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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 22 of 22. This is the beginning of the thread.
Posted by crabwalk on January 14, 2007, at 10:52:50
Ever since I took and then quit ssris, I have a seriously disrupted ability to experience pleasure, which includes all areas of sex--visual stimulation, desire, infatuation, physical sensation al over my body, terrible orgasms--everything is messed up. Also things like music, art, nature, deep friendship, familial love, anything that used to stimulate or captivate me and give me that 'warm fuzzy' feeling--well that warm fuzzy feeling has been replaced by a sort of empty and uncomfortable chill. I guess the way I'd describe it is that the physical sensations associated with rapture and pleasure of any source are completely f-d up. This is exacerbated by any stress and anxiety, especially socially. I have no doubt in my mind that this state that I have been in for almost 2 years now was induced by ssris and that the sexual side effects are part of a wider, generalized disruption of pleasurable sensation on several different levels, but most obvious and noticeable in physical sensations. (Not so coincidentally, marijuana, which used to enhance all pleasurable experience, now does very little; I seem to be immune to what was my favorite drug and, in my opinion, the greatest drug in world).
Also, on the flipside, I seem to be more sensitive to aversive stimuli; for example that sort of 'nails on the chalkboard' feeling seems to happen more easily and more intensely when one of those 'nails on the chalkboard' stimuli happens (e.g. nails on a chalkboard, or imagining something painful). People often use the word anhedonia, but I was wondering if my description fit with others' use of the word.
I'm now up to 450 mg of wellbutrin, and it doesn't seem to be addressing the anhedonia. I have tried lots of other remedies post-ssri including buspar, emsam, tianeptine, ginkgo, yohimbe, and emsam, some in combination. Not once since being on ssris have I felt any sort of joy or fulfilling pleasurable experience. Before ssris I had no sexual problems and always got great satisfaction from music, art, etc., which have always been a big part of my life. I was able to feel romantic and sexual pleasure and have fulfilling relationships. That's been impossible since ssris.
I'm running out of ideas quickly. One thing I was thinking of is adding remeron to the wellbutrin, mostly because I can't think of anything much better to try and remeron would at least help me with my wicked insomnia and hopefully anxiety. I was wondering if anyone found remeron to be at all alleviating of anhedonia; in my case I'm especially interested in the more tangible pleasures. If anyone can comment on that, I'd greatly appreciate it. But also, any general comments on anhedonia, related or unrelated to ssris or other ad's, I'd be interested to hear others' experiences. I know I'd give anything to have never taken ssris, I've been devastated by their lasting damage.
Sorry so long, thanks for reading!
Posted by Phillipa on January 14, 2007, at 11:40:29
In reply to SSRIS AND ANHEDONIA, can anyone relate?? (long), posted by crabwalk on January 14, 2007, at 10:52:50
No idea but I'd like to follow. thanks Phillipa
Posted by linkadge on January 14, 2007, at 12:30:48
In reply to SSRIS AND ANHEDONIA, can anyone relate?? (long), posted by crabwalk on January 14, 2007, at 10:52:50
I know what you are saying. Sexual function for me is gone. What little there exists is worthless. Its not even worth the time presuing.
It is a big waste of time. I am 23 yr old male in good physical shape.Anyhow, I definately think it is some biochemical f*ck up on the part of the drugs. Perhaps without them, the parts of the brain generating orgasm have become so blunted because of excessive neurotransmitter that they cannot function normally again.
I don't know if it has a name, antidepressant induced persistant sexual dysfunction or something, but the point is that I have heard many people speak of it over the net.
Loosing the pleasure from sex is like loosing a sense. To be honest I'd rather loose my sense of taste or smell.
Linkadge
Posted by MIke Lynch on January 14, 2007, at 20:18:21
In reply to Re: SSRIS AND ANHEDONIA, can anyone relate?? (long), posted by linkadge on January 14, 2007, at 12:30:48
Post SSRI Sexual Dysfunction
http://health.groups.yahoo.com/group/ssrisex/
http://en.wikipedia.org/wiki/PSSD
and yes i can relate to all of that, the sexual problems aren't as big as the emotional disconnect from things that use to provide me with much pleasure
Posted by blueberry1 on January 15, 2007, at 5:35:22
In reply to SSRIS AND ANHEDONIA, can anyone relate?? (long), posted by crabwalk on January 14, 2007, at 10:52:50
Your complaints are popping up more and more. I think they are under recognized effects of longterm antidepressants. Even wellbutrin is guilty from what I've heard, given enough time on it. No idea, but somehow the extra pool of neurotransmitters must somehow shut down the sensitivity of receptors, or decrease their numbers, or something.
