Editorial Note: This is the fourth in a series of posts about PSSD (Post-SSRI Sexual Dysfunction), with more to come. The earliest was Buried Alive, but in this recent series the first was Drugs and Sex Don’t Go, followed by PSSD: If a Drug Caused Blindness and then No Sex and the City.
Possible treatments
In Drugs and Sex Don’t Go, we outlined how the PSSD community has tried most of the obvious treatments – S1 agonists and antagonists, S2 antagonists, and others along with dopamine agonists, Viagra and related drugs and hormones with little effect.
Ondansetron?
Some related drugs that do not appear to have been tried have been the S3 antagonists ondansetron or granisetron. These are usually given for nausea. They can stimulate libido. If anyone has tried these and can offer feedback it would be helpful.
Ketamine
Several subjects with PSSD have recently tried a completely different kind of treatment – ketamine, which is an anaesthetic. However where other anaesthetics sedate, it stimulates. It acts on the glutamate system which is the major excitatory neurotransmitter in the brain.
Ketamine can flip a switch in people who are profoundly depressed. People, who are psychotically depressed one day, contemplating treatment with ECT, can be well the next day and stay well without further medication for months. Almost as though a switch had been flipped.
When given intramuscularly, the effects of ketamine come on within minutes. The subject dissociates. The experience may be profound. People report marked changes in their perceptions of time and space and typically report a sense of meaningfulness and connection with the Universe.
Ketamine appears safe to give to people who have had SSRIs in that doctors regularly used it combined with cocaine when clubbing – in a combination called Calvin Klein.
We have been able to collate the reports of three people who took ketamine to see if it might make a difference to their PSSD – if it might flip the switch back and reconnect them.
All three reported having a comfortable experience after ketamine 100mg – this is not always the case; ketamine can cause very unpleasant effects in people who have SSRI dependence and withdrawal. The question was whether there would be a benefit afterwards over the following week or two. One of the three reported some benefit but this was not sustained and it was difficult to link the outcome to ketamine.
But there was sufficient here to warrant a further course of treatment at a slightly higher dose. It seemed a good idea for the three subjects to repeat the treatment. Again it went smoothly. Again there were some hints of benefit in the same subject who had a benefit the first time around but not a cure.
Based on this it does not seem at present that ketamine is the way forward in PSSD.
Donepezil
One other treatment that has come to our attention is donepezil. This choline esterase inhibitor was used for Alzheimer’s dementia, marketed as Aricept. Patients with dementia are not likely to report its effects but younger people taking it report that it can make touch and other sensory experiences more vivid and readily triggered.
PSSD involves a profound depersonalization generally and an anaesthesia that is most profound genitally but can be more extensive. So it looks like a drug that made skin more sensitive might help. Donepezil fits this bill.
The present status of usage for this is that two subjects have reported trying a 5mg dose in the morning for two weeks. One had no effect. The other reported much more vivid dreams and in particular dreams of a semi-sexual nature.
One of the surprising things about this is that he became aware that he had not been dreaming for years and asked the question whether this might also be a feature of PSSD that people have not noticed to date. Does PSSD inhibit dreams?
We are interested to hear from anyone with PSSD whether they dream or whether the condition has affected their dreams.
We are aware of a number of other treatments in use for PSSD and will be reporting on these immediately if there are any hints of a benefit.
J says
I use Ondansetron on a fairly regular basis to ward off nausea before an adrenal crisis occurs and it hasn’t improved libido.
michael says
thank you for this EXXCELENT ARTICLE.
michael says
Re; the dreams and sleep. NO, i am not sleeping very well at all, due to pssd. Its a serious situation. we can imagine why not…. normal activity results in very deep sleep, and now my sleep is very bad. shallow, i am almost not sleeping at all. dreams : none. no deep sleep = no dreams. thank you for the analysis of these treatments for pssd. I would like to try all of these myself. again thank you for the good work. and I would like to learn more about the substances here listed and experiment cautiously myself with a prescription. I cannot have kids in my present condition, but I want to have kids. so i need a solution. thank you again for the research and info. 🙂
Johanna says
Is ketamine’s effectiveness supposed to be a purely chemical thing — or does it depend in part on the kind of experience (“trip” or otherwise) it leads to? One reason I think this might matter: I’ve talked to lots of people who’ve had steroid injections in their spine and other minor but stressful medical procedures under ketamine anesthesia. They never talk about feeling euphoric or joke about wanting to go back for more, like some people do with nitrous oxide at the dentist. The steroid injections are a nasty experience even when they help. Maybe the minor trauma and overall bad atmosphere of Same Day Surgery cancels out the euphoria – if so, does a positive experience help? It wouldn’t have to be sex, necessarily – what you lose in this condition extends to all kinds of joy or empathy. Some people might want to spend time with the grandchildren, or go fishing, or listen to Bach, who knows.
