Serotonergic antidepressants, emotional numbness and sexual dysfunction

[Neuroprotection]

Selective serotonin reuptake inhibitors (SSRIs) are The most popular antidepressants and the first line treatment in most western countries. perhaps the second most popular are the serotonin norepinephrine reuptake inhibitors (SNRIs). unfortunately, both these medication classes are linked to serious side-effects including emotional numbing/flattening and sexual dysfunction including limited or non-existent pleasure from orgasm. some researchers have now recognised a post SSRI syndrome that may include long-term emotional flattening combined with long-lasting or permanent sexual dysfunction after stopping the medication.
I’ll post a link to the Study I read, which seem to suggest that this syndrome might not actually be due to permanent damage, but rather through a stable and sustained change in certain brain circuits. once pinpointed, it may only take a few doses of another drug or even magnetic brain stimulation to completely reverse the syndrome.
In the meantime, I’d love to hear everyone’s opinions and experiences with Serotonergic medication especially if you suffered from emotional numbing or sexual dysfunction. does anyone agree that non-serotonergic antidepressants like bupropion should actually be the first line of treatment?

 

[Frog Dreams]

SSRI drugs is man (science) trying to copy nature (God) and failing abysmally.

The natural substances that evolved alongside us don't require perfecting.

Psychedelia is perfect.

We have such a limited understanding of what any psych does to the brain, it's absurd to think we can try to replicate the results.

Mushrooms are perfect. Ayahuasca is perfect.

5-MEO-DMT is God.

We don't need pharmaceuticals.

...

EDIT: I'll respond more directly to the (specific) topic.

...

I've had many different types of SSRI drugs.

I've also had an enormous amount of "natural" serotonergic (not sure if this is the correct term, I'm not a scientist... read between the lines) drugs.

Pretty sure my wife would rather me have high doses of experimental SSRI drugs than having daily micro doses of LSD or psilocybin/psilocin.... My parents, definitely. No question.

Doesn't matter if I tell them: SSRI drugs make me unhappy and unstable.
Doesn't matter if I tell them: psychedelics make me happy and stable.

The government says ABC, so that's it.

...

I've had SSRI's that make me have no sexual drive and I've had SSRI drugs that make me hyper sexual and unable to climax.

Man-made drugs are always the worst.

Methamphetamine versus mescaline.

Prozac vs LSD.

Even opium in it's natural state is relatively non-toxic.

...

A full psychedelic state is bliss.
A full SSRI state is what?

 

[Neuroprotection]

SSRI drugs is man (science) trying to copy nature (God) and failing abysmally.

The natural substances that evolved alongside us don't require perfecting.

Psychedelia is perfect.

We have such a limited understanding of what any psych does to the brain, it's absurd to think we can try to replicate the results.

Mushrooms are perfect. Ayahuasca is perfect.

5-MEO-DMT is God.

We don't need pharmaceuticals.

...

EDIT: I'll respond more directly to the (specific) topic.

...

I've had many different types of SSRI drugs.

I've also had an enormous amount of "natural" serotonergic (not sure if this is the correct term, I'm not a scientist... read between the lines) drugs.

Pretty sure my wife would rather me have high doses of experimental SSRI drugs than having daily micro doses of LSD or psilocybin/psilocin.... My parents, definitely. No question.

Doesn't matter if I tell them: SSRI drugs make me unhappy and unstable.
Doesn't matter if I tell them: psychedelics make me happy and stable.

The government says ABC, so that's it.

...

I've had SSRI's that make me have no sexual drive and I've had SSRI drugs that make me hyper sexual and unable to climax.

Man-made drugs are always the worst.

Methamphetamine versus mescaline.

Prozac vs LSD.

Even opium in it's natural state is relatively non-toxic.

...

A full psychedelic state is bliss.
A full SSRI state is what?