How to fix it? That's a tough one. I can only think of a few choices. They all have to do with giving dopamine a boost.
The supplement tyrosine in 100mg to 500mg prn can boost your sex drive in a couple hours. Ritalin or Adderall prn have the potential. In the natural arena there are lots of herbs for boosting sexual desire and pleasure, but the one spoken of most highly is tonquat ali. Other herbs are more popular than it is, but from actual users who have tried them all, it is their gold standard for sex. The only herbs I've tried are Maca (I definitely notice an increase in desire in 2 days). Maca is actually a food and is healthy for you in many ways. And it does increase sexual desire. And yohimbe...yikes, now that is a powerful scary substance...stay away unless you want anxiety out the roof and insomnia all night...you'll be too nervous and keyed up to have any desire in sex. And of course viagra, which doesn't boost sex drive directly, can boost sex drive indirectly by seeing an erection pop up and going 'wow look at that, gotta do something with that'.
For the overall anhedonia thing, I can relate. I have that too. Bigtime. I have heard that dopamine or stimulant stragegies are the ways to treat it. Candidates are Provigil, Adderall, Ritalin, and dopamine agonists such as Requip, Pramipexole, or Cabergoline. It has been mentioned here a couple times in the last few months where people added Requip or Cabergoline or Bromocriptine to their SSRI to beat the numbness thing. Provigil or its parent in Europe Adrafinil are marketed there as vigilance enhancers. They can increase the pleasure of ordinary life things.
Anhedonia is a tough one. I think it is a longterm and maybe permanent side effect of SSRIs that has not been recognized due to lack of longterm studies. You'll only see it here at pbabble where real world longterm users keep a track record.
Posted by linkadge on January 15, 2007, at 8:57:46
In reply to it's called pssd, posted by MIke Lynch on January 14, 2007, at 20:18:21
Wow, that Wikipedia article was intense.
>But experiments with rodents have shown that >chronic treatment with SSRIs at a young age >results in permanently decreased sexual behavior >that persists into adulthood and is similar to >PSSD[9][10]. At the cerebral molecular level >there are profound and permanent reductions in >both the rate-limiting serotonin synthetic >enzyme, tryptophan hydroxylase, in dorsal raphe >and in serotonin transporter (SERT) expression >in cortex.
I'm f*cked. OH well, what can you do?
Linkadge
Posted by crabwalk on January 15, 2007, at 11:29:31
In reply to Re: it's called pssd, posted by linkadge on January 15, 2007, at 8:57:46
There is a new board here: http://www.sexual-dysfunction.info/forum/ in addition to the older yahoo board. Both are in use right now.
Posted by blueberry1 on January 15, 2007, at 15:44:49
In reply to Re: SSRIS AND ANHEDONIA, can anyone relate?? (long), posted by blueberry1 on January 15, 2007, at 5:35:22
I was reading on the web some article yesterday about Zoloft. (web...sometimes useful sometimes garbage, so what can I say)
Anyway, the article said Zoloft was the only SSRI to not blunt vigilance. And that it is good for anhedonia. They tested the time course of its therapeutic action. Anti-anxiety kicks in from day 1 to day 7. Anti-depression kicks in from day 7 to day 30. Anti-anhedonia kicks in from day 30 to day 54. Zoloft supposedly follows this pattern.
I am admittedly skeptical because plenty of people have complained about emotional numbness and sexual numbness from not only all the ssris, but Zoloft as well.
I guess what makes Zoloft different is its slight effect on dopamine and on sigma-1 receptors (though I don't know what those are). And it supposedly does not have the effect on cortisol that other ssris do.
Obviously mileage varies, and none of this stuff predicts anything.
Posted by laima on January 15, 2007, at 16:09:48
In reply to Re: SSRIS AND ANHEDONIA, can anyone relate?? (long), posted by blueberry1 on January 15, 2007, at 5:35:22
>Anhedonia is a tough one. I think it is a longterm and maybe permanent side effect of SSRIs that has not been recognized due to lack of longterm studies. You'll only see it here at pbabble where real world longterm users keep a track record.
This scares me to death. I can't fathom how anyone is allowed to put a drug on the market that poops out after a number of years, and then to top it off comes along with this "side effect". I hope we later find out it's not permanent.