The articles I’ve seen about ketamine for depression all seem to miss this — many stress the need to develop a drug that works just like K but does not cause what one writer called “symptoms of schizophrenia” (an obvious reference to “tripping” effects). Most also assume people will have to be on ketamine maintenance for life, which sounds dangerous to me. None consider the idea of a “reset” experience that you mention, much less how to benefit from it.
russ says
i have suffered from this for almost 4 years now. No sexual thoughts, no pleasure in sex, genitals are numb. I have not had a dream in all this time with the exception of maybe 10 or less. On these occassions I would say sentativity in the morning after the dream was somewhat improved but by very little.
I definialty have noticed a lack of dreams and a lack of sleep activity i,e i used to sit up or imagine things like snakes or ghosts. None of this happens anymore.
Jacob Gourd says
6 years since citalopram ssri and persistent symptoms of pssd, low motivation, apathy etc. I dream every night, find dream recall hard though.
Daniel says
I have PSSD since 2009 and recently dreams have returned. About maybe 2 months ago I started dreaming again, or at least being able to remember that I dreamt. No improvement in sexuality though.
josh says
Everyone should try valerian root, i used it for a couple weeks and i havent used it in about 3 now and its still fixed the problem of premature ejaculation. But i still dont have much interest in sex so only part of the issue was fixed i just believe there may be something to this so people should try it out and maybe it will help some of you.
Floriano says
Hai risolto l’eiaculazione precoce con la valeriana?
Cody says
I tried the peptide PT141 worked awesome but felt like a artificial feeling. I also dont like knowing if theres any serious side effects.
I just want to be feel normal with a natural sex drive.
Dan says
Why does no one try nitrous oxide supplements?
Hitter pinch says
Side effects : visual loss and hearing problem
mike says
Rhe page about PSSD was removed from Wikipedia 🙁
johny says
i tried NO supplement but it didnt help to me
Mike says
I have been struggling with pssd for some time, and I to have noticed that I only dream once in a very spaced out time frame. And even then Ithe dream only lasts what seems like a second.
shriram s says
I’ve had pssd for about 13 years, and I’m 28 now. I used to dream a lot before pssd.I don’t dream anymore. I have very weak dreams may be once in a couple of months, which feel so the opposite of intense, and almost as if there is a layr of insulation between me and my own dreams. It sucks.And the visual arousal is totally not there. And i took fluoxetine only for a couple of weeks, 13 years back, and never before or after. I noticed lack of arousal two days into the treatment, and my pnis shrunk to a size I had never seen it before, and that small size has been my flacid size ever since. It sounds unreal, but its true, and sadly doctors are not aware of pssd, and claim that NY medicine when stopped, stops having what ever effect it may have had. That to me, sounds like insult to injury, afternharming me, kind of saying that my complaint is lies.
Scott says
Hi, just to say I’ve had PSSD since July 2014. My penis size has also shrunk and I also do not dream about sexual stuff anymore. Just like you experienced, the doctors say that I should be ok after treatment stops…but this is not the case. I’ve found the last few months difficult. I hope I won’t have years ahead of me like this.
shona says
I have pssd since october 2010 paxil/escitalopram no sex drive numb penis – after doing tremendous amount of research I finally upregulated my dopamine receptors with a lot of supplements and drugs .. that solved the deprssion ahnedonia but did nothing for pssd .. I tried ropinirole with testo booster for a month and it caused me hyper sexuality .. i wanted to f*** every women i see . masturbated all day. and did nothing except sex . it felt amazing after all these years like70% improved sex rive and sensation was improved 60-70% after a month. too bad couldn’t tolerate the side effect.. adderal & weed had the same effect. so does PT141 …. epidium has benefit too .. moclobemide was awesome too. Mao’s are awesome..all are “take it as you need it” and it is suppose to work for 6 hours …
I guess its not a cure because you have to take the pill everytime for making you normal and they are expensive .. also there are long term risk of dopamine regulation after 10-15 years of use !