Love your thinking, whatever works for you go ahead with it and never let anyone pressure you into taking something you don’t want. I do however, respectfully disagree with you regarding natural drugs being perfect. Psychedelics aren’t for everyone and they’ve ruined peoples lives too. I made a thread about this explaining how I’ve always had a very deep innate fear of psychedelics and aversion to them, Kind of like an overwhelming gut instinct that they will ruin my perceptions of the world. when I research this, I found anecdotes from people Who were happy and relaxed before taking LSD or magic mushrooms but became severely depressed, withdrawn, constantly questioning their reality to the point of panic attack amongst many other symptoms.
Meanwhile, some synthetic drugs are absolutely amazing. For example, selegiline has helped many people who completely lacked motivation to become highly driven, and apparently it also works very well for boosting libido in some people. likewise, the antidepressant bupropion, despite being far from perfect, has a very positive rating amongst those who use it. interestingly, although nicotine is largely natural, I feel like it behaves more like a synthetic drug. can’t really explain why, just the euphoric sensation it gives me.
I do understand where you’re coming from, taking natural drugs usually comes with more balance and a broad range of effects due to multiple active compounds. it is also true that in our quest to improve drugs, it is easy to forget what the natural world may hold and that almost all psychiatric drugs are built on structures found in nature.

I wish you all the best.

 

[Frog Dreams]

Bufo is the ultimate test of psychedelic fortitude.

Beyond 5-MEO-DMT, specifically, there is really nothing else.

If you can stand strong to bufo, you can stand strong to anything.

There are 2 things.

Love and Fear.

God and Ego.

The Ego is afraid of Love.

I wish you all the best.

Likewise, my friend.

Lots of love.

 

[Skorpio]

Let's keep the focus on mechanisms of ssri emotional numbness/sexual dysfunction. Psychs can be great antidepressants for some, but that's really neither here nor there.

If circuit level changes occur, I would doubt a magic bullet like another drug could undo such things. Though I wonder if some peptide hormone mimetics could at least alter the sexual sides of SSRI aftereffects.

 

[Neuroprotection]

Let's keep the focus on mechanisms of ssri emotional numbness/sexual dysfunction. Psychs can be great antidepressants for some, but that's really neither here nor there.

If circuit level changes occur, I would doubt a magic bullet like another drug could undo such things. Though I wonder if some peptide hormone mimetics could at least alter the sexual sides of SSRI aftereffects.

Yes, you’re right. One pill likely won’t change it, but maybe a drug or cocktail of drugs given over a few weeks or months could reverse the changes especially if no physical neuronal damage is involved. if it is possible that a drug like an SSRI can induce circuit level changes, once we identify the exact mechanism responsible this mechanism could be blocked and changes reversed.

 

[Neuroprotection]

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

Sexual dysfunction is an underdiscussed adverse effect to selective serotonin reuptake inhibitors (SSRIs) and may increase the risk for discontinuation and nonadherence to antidepressant pharmacotherapy. Given the prevalence of depression, health care ...

www.ncbi.nlm.nih.gov

 

[Neuroprotection]

Post-SSRI sexual dysfunction & other enduring sexual dysfunctions

Enduring sexual difficulties following treatment with selective serotonin reuptake inhibitor antidepressants have been reported to regulators since 1991, but it was only in 2006 that a formal post-SSRI sexual dysfunction syndrome was reported. The clinical, ...

www.ncbi.nlm.nih.gov

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

Post-SSRI sexual dysfunction (PSSD) is a set of heterogeneous sexual problems, which may arise during the administration of selective serotonin reuptake inhibitors (SSRIs) and persist after their discontinuation. PSSD is a rare clinical entity, and it ...

www.ncbi.nlm.nih.gov

 

[ChemicallyEnhanced]

Selective serotonin reuptake inhibitors (SSRIs) are The most popular antidepressants and the first line treatment in most western countries. perhaps the second most popular are the serotonin norepinephrine reuptake inhibitors (SNRIs). unfortunately, both these medication classes are linked to serious side-effects including emotional numbing/flattening and sexual dysfunction including limited or non-existent pleasure from orgasm. some researchers have now recognised a post SSRI syndrome that may include long-term emotional flattening combined with long-lasting or permanent sexual dysfunction after stopping the medication.
I’ll post a link to the Study I read, which seem to suggest that this syndrome might not actually be due to permanent damage, but rather through a stable and sustained change in certain brain circuits. once pinpointed, it may only take a few doses of another drug or even magnetic brain stimulation to completely reverse the syndrome.
In the meantime, I’d love to hear everyone’s opinions and experiences with Serotonergic medication especially if you suffered from emotional numbing or sexual dysfunction. does anyone agree that non-serotonergic antidepressants like bupropion should actually be the first line of treatment?