Posted by blueberry1 on January 15, 2007, at 16:32:01
In reply to Re: it's called pssd, posted by linkadge on January 15, 2007, at 8:57:46
Well, maybe if ssris permanently screw with the serotonin synthesis from tryptophan in a negative profound permanent way, then it would be easy to win that battle with simple 5htp supplements? Just completely bypass the tryptophan conversion thing. With or without an antidepressant, maybe carelful 5htp dosing could do that?
To partially answer my own question though, 5htp did zilch for my anhedonia and actually made my sexual dysfunction far worse than any medication ever did. It did a fair job of masking or numbing out the depression, similar to ssris, with the same blah feeling, serotonin anxiety, and serotonin insomnia. Just the opposite of what 5htp fanatics claim.
Oh well. You are probably right. We are f**cked, at least for a while, until we find the right meds or alternative supplements for ourselves. I have faith it will happen.
> Wow, that Wikipedia article was intense.
>
>
> >But experiments with rodents have shown that >chronic treatment with SSRIs at a young age >results in permanently decreased sexual behavior >that persists into adulthood and is similar to >PSSD[9][10]. At the cerebral molecular level >there are profound and permanent reductions in >both the rate-limiting serotonin synthetic >enzyme, tryptophan hydroxylase, in dorsal raphe >and in serotonin transporter (SERT) expression >in cortex.
>
>
> I'm f*cked. OH well, what can you do?
>
>
> Linkadge
>
>
Posted by linkadge on January 15, 2007, at 17:27:11
In reply to Re: it's called pssd » linkadge, posted by blueberry1 on January 15, 2007, at 16:32:01
I think its still rather lame that doctors try to pawn off such side effects as a symptom of depression.
Do they not think we have realized the fact that this excuse is used for just about every drug problem a patient might encounter?
I think they should move onto excuse #2 in the psychiatrist's guide to getting out of tight situations?
I don't even want somebody to fix the problem as much as I want somebody to say "yes, these drugs can f*ck you up".
Linkadge
Posted by Edwin Ransom on January 15, 2007, at 17:55:35
In reply to Re: it's called pssd, posted by crabwalk on January 15, 2007, at 11:29:31
I am relieved to hear that other people have had post-SSRI anhedonia. Seeing this thread has reinforced my decision not to take one again. (My doctor wrote off my complaints as evidence of a depressive episode that onset concurrently with the discontinuation of Lexapro.)
I also have a question: those of you who think you have anhedonia induced by SSRIs. How do you respond to music? Do you still enjoy music as much as you used too? Are there particular kinds of music you like more now then before? I know Crabwalk mentioned loss of interest in music. I feel like it was the first thing I started to enjoy again. I also think I am much more interested in beats and rythym now than I was before.
Posted by linkadge on January 15, 2007, at 20:01:31
In reply to Re: it's called pssd, posted by Edwin Ransom on January 15, 2007, at 17:55:35
Loss of interest in pleasurable activities can certainly be a sign of depression.
When I am depressed, I can't listen to music. There is very little depth and force to the music. It also seems like the frequency response is narrowed, like I am listening to it through a cheap radio.
I havn't really thought about how SSRI use has effected that dimention of things.
Linkadge
Posted by MIke Lynch on January 15, 2007, at 22:31:06
In reply to Re: it's called pssd, posted by linkadge on January 15, 2007, at 17:27:11
> I think its still rather lame that doctors try to pawn off such side effects as a symptom of depression.
>
> Do they not think we have realized the fact that this excuse is used for just about every drug problem a patient might encounter?
>
> I think they should move onto excuse #2 in the psychiatrist's guide to getting out of tight situations?
>
> I don't even want somebody to fix the problem as much as I want somebody to say "yes, these drugs can f*ck you up".
>
>
> LinkadgeI was just about to post, that I think the main reason that these effects are underreported and recognized is because so many people are labeling themselves as depressed, and using that to account for the symptoms when it was the medications that caused them in the first place. If your symptoms are due to the medication you have a gut feeling that they are and your usually right. I went on treatment that probably worsened sexual problems and emotional problems because my doctor convinced me that I was experiencing symptoms of depression, the treatments made everything worse and I know I was right all along.
Posted by MIke Lynch on January 15, 2007, at 22:33:08
In reply to Re: it's called pssd, posted by Edwin Ransom on January 15, 2007, at 17:55:35
> I am relieved to hear that other people have had post-SSRI anhedonia. Seeing this thread has reinforced my decision not to take one again. (My doctor wrote off my complaints as evidence of a depressive episode that onset concurrently with the discontinuation of Lexapro.)
>
> I also have a question: those of you who think you have anhedonia induced by SSRIs. How do you respond to music? Do you still enjoy music as much as you used too? Are there particular kinds of music you like more now then before? I know Crabwalk mentioned loss of interest in music. I feel like it was the first thing I started to enjoy again. I also think I am much more interested in beats and rythym now than I was before.The only time I feel like listening to music is when I'm drunk. I don't think I really get much emotional reaction to it, or anything for that matter : (
Posted by MIke Lynch on January 15, 2007, at 22:34:33
In reply to Re: it's called pssd, posted by linkadge on January 15, 2007, at 20:01:31
Also I remember the first time I noticed I wasn't responding emotionally to things was a couple months on paxil. Never noticed it at any other time before that, but a lot after
Posted by laima on January 15, 2007, at 23:14:43
In reply to Re: it's called pssd, posted by MIke Lynch on January 15, 2007, at 22:34:33
This is weird, I lost much interest in music by the end of using SSRIs too. Most of it doesn't do much for me one way or another, lack of emotional response to a lot of it. I used to love all of it.
Posted by snapper on January 18, 2007, at 3:08:03
In reply to Re: SSRIS AND ANHEDONIA, can anyone relate?? (long), posted by blueberry1 on January 15, 2007, at 5:35:22
Yup, and I did'nt even read all the other posts. All I can say and sumise is the FACT that even my pdoc admitted to was this:.... Increased Serotonergic activity....Simply put....down-regulates Dopamine. I wish I had the Immediate answer but I don't. So in effect....depression robs one of the few pleasures in life...and then a drug(substance X) comes along and 'artificially' makes one feel like all is ok and h*nky dorey and then anhedonia and apathetic sex sets in. I know it may not be the case for everyone. But hey.c'mon apathy and anhedonia are definitely 2 of the major deficits of the big "D" in my book!
I can relate. But it just does not make sense!
Snapper
Posted by snapper on January 18, 2007, at 3:12:32
In reply to Re: it's called pssd, posted by linkadge on January 15, 2007, at 17:27:11
> I think its still rather lame that doctors try to pawn off such side effects as a symptom of depression.
>
> Do they not think we have realized the fact that this excuse is used for just about every drug problem a patient might encounter?
>
> I think they should move onto excuse #2 in the psychiatrist's guide to getting out of tight situations?
>
> I don't even want somebody to fix the problem as much as I want somebody to say "yes, these drugs can f*ck you up".
>
>
> LinkadgeROFL. That is 'sadly' very funny Link!
Thanks for the latenight laugh! They can either fu*k u up or down!
Snapper
Posted by snapper on January 18, 2007, at 3:18:53
In reply to Re: it's called pssd, posted by laima on January 15, 2007, at 23:14:43
>
> This is weird, I lost much interest in music by the end of using SSRIs too. Most of it doesn't do much for me one way or another, lack of emotional response to a lot of it. I used to love all of it.Oh...and sorry to be such a downer but I did look my PDOC in the eye 6 months or so ago and said...' ya know doc... all theses meds are is emotional anesthnatizers'(sp?) and he said yep. I am def not stating that these drugs do not help us..people and then some....all I am saying is this.... there is a pro to every con and I do definitely beleive these meds can and do, save lives every day. The problem is ...they just have'nt figured out how to save lives and make us feel 'normal' I hope I have not offended anyone!
Snapper
Posted by crabwalk on January 19, 2007, at 19:39:41
In reply to Re: it's called pssd, posted by MIke Lynch on January 15, 2007, at 22:34:33
> Also I remember the first time I noticed I wasn't responding emotionally to things was a couple months on paxil. Never noticed it at any other time before that, but a lot after
Yup, for me it began on paxil, then after I switched to prozac, a weeks later sexual side effects 're-kicked' in (they went away briefly after quitting paxil), and around the same time I noticed no emotional response to music, no nostalgia, nothing could really strike me. I used to find so much solace and passion in music, it's been pretty much dead since prozac. Never was that way before ssris.
Posted by Alexanderfromdenmark on April 7, 2009, at 15:05:17
In reply to SSRIS AND ANHEDONIA, can anyone relate?? (long), posted by crabwalk on January 14, 2007, at 10:52:50
Bump, I have the same problem. What do we do?
This is the end of the thread.
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