But still better than nothing !
Melina says
I am currently suffering from PSSD after a year on sertraline, and around 3/4 months being off it. I thought I was falling into depression again when I had my first symptoms (social anesthesia, absolute lack of sexual desire, anxiety, lack of memory), so after a quick search I stumbled upon this website and felt less lonely. I’ve always had a high sex drive, and feeling completely numb to sexual stimulation (physical or not), is a cretao or more anxiety and low mood.
Are there any natural supplements that could improve this condition, or that somebody has tried, that might work? Anything from improvements in the diet, exercise regime (even regular masturbation, even if not completely aroused) or natural supplements like gineng? Even if it is a placebo, I think hearing from others could help us. I’m sure I’m not the only one who feels completely out of their comfort zone – I don’t think we’ve ever realized how much our sexuality was linked to every aspect of our lives.
WF says
Melina: I advise you to join: http://pssd.forumotion.com/
You can also contact me by email: wildfaun@gmail.com
Take care!
DJ says
the site above has been moved to http://www.pssdforum.com — please join should you be suffering from pssd or other sorts of drug-induced sexual dysfunctions!
Daniel says
Hi. Cannabis seems to resolve the problem. Just make sure you smoke a lot.
Mike says
My SSRI use 10 years ago has left me with some impairments to libido and major impairments to arousal. I pretty much can only get an erection from manual stimulation and I no longer feel like the sexual person I used to be.
Pre-SSRI, I used to dream vividly regularly and had good dream recall in the morning up until the point when I was fully awake. I used to watch my dreams like a movie every night. Post-SSRI, I almost never have dream recall and only occasionally can I “watch” my dream while I’m sleeping but it’s so vague compared to how it used to be. I remember reading somewhere that SSRIs affect dreams and REM sleep somehow.
PSSD Paxil says
tried everything,, combos the lot..
erection drugs only helped slightly with penile rigidity… i believe the real issue is with the brain, neuro steroids dopamine etc,,,
i self medicated for several months with buproprion… trust me, it helps a lot, penis became much larger (flaccid and erect), sexual dreams, and dreams in general… issues with buprproprion were memory problems with it being anticholinergic… i suprprising discovered that the combined use of piracitam helped reduce memory issues.and brain fog.. i then added dianabol (a powerful oral steroid) into the mix… the effects were astounding, anhedonia dissapeared, erections were the best (any time of day) sexual desire returned.. orgasms were out of this world… energy, sleep, all the good things in life came back… my friends and family commented on my changes.. i also made and consumed several potions, 1 colloidal gold, colloidal silver, and the schweitzer formula, the latter is zinc laden and easy to make with a few ingredients
also tried seligeline… didnt seen to notice a difference, only made having a coffee a difficult experience as the jitters were out of this world.
but the real success i had came from the combination of dianabol steroid and buproprion…
other things i tried were home made DMT, magic mushrooms, etc etc etc
dianabol is off limits for women as its a strong androgen, mayve lighter ones can help combined with buproprion…
all of the above was done over several months with intense excercise, cardio and weights, and with abstinence from alcohol and recreational drugs,,
this is just my experience
i hope it can help, and if anyone else can add their experience please let me know…
this is a real battle for all, were fighters…
Crank92 says
PSSD Paxil, this is an interesting combination buprop and dianabol. I am curious to see how you are doing today and what sort of protocol you followed on these two and any sort of recommendations? Did you follow a PCT or taper for either of these compounds?
Scott says
pssd paxil,
Hey Man,
Just curious, did the buproprion keep the pssd down over time?. Happy you had success!. I’m worried about taking it after the Paxil did damage.
Thanks for the advice.
Guillermo Beraza says
I have had PSSD for 18 months and I dream almost every night. It was like that before the PSSD, it has not changed. As I read, without being an expert, I think there are many types of PSSD and not one treatment for all so maybe the best way of finding a solution would be to classify them first. If I can be of any help please write me and if anyone has information on PSSD after taking St. John’s Wort I would really appreciate help. Thank you.
Sam says
I used st john wort last year and i was reduceing my med it help me for that .and all of a sudden it fill good and my sex drive was great but it after a month i started to have pssd.
Mike kujath says
I’m 22, was put on antidepressants when i was 12. Discovered i had pssd when i was 16 and realized i wasn’t having dreams and i was impotent. Still have pssd and I’m just looking for a way out.