IME the sexual side-effects go away (mostly) within a few weeks and (completely) within a few months.

 

[Neuroprotection]

IME the sexual side-effects go away (mostly) within a few weeks and (completely) within a few months.

Yes, that’s usually the case. but for some people, emotional blunting, anhedonia and the complete inability to experience sexual pleasure can last for decades. A similar phenomenon has been reported with five alpha reductase inhibitors like finasteride where permanent sexual dysfunction and emotional problems persist permanently after stopping the drug.

 

[Neuroprotection]

it’s quite interesting that only antidepressants acting on serotonin seem to produce these long-term negative effects. temporary emotional blunting and sexual dysfunction makes sense given that serotonin, through some of its receptors acts as a mood stabiliser and opposes the effects of dopamine. however, why the effects are sometimes permanent is still a mystery. interestingly, other antidepressants like bupropion which acts on norepinephrine and dopamine actually improve sexual function in many people and in the worst case scenario, it might have no impact. furthermore, the highly selective norepinephrine reuptake inhibitor Reboxetine has Little to no impact on sexual function and in the very rare cases that a negative impact was realised, it was rapidly reversible after stopping the drug. I would love to know if anyone has had experience with an antidepressant that doesn’t affect serotonin and to know how that affected their sexual function and emotional well-being, whilst taking the drug and after discontinuing it if applicable.

 

[Neuroprotection]

to be honest, I’m so glad I never tried an SSRI when I fell into temporary depression/anhedonia last year. according to anecdotal reports, sufferers of post-SSRI syndrome say they severely regret trying the medication. they claim that whilst they were often down and sad before, they could still look forward to rewards like food, sex and social interaction. unfortunately, after taking the medication they became emotionally numb and couldn’t even look forward to/enjoy these rewards anymore. I do know that SSRIs have helped many people, but even some medical professionals are now acknowledging that these medications work predominantly by numbing emotions. this might be interpreted as as relief by a chronically sad and anxious patient in the short term, but some of them will quickly realise that shutting down their emotions was not what they wanted and it’s even worse if these affects are persistent.

 

[ChemicallyEnhanced]

Yes, that’s usually the case. but for some people, emotional blunting, anhedonia and the complete inability to experience sexual pleasure can last for decades. A similar phenomenon has been reported with five alpha reductase inhibitors like finasteride where permanent sexual dysfunction and emotional problems persist permanently after stopping the drug.

I still get some blunting but I have BPD so that's a good thing usually. Weird that anhedonia is listed as that's one of the things anti-depressants are prescribed FOR.
I think these long-term effects are more likely when someone just just sad or low about something and takes the meds, rather than people who have an actual imbalance.

 

[Neuroprotection]

That's exactly how i felt when i first lost my boners and then got my boners back but lost the ability to orgasm when trying out different SSRI/SNRI meds for my depression over a decade ago.

The anorgasmia persisted for years, which made sex surprisingly awkward even with a trusting partner. Women tended to act all hurt when i couldn't cum with them. I kind of understand, but it's a medical condition ffs.

I could eventually get aroused and orgasm normally again, but after suffering the nasty side effects of SSRI, SNRI and neuroleptics (talk about emotional numbing), i decline any psychiatric medication nowadays.

Firstly, congratulations on getting your sexual health and hopefully your emotional health back. you are another living proof of the potential dangers of SSRI medication and perhaps even antipsychotic medication. I know these medicines can help people, I’m just infuriated that The psychiatric establishment doesn’t seem to want to address these serious side effects and also pay so little attention to the treatment of anhedonia in depression. I mean, we have all this knowledge on the rewards system and how it works, yet some medical researchers are still insisting on medications that shut down emotions, including SSRIs, antipsychotics and even mood stabilisers like lithium.

