For Millennia, the Moon has been linked to Fertility, Healing and Creativity. It was the Goddess for Fertility. None of our ancestors, however, had to wonder if a Robot on the moon might have implications for Fertility. If you think last week’s Lunar Landing of an Intuitive Machine Robot could have nothing to with Fertility – think again.
We normally link medicine to the Healing Arts and link the Healing Arts to women – nowhere more so than in matters of reproduction, where as Ned Shorter found even writing about The History of Women’s Bodies can land men in trouble.
But if you really grapple with the history of medicine, it comes as a big surprise to find that for the last two centuries the military has shaped more of that history than anyone else. The military input increases with every year that goes by.
Anyone who figures they need to go back to the Greeks or Chinese to tell the story of medicine risks missing this. There was little military input to medicine before Napoleon.
History purists, who view ‘news’ not as the first draft of history but something very different to history, or view a history of the present as a contradiction in terms, risk missing this.
You will miss this, unless you engage with the present and stumble against or fall over something that should be obvious but is invisible to most people, and is certainly not on the radar of historians, social scientists, or philosophers like Thales, who don’t live in the present and as a result risk falling into wells (wells not wellness).
The biggest single medical event of our time – the Vaccine response to the Covid pandemic was sponsored by the US military. Pfizer and other companies who needed funds to develop candidate vaccines, run trials, and then have the products bought, signed contracts with the American Department of Defense – not with the Department of Health. Part of the difficulty in finding out what went on in these trials, or what the trial results show, stem from the fact that it’s a matter of national security.
On the day before the Trump-Clinton vote in 2016, Barack Obama signed Executive Order 13747
Advancing the Global Health Security Agenda to Achieve a World Safe and Secure From Infectious Disease Threats
This order aimed at creating a coordinated international network to respond to threats like novel infections, whether arising by accident or from a laboratory.
See Military Maneuvers in the Dark.
Readers can speculate on exactly what security matters are involved. We are not likely to be told in the near future. This doesn’t mean that the vaccine programs or reasons behind the silence are sinister or nefarious – it may just be that all militaries have to keep ahead in the technology race.
Sex and Health and the Military
When it comes to sex and reproduction there is nothing like the internet. The most sought after items all have to do with Sex and the second most sought after have to do with Health. In health today, the internet is perhaps even the dominant player.
And we have the US military to thanks for the internet – see Military Maneuvers in the Dark.
Many men with prostate problems these days will express a preference for robotic surgery rather than surgery in the old-style. Commercial robotic surgery now extends way beyond prostate surgery, thanks to a company called Intuitive – an offshoot of US military research.
There’s that word Intuitive again.
Everyone likely is aware that the pandemic has opened doors to telemedicine and video-consults, but the combination of telemedicine and robotic surgery several years back opened the door to telesurgery. Nearly a decade back, surgeons began carrying out operations on injuries several thousand miles away. Was this just surgical machismo? Nope. It was part of a program to enable us to carry out operations for people needing them while in space.
Men and Machines
Up till this, military involvement in health has not been just a matter of supporting technological developments. For several centuries the army with the best technologies has won wars but with Napoleon it also became clear that the army that lost less men to disease than to enemy weapons won Wars. Napoleon was famously dismissive of medical mumbo-jumbo – he wanted things that worked. He supported surgery and his army made the first efforts to treat people on the battlefield and remove them behind the lines using what we now call ambulances.
Napoleon’s new approach to medicine in military settings became a dominant military concern in the 1860s American Civil War, on both sides, and led to extraordinary developments in surgery, anesthesia, and disinfection.
The Russian-Japanese War in 1904, astonishingly won by Japan, was the first war in which a country, Japan, lost fewer men to disease than they had lost to enemy weapons and much fewer men than the Russians. The Japanese put in place methods they learnt from Germany, who had adopted the lessons they learnt from the American Civil War.
The ways our histories get written, European doctors are pitched as leading the development of all medical specialties. We hear of American doctors coming to Paris and later Berlin to hear about the latest developments. The implicit message is the primitive Americans were learning from their European betters. This is not the way medicine developed.
World War I and World War II led to a huge increase in military input to medical technologies and disciplines from surgery to mental health. The extent to which these Wars shaped our medical world is outlined in Shipwreck of the Singular and The Decapitation of Care. The Korean, Vietnam and other Wars were in the original Shipwreck but ended up cut because the book was far too long.
The Military and Public Health
Military policy was not just a matter of battlefield developments. Before the Revolution the French were keenly aware that it was in the national interest to ensure there were more French than Germans. This need played a huge part in a push to transform medicine from a Boys Club into a science. A science that would support battlefield medicine but also public health aimed at ensuring French children survived and could join the Army when needed.
A century later Josephine Baker in America could still warn the US government that there were more children dying in the first year of life than in European trenches.
This was the start of what is now called pronatalism a word that has suddenly reappeared in the wake of Macron’s call for France to demographically rearm – Liberty, Equality and Fertility.
Macron’s call reflects standard military input to national health policies for two centuries. But what about now? With increasing development of robots and A.I. the military are now wondering if soldiers will be needed in future wars – could they be waged entirely by robots? If they decide they could, there may be much less need for the military to take an interest in national fertility issues.
War and Sex?
War factors into Fertility in another way. This graph shows British Fertility Rates falling from almost 3 children per woman in 1965, comfortably over the 2.1 reproductive replacement rate, to 1.6 in 1995. It tempts many to make an ‘obvious’ connection with the availability of oral contraceptives, which gave women the freedom to choose to have children.
This second graph complicates this appealing idea.
There was an almost identically sloped drop 30 years earlier – a drop from 5 children per woman around 1890 to 1.8 in 1935. What began happening around 1890 is that children began surviving. Women had been giving birth 10 or more times but only 5 or fewer children were surviving. Once survival became the norm, the pressure to have children eased.