PJ says
For fuck sakes, find us a cure already!!!! I’m sick to death of this shit! This shouldn’t e that hard to fix!
AMD says
I think none of these drugs could help anybody. What caused PSSD is because of
1-Neurons which has dystroyed, and;
2-Toxics which are in the brain.
the same as a pipelines which has destroyed in some parts and some sediments has accumulated in other parts!. The first step is to build the pipelines (Neurons) and then clear the sediments (Toxics).
I just say as a person with PSSD condition after 4 years: The situation is Terrible !!!
Jordan Rumble says
Has anyone tried TMS?
dann says
I was on Fluvoxamine and other SSRIs for 4 years since 2009. Still I have got PSSD. No dreams at all and no deep relaxed sleep. Why the hell no big organization try to find a cure for this???
William says
I have had PSSD symptoms exactly the same as others except I used tetracycline and finacea for rosacea. Treated my rosacea but killed me sexually. Wouldn’t have made the trade.
Treatments I have found that help:
ginseng
big energy coffee from 711
horny goat weed
clomid for low testosterone
PT-141
Levitra
low alcohol use (1, 2 drinks)
summer heat/sweating a lot/very tough diet even though Im not obese
If you know of other things let me know!
Jay says
That’s actually very interesting but horrifying about the dreams ,I’ve had pssd for 6 years and persistent depersonalisation like I’m not even alive , I never dream, like at all, i just wake from a haze with no awareness of anything from going to sleep and awakening , very very rarely do I recall any dreams whatsoever
Ella says
The same. Is this related to dopamine inhibition or is it more complex? I took a number of different antidepressants consistently for 17 years stopped in December, developed PSSD in February. Completely depersonalised and derealised also. Feels like I somehow killed myself yet I’m still existing as a disembodied audio-visual processing system. Although the visuals aren’t that great, everything seems distant and blurry and marred by static. No emotions, close to no bodily sensations, no connection or pleasure response, cognition utterly destroyed, no sense of passing time. & I’ve always had incredibly vivid, complex, creative dreams, with a lot of lucid dreaming since I was a child every night with perfect recall. I could even build on previous dreams & pick up where I left off occasionally. Since I stopped the AD I’ve had hypnagogic hallucinations, nightmares, now no dreams whatsoever. Perhaps because dreams are supposed to be making sense of emotional/psychological developments and now I have no inner life/psyche, just a void. This condition is a complete annihilation of self and everything that makes us human.
Sam Hyde says
I can’t take it anymore, I never agreed to being sterilized, I I can’t have children of my own, the people who make the medication would have to know the side effects they ether don’t care or there pushing it on purpose.
They will pay, people will know what they’ve done, all the lives they’ve ruined.
Nobody will weep for me.
Lee Edward says
The dreams are opposite for me, I hardly dreamt and as soon as I started my SSRI i dreamt crazy all night, iv been off them 1 year and still dreaming every night.
Sexual desire is not there though, desensitised, i feel dead in the lower part of my body like no magic…
I have been trying supplements which have perked it up , burbur drops, MSM, choline, zeolite all in one drink, tried that for 3 days, it definitly brings emotions back slightly.
I spend lots of money on a huge amount of things so I will update as Go along,
Currently taking edovis drinks which have been
Said to cure it, so we will see
Have faith all, we will get there
Lee
Luis says
Did the Edovis eventually help?
D says
Has anyone examined the response of Transcranial Magnetic Stimulation on PSSD? This is novel treatment for depression, anxiety, OCD, and seems to have both evoked increased libido, and normalization of hypersexuality in case, when different areas of the brain are stimulated.
I think TMS is the future of much psychological treatment, unfortunately Big Pharma and the FDA seem more equipped to keep people sick and dependent, than offer long-term solutions with less recidivism. However, TMS is increasingly covered by insurance but over selective diagnoses. Something to consider.
T says
20 years of non stop PSSD
Lucky for me, my dreams haven’t changed, they have always been fun interesting dreams.
That really would have upset me even more to have lost dreaming
For me if I could just have sexual pleasure, once a year at least it would give me something to look forwarded to.