 

[Neuroprotection]

I still get some blunting but I have BPD so that's a good thing usually. Weird that anhedonia is listed as that's one of the things anti-depressants are prescribed FOR.
I think these long-term effects are more likely when someone just just sad or low about something and takes the meds, rather than people who have an actual imbalance.

Of course, SSRIs do really help some people, especially those who might welcome some emotional numbing. regarding anhedonia, it is a major component of depression, but its treatment has been generally overlooked by most professionals, and it is actually known that serotonergic antidepressants can make it significantly worse.

 

[RDP89]

I still get some blunting but I have BPD so that's a good thing usually. Weird that anhedonia is listed as that's one of the things anti-depressants are prescribed FOR.
I think these long-term effects are more likely when someone just just sad or low about something and takes the meds, rather than people who have an actual imbalance.

The “chemical imbalance” theory of depression has been pretty much debunked at this point.

 

[ChemicallyEnhanced]

The “chemical imbalance” theory of depression has been pretty much debunked at this point.

Yes and no. It only has because most people with depression don't have depression. Like if you can say "I'm anxious about..." or "I'm depressed because..." then you don't have an anxiety disorder or depression, you're experiencing a normal emotional reaction to something. But a lot of people in those situations get prescribed anti-depressants (and I'm not saying they necessarily shouldn't) but they make up the majority of people diagnosed with those conditions and obviously they don't have any sort of imbalance.
For me, no type of thinking/talking therapy has ever made any difference at all, but medications have made a big difference.

EDIT: I actually watched a documentary on the harm of psych meds not that long ago and I think the real results on SSRI/SNRI's were that about 1/3rd of people benefitted from then, they were ineffective (or made negligible difference) in around 1/3rd of people and had a negative impact on about 1/3rd of people.
I wouldn't say a med that only helps ~33% of them time was a great result, but there's definitely a place for them as they help millions of people. Kind of like how anti-psychotics can be really damaging and have permanent, disabling affects for some people, but also allow millions to live normal lives.

Personally, I would 100% be dead without Sertraline/Zoloft.

 

[RDP89]

I’m r

Yes and no. It only has because most people with depression don't have depression. Like if you can say "I'm anxious about..." or "I'm depressed because..." then you don't have an anxiety disorder or depression, you're experiencing a normal emotional reaction to something. But a lot of people in those situations get prescribed anti-depressants (and I'm not saying they necessarily shouldn't) but they make up the majority of people diagnosed with those conditions and obviously they don't have any sort of imbalance.
For me, no type of thinking/talking therapy has ever made any difference at all, but medications have made a big difference.

EDIT: I actually watched a documentary on the harm of psych meds not that long ago and I think the real results on SSRI/SNRI's were that about 1/3rd of people benefitted from then, they were ineffective (or made negligible difference) in around 1/3rd of people and had a negative impact on about 1/3rd of people.
I wouldn't say a med that only helps ~33% of them time was a great result, but there's definitely a place for them as they help millions of people. Kind of like how anti-psychotics can be really damaging and have permanent, disabling affects for some people, but also allow millions to live normal lives.

Personally, I would 100% be dead without Sertraline/Zoloft.

I’m not saying clinical depression isn’t real or that SSRI’s don’t work some of the time, but neither of those things mean that the cause of clinical depression is a chemical imbalance. The most current research points to serotonin levels having nothing to do with depression. https://www.ucl.ac.uk/news/2022/jul...not-caused-chemical-imbalance-brain-new-study

 

[Skorpio]

I haven't yet read this, but saw it when doing work-focused journal browsing, and thought of this thread.

I'll read it this evening.

Antipsychotic drugs selectively decorrelate long-range interactions in deep cortical layers

elifesciences.org

 

[ChemicallyEnhanced]

I haven't yet read this, but saw it when doing work-focused journal browsing, and thought of this thread.

I'll read it this evening.

Antipsychotic drugs selectively decorrelate long-range interactions in deep cortical layers

elifesciences.org

^do you have a dumbed-down synopsis of that link lol?