On the flipside, if you have problems with premature ejaculation, taking one of those might mitigate the issue. Not a doctor, by the way.
Probably. Clomipramine, a TCA, is sometimes used for premature ejaculation.
Post-SSRI sexual dysfunction
71–80 of 282 posts
Re: Post-SSRI sexual dysfunction
#72Has anyone taken SSRIs and actually thought it was worth it? I have severe social anxiety and I’m trying to decide if I should try medication or not.
Anecdotally, yeah. It's worth it. To be frank (I'll comment more on this elsewhere) I think the risk of permanent sexual dysfunction or any other permanent effect is dramatically overblown by articles like this one. The short-term and while-you're-taking-it side effects are real, but for me and many others well worth it.
Everyone in my family has some sort of anxiety issue. Citalopram (with the help of therapy and lifestyle changes) helped me overcome severe anxiety, helped my brother stop throwing up whenever he got in a too-high-pressure situation, and gave my sister the willpower to move out of my parents' house and get a job.
They're good drugs with frustrating downsides. That's life. I'd still recommend them.
Re: Post-SSRI sexual dysfunction
#73I don’t usually post here, especially on such personal topics, but feel I should. I’ve been on SSRIs and SNRIs for some time now (Pristiq, and now Zolof), and can definitely attest to the some of the changes described in the article. I clearly remember reading the documentation in full that came with both drugs before starting each, and the mentioned side effects were only mentioned in passing, along with possibly ev…
Sertraline (Zoloft) often causes more sexual side effects in males than it does in females. I have seen this used at the max dose to control hypersexual behaviour in a patient with dementia.
I spent about 18 months on sertraline. Even on the 'therapeutic' dose that I started off with, it basically nuked my ability to perform. Could still get an erection easily enough, the frustration was being unable to do anything with it.
It wasn't that much better with fluoxetine, but with that I found that I could at least wait a few days to sort of build up the energy.
As with another poster here, I'm happy being open about this stuff too. The first hurdle is opening up about mental health, I think that already puts you on a good track to take the shame away from the sexual aspect.
Re: Post-SSRI sexual dysfunction
#74I think this article is a little alarmist. Warnings like these scared me away from SSRIs for a long time despite their likely efficacy in helping treat my symptoms.
I sent a number of articles like this one (and several of the medical publications it cites) to my psychiatrist. To her credit, she read them, and her response was that she agreed this kind of permanent change is possible, but it is extremely unlikely. (Anecdotally, she told me, she's treated thousands of people with SSRIs and had never had a report of something like this; she hadn't heard of it happening until I showed her case studies.)
I don't think that means my doctor is ignorant - I think that means permanent damage is indeed likely very uncommon.
Here is a write up from Lorien Psych (the day job of Scott Alexander at Slate Star Codex) that I think is evenhanded: https://lorienpsych.com/2020/10/25/ssris/
Alexander has his issues, but this is an area where he's actually an expert and his approach to the topic helped me a lot.
As for me, the benefits of a relatively low dose of an SSRI have really outweighed the risks so far.
Re: Post-SSRI sexual dysfunction
#75This was one of the factors that made me think twice about going back on anti-depressants, until I made peace with the fact that my ability to orgasm wasn't going to pull me out of the hole I was in. It's a shitty choice but the desire to not be suicidal forces your hand. It's literally like flipping a switch. One day, the plumbing works. The next day, it doesn't. Many times I'd just give up, out of boredom. The side…
Have you considered augmenting with something like Wellbutrin? Some people find it helps with the side effects. I've tried it myself and while I found it was too anxiety-inducing (I felt too keyed up) there's truth to that at least.
Re: Post-SSRI sexual dysfunction
#76I think this article is a little alarmist. Warnings like these scared me away from SSRIs for a long time despite their likely efficacy in helping treat my symptoms. I sent a number of articles like this one (and several of the medical publications it cites) to my psychiatrist. To her credit, she read them, and her response was that she agreed this kind of permanent change is possible, but it is extremely unlikely. (A…
Your psychiatrist may have had patients suffering from this that never told her.
They would have discontinued the medication, terminated the doctor patient realationship, then waited for things to "go back to normal" when they were off the drug but found it never did.
In fact they may have voiced concerns to her and she may have said "it will go back to normal if you discontinue the drug". But they never went off the drugs until they fired her as their doctor, so she would never know about the subsequent problems.
Re: Post-SSRI sexual dysfunction
#77Earlier quoted context omitted.