For over a century Wars, the First and Second World Wars have been the only thing that have led to Baby Booms, as this graph of Danish Fertility Rates shows.
Remove the Second World War and the downward slide of national Fertility Rates makes oral contraceptives look irrelevant. How much of what happens in War is chosen?
What is dramatically different now are figures of 1.2 or lower for Spain, Italy, Korea and other countries.
What is dramatically different is the emergence of phenomena like asexuality. In response to last weeks Fertility and Desire post 3 different people sent comments drawing attention to a blog post and a news program which reported that post linking antidepressants, asexuality and PSSD. The link here gives a read-out of the post – the text that is read out can be found in last week’s comments.
There are several RxISK posts making this link that date back a decade – See Asexuality A Curious Parallel. The prompt to this post from so long ago came from work linking SSRIs to birth defects and miscarriages etc. Research from two decades ago points to animals born to mothers on antidepressants while pregnant being asexual.
The Asexuality post was put up nervously. It was clear the response would be – Asexuality is our Choice. Who are you to say otherwise?
We seem to think we have more control over events than perhaps we have. A report from the Resolution Foundation just out paints an extraordinary picture – young people today are the sickest most disabled ever. Much more disabled and sick that middle-aged folk. Resolution are calling for more input and treatment – more antidepressants. The Report is great for anyone who likes figures and graphs, the BBC cut to the chase.
If we want some control, we need to demand information and not just information but the free circulation of information. People who ask questions should not risk prosecution for spreading misinformation. Supporting the free circulation of all information has not up till this been seen by the military as a desirable option – See Fertility and Desire.
annie says
Robot ‘Odie’ and Le ‘Body’
In the Dark…
Le Monde
By Camille Stromboni
France’s delicate approach to preventing infertility
Medical professionals do not find the Elysée’s proposal of fertility consultations at the age of 25, including spermograms or gynecological examinations, suitable. Instead, they emphasize the need for more information on the topic.
https://www.lemonde.fr/en/france/article/2024/02/06/france-s-controversial-approach-to-preventing-infertility_6496867_7.html
How do you prevent infertility? This is a delicate and complex matter given the personal nature of the subject. Nevertheless, the government has taken up the issue, at a time when it affects three million people in France. In the wake of Emmanuel Macron’s January 16 announcement of a plan to combat this “scourge” described as the “taboo of the century,” a commitment has been made to introduce infertility consultations at the age of 25, with a gynecological examination offered to women and a spermogram test for men. The measure, which is part of the “demographic rearmament” called for by the French president, has provoked strong reactions among doctors. Screening for fertility or infertility at this age, with this type of examination and with no connection to family planning, makes little sense to them.
The idea is to build on “prevention reviews,” which are government-promised health consultations at key stages of life, including for the 18-25 age group, which are expected to be introduced soon. This will be an opportunity to “raise awareness” of these issues at an earlier stage, said the Elysée, assuring that it will not be an obligation.
Although the spotlight on this “public health issue” has been welcomed given that it has been a “blind spot for public authorities,” according to the report submitted in 2022 by Professor Samir Hamamah, incomprehension prevails. “It’s far too early. This appointment at age 25 doesn’t make sense, we don’t understand where it’s come from,” said Hamamah, head of the reproductive biology department at Montpellier University Hospital. His report, which was intended to inspire “a major national strategy” on infertility, though without any action so far, proposed a consultation at the age of 29, closer to the average age of childbirth – 31 – and the same age that women gain the right to “fertility preservation,” following the bioethics law of 2021.
How do you prevent infertility?
susanne says
There are more and more ways AI has capabilities of wiping untold numbers of us out while those making the decisions hide in their bunkers as ever. Those of us lucky enough to still be able to see dark skies can’t but find the sight awesome and beautiful beyond words. What those governing the world see is opportunities like this . That twinkling little satellite journeying through the sky may no longer be harmlessly beaming The moon is being pillaged by governments and big business:- Hopefully they will fly too near the sun in their gross endeavours and come hurtling to earth before, the damage to space becomes as serious as what is happening on earth.
PEMBROKESHIRE BARRACKS PREFERRED SITE FOR NEW DEEP SPACE RADAR, WHICH
WILL TRANSFORM UK SECURITY
Monday, 4 December, 2023
A new landmark radar initiative with the UK’s closest partners will
increase UK security by being able to better detect, track and
identify objects in deep space.
The Deep Space Advanced Radar Capability (DARC) programme – unveiled
by the respective Defence Secretaries of Australia, the United Kingdom
and the United States – will provide 24/7, all-weather capabilities
that will increase AUKUS nations’ ability to characterise objects deep
in space up to 22,000 miles (36,000 kilometres) away from earth.
DARC will see a global network of three ground-based radars to be
jointly operated that will assist in critical space-traffic management
and contribute to the global surveillance of satellites in deep space.
The unique geographic positioning of AUKUS nations means that DARC can
provide global coverage, including detecting potential threats to
defence or civilian space systems.
As the danger of space warfare increases, this landmark capability
will benefit all three nations’ land, air, and maritime forces, as
well as protecting critical infrastructure and benefitting our
domestic construction and space industries.
Harriet Vogt says
Prompted by Fertility, the Moon and the Military, I took a social media research foray into – Asexuality. Turns out to be an extremely complicated system of socially constructed states of sexual and/or romantic being and nothingness.
Just a few of the options for those developing asexual or ace spec psychosociosexual identities:
Apothisexual: asexual and sex-repulsed
Cupioromantic: does not experience romantic attraction but has a desire to be in a romantic relationship.
Cupiosexual: desires a sexual relationship, but does not experience sexual attraction.
Frayromantic: experiences romantic attraction