.

By PSSD, you mean post-SSRI sexual dysfunction? The horror of it is that seems to be a real thing. It's bad enough when you're on the things, to think you can be stuck with less-than-spectacular ejaculations for potentially the rest of your life, is enough to put you back on antidepressants.

Good news for you is you took an SSRI for all of a few days, and not even a whole dose. It may have made you sick, or maybe it was something you ate, but you just never did enough citalopram to get discontinuation symptoms, much less permanent sexual problems.

Okay, let's review the side effects while on SSRIs, that covers 99% of users (so common, they basically happen to every guy, at least; and we (I've been a long-time on/off sertraline user) all describe the same thing pretty much. Of course there can be other rare side effects). Our peckers function just fine. Let's be clear about that with any suitors/lady callers. It's only the final act that's a problem. Totally lacking at first, it gradually returns to apparent normalcy, but with a vague disappointed feeling. Like getting free Safe N Sane fireworks when you used to rig buildings for controlled demolition.

So, not impotence, really. Reduced libido, yes. Reduced reason to bother, yes. Numbness or tingling, not usually.

From what I understand, similar things happen with women. It's been too long though, and I don't remember what parts they all have anymore.

Also from what I understand, which is a warning that you should look it up--the very rare cases of continued sexual dysfunction are more in line with that emotional/mental side, like reduced libido, less pleasure. Nothing apparently physical.

OK, so, now the question is, could you have persistent problems from the risperidone, the benzos with it, the mianserin, or anything else you left out? Well, you could of course, but it would be very unusual. Some antipsychotics are known to rarely cause permanent movement disorders. Mianserin is a weird antidepressant, and I have no idea what sort of unusual side effects it could have, but I have read that stopping it can cause itching and rash-like symptoms.

But you haven't been on anything in nearly four months. If your symptoms are getting worse, you might want to ask yourself about all the factors that went into your first hospitalization and placement on risperdone. There may be something going on that first started then, that wasn't your citalopram. Maybe you can ask your family, let them know some symptoms are returning.

Good luck.

 

[Janzio]

Hi everybody!
Will try to sum up shortly the nature of my problem:
- Jun'17. Big family tragedy. Got nervous, could barely sleep at night (3-4 hours daily max.), lost appetite. Used simple herbs-based anti-axiety pills to calm myself. No big impact.
- Jul'17. Nervousness continues, sleepless nights, poor appetite. Added other more potent natural pills (as I live in Germany - Neurexam). Took Stillnox (aka Zolpidem) as sleeping aid. To no avail. To calm down took 1 single pill of Laif 900 (Saint John's Wort, SJW). My anxiety paradoxically increased even further. maybe because I drank juices (which is not advisable with SJW).

As my nervousness continued went to doctor, who prescribed escitalopram 10 mg per day (in the morning). To be on the safe side, took half of the pill (i.e. 5 mg), immediately felt unwell (sweating, heart palpitations, giddiness). Took char coal to wash the pill out. As I did not know what an antidepressant is (thought it to be a sort of anti-anxiety / sleeping pill), took 2.5 mg before sleep for the next 2-3 days. My agitation got worse. In retrospect I think that I provoked a mild serotonin syndrome, given that I took escitalopram soon after taking SJW. My body was shaking, trembling, I was not able to control my hands. Neede even to call sick from work. Got strange suicidal thought which I had never had in my life. Did not know this state was provoked by pills. I somehow foolishly decided that because of my insomnia and malnutrition, my brain started to die off.

Dropped escitalopram. Got electric splashes in my head. Panicked. Did not know it was a side effect of escitalopram withdrawal. Was afraid that my brain was harmed beyond repair and decided to commit suicide by jumping from the balcony. My relative held me tight, but I somehow managed to drop him on the floor and get loose. Panicked that I harmed my relative. I called ambulance but they came not alone but with ... police (apparently neighbors called them as I shouted a lot). Was not able to understan what was going on, tried to jump off the balcony in the presence of doctors / cops. Was hospitalized in the ward involuntarily.

- Aug'17. Spent 14 days in the ward on 4 mg risperidone (aka risperdal) daily in pill form + tranquilizer (lorazepam).
After this "treatment" did not feel well. No thoughts, no emotions, personality erased. Dropped risperidone cold turkey.
Was not able to sleep for a week. Went to private psychiatrist. He reinstated risperidone at 1 mg ( I went from 1 mg daily to 0 within 1 month) + gave lerivone (mianserin) 15 mg as antidepressant for sleep.
Have been on various doses of mianserin (from 15 mg up to 45 mg and then progressively down to 0) from September to December (i.e. 3 months). Dropped the last 5 mg cold turkey.

Since Dec'17 - drug free. Though my initially poor thinking / no thoughts etc has dramatically improved (thanks God), I still suffer from a symptom which first appeared somewhere in mid November: genital numbness, loss of sexual interest, decrease in libido. I found out it is PSSD.

My questions are as follows, to which I would kindly ask to help me:

1. Why is this impotence? What is the more likely culprit: risperidone or mianserin. I ask as I have read that SSRI / SNRI are the most likely culprits of PSSD, whereas mianserin is actually used to treat it (with varying success though).

2. How can it be cured?

3. Has anyone experienced reduced eyesight (increased myopia) on antipsychotics / antidepressants and will the issue resolve itself?

Thank you very much in advance for your kind help !!!!

Hey OP, are you still having the symptoms of PSSD?