Probably eating the oatmeal that made his cholesterol get higher. There are now tons of research coming out about how cereals (wheat and corn specially) are basically the culprit of a lot of diseases that in the past were blamed on "fat", and also that this past blame was partially due to corruption (for example coca-cola literally gave six digits money to Harvard scientists so they would lie and say sugar was safe a…
> Probably eating the oatmeal that made his cholesterol get higher. I... don't think so https://www.health.harvard.edu/heart-health/research-were-wa... https://www.sciencedaily.com/releases/2016/10/161007085247.h... https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5885279/ https://www.sciencedaily.com/releases/2008/01/080108102225.h... https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5394769/ > There are now tons of research…
(not op) for reference, 39g of oats contains 28g of carbohydrates.
https://www.hsph.harvard.edu/nutritionsource/what-should-you...
- The biggest influence on blood cholesterol level is the mix of fats and carbohydrates in your diet—not the amount of cholesterol you eat from food.
- Although it remains important to limit the amount of cholesterol you eat, especially if you have diabetes, for most people dietary cholesterol is not as problematic as once believed.Re: Post-SSRI sexual dysfunction
#78I don’t usually post here, especially on such personal topics, but feel I should. I’ve been on SSRIs and SNRIs for some time now (Pristiq, and now Zolof), and can definitely attest to the some of the changes described in the article. I clearly remember reading the documentation in full that came with both drugs before starting each, and the mentioned side effects were only mentioned in passing, along with possibly ev…
As a herbal observation, it seems like such a scam that medical pamphlets will list possible side-effects, but not frequencies. Knowing that one person in one thousand saw some issue is very different from 20% of people. Especially as almost every medication I've ever seen advertised has a list two pages long of possible side effects. How is a person supposed to make an informed judgment?
All US drugs have to include the rate of side effects in their clinical trials.
Google "Product name prescribing information"
Re: Post-SSRI sexual dysfunction
#79I think this article is a little alarmist. Warnings like these scared me away from SSRIs for a long time despite their likely efficacy in helping treat my symptoms. I sent a number of articles like this one (and several of the medical publications it cites) to my psychiatrist. To her credit, she read them, and her response was that she agreed this kind of permanent change is possible, but it is extremely unlikely. (A…
Your psychiatrist may have had patients suffering from this that never told her. They would have discontinued the medication, terminated the doctor patient realationship, then waited for things to "go back to normal" when they were off the drug but found it never did. In fact they may have voiced concerns to her and she may have said "it will go back to normal if you discontinue the drug". But they never went off the…
That's possible but it's an awful lot of speculation. She also might have had lots of patients who did so well on SSRIs they stopped seeing her and just had their GP prescribe the medication from then on. Or all her patients might have overdosed on an unrelated drug and died. You can come up with lots of scenarios other than the most likely one.
But this:
> They would have discontinued the medication, terminated the doctor patient relationship, then waited for things to "go back to normal" when they were off the drug but found it never did.
is not the way a good psychiatry practice (like the one I frequent, IMO) is designed to work. You try a lot of different things and you see what works. You're told upfront that this is part of the process and that if you don't like a medication, you don't have to keep taking it, and you should tell the doctor why and what you're open to trying next.
I tried buspirone (which I still take), duloxetine (intolerable GI side effects; didn't take for long enough to experience anything sexual), and bupropion (too stimulating, not right for my condition) before I settled on citalopram. I had been specifically avoiding citalopram because I was scared of it, and I feel a little foolish for that now.
So I think your scenario is unlikely in my case. I can't speak for other doctors.
Re: Post-SSRI sexual dysfunction
#80Earlier quoted context omitted.
Your psychiatrist may have had patients suffering from this that never told her. They would have discontinued the medication, terminated the doctor patient realationship, then waited for things to "go back to normal" when they were off the drug but found it never did. In fact they may have voiced concerns to her and she may have said "it will go back to normal if you discontinue the drug". But they never went off the…
That's possible but it's an awful lot of speculation. She also might have had lots of patients who did so well on SSRIs they stopped seeing her and just had their GP prescribe the medication from then on. Or all her patients might have overdosed on an unrelated drug and died. You can come up with lots of scenarios other than the most likely one. But this: > They would have discontinued the medication, terminated the…
You don't have to keep taking the drug, I agree. But the doctor will give you another instead, and if the dysfunction continues it will be assumed to be a "temporary" symptom of the subsequent drug like it was with the old drug.
You won't go "cold turkey" to see if things go back to normal unless you fire the psychiatrist because frankly, in America at least, psychiatrists are pill pushers and, unless you are wealthy and will pay out of pocket, you will only get insurance covered talk therapy with a cheaper psychologist or social worker.
Psychiatrist are often only there for quick discussions about medication. The time intensive talk therapy is done by someone less expensive. In my area psychiatrist will often partner with therapy practices and only handle the drug side of things. If someone stops taking drugs, there would be no reason to see the psychiatrist.