Steve says
I’ve been suffering fronm PSSD for 23 years. In ’98 I experienced a total loss of visual arousal along with genital pain and a 50% reduction in semen volume, erections had to be provoked manually. I certainly didn’t associate it with the Sertraline I was taking, these problems have persisted to daye. This realization only came in 2016 when I was prescribed Sertraline again. I had a massive adverse reaction to the first dose and finished after the 3rd dose. This resulted in tinnitus, memory problems, insomnia and worsening of erections problems, further reduction in semen volume. Of course I was brushed off by the doctor with “its out of your system now so it can’t be causing problems” and “there are no recorded instances of this”… He knew that pretty quickly! Fast forward to 2019 and I was prescribed Levothyroxine for hypothyroidism, one or two weeks of this was enough to destroy my remaining libido. Another year later in 2020, I was prescribed a mild steroid cream to clear up a fungal skin rash… All hell was let loose, worsening of all existing symptoms plus emotional blunting, numb and atrophied penis, chronic fatigue, loss of motivation, genital pain that does not respond to pain killers and lost 2kg in weight. My sleep is terrible, I manage about 2-4 hours per night… I ve only recently begun to dream again, but they crumble as I try to recall them. All in all a bit of a mess.
It seems once you are hit by PSSD your body is ultra sensitive to virtually any medication in a way that people without the problem can’t comprehend. I recommend not to take anymore meds unless you are in a life threatening condition. I’m 63 now and am so lucky I have a very understanding girlfriend. I hope in the near future SSRIs will be looked back on in the same way lobotomy is now.
Alexander says
It’s funny that thyroid medication made your PSSD symptoms worse. They did the same too me. I’ve read others having a similar response. There seems very much be a damned if you do and damned if you don’t scenario in this.
Michaelsons says
You are right. I have that feeling also. After ssri and pssd, you are more sensitive to any medication and even if you have cold, of flue, or any other condition you feel 100 times worse. Its like your organism and life is destroyed and you are im living hell. IT TERRIBLE !
Chloe says
I’m 33 and stopped taking my daily 50 mg of Zoloft about 2 years ago. I had been on it for almost ten years now. I noticed a decline in my libido, and panicked when my nipples and genitals felt numb. I am in a loving relationship with someone who I used to have plenty of sex with, I have always been easily aroused and had a healthy sex life since I was 16. Now it is the last thing on my mind and when I muster up the courage to have sex with my boyfriend it’s physically and mentally uncomfortable. It’s hard to explain how it all makes me feel, anger is a big part of it. I am
noticing a lot of articles directed towards men and PSSD, do woman suffer less from it? I am going to try a cocktail of natural supplements I am told may help and will keep you all posted.
PSSD woman says
Thank god for a resent post from a woman. I suffer too. Did you find any supplements that cured you?
T says
Sorry yes I’m male
But there isn’t much I have tried over the last 22 years
at this stage nothing has made any difference
I would pay a $1000 for a pill that would make me feel normal for a day at least give me something to look forwarded to once or so a year.
Chloe says
I haven’t noticed much of a difference while taking a plethora of natural supplements. However, and yes this may be controversial for some, I have noticed a slight difference while micro dosing psilocybin mushrooms.
Zelda says
Good to know! I have had positive effects +10% on arousal and desire with bupropion, but the side effects (reduced sleep quality and time – I’m sensitive to all stimulants) were intolerable for me to stay on it longterm.
Michaelsimonsin says
I have PSSD for 13 years. Its like one part of me is missing, and I feel very sad. Will someone find us a cure and save us? Its like living in hell…
john peters says
Make my penis great again!
mangus says
is there any cure guys? or something that can make us feel sex life?
T says
Id like to think so Mangus
Same time I’ve been like this for 23 years & have pretty well given up
Shauna says
I’m early in, I guess it’s not considered “real pasd” until after 3 months, but I still have all the debilitating symptoms. Such as severe anhedonia, horrific cognitive decline, and devastating emotional bluniting, and complete anhedonia of the genitals. When I sleep, I do dream. But even my dreams are emotionless and blank. Like waking life.
T says
Hi Shauna
Good Luck
Its been 25 Years for me & not good, still live in hope that I can one day feel like I use to
Male 62
Jeremy says
Has any men had any positive experience with Man 1 Man Oil or Sensum+ or Exum for improving penile sensitivity?
T says
Hi Jeremy
Not those, but I will be shortly trying Tribulus Ultra & will let you know if any improvements.
Not that I’ve had much luck with anything in the last 20 odd years.
T says
Tribulus Ultra – Hasn’t help me at all (May assist people without PSSD)
25 years ago, I took some tablets that turned off a switch within minutes of taking
I need it turned back on & hopefully before I turn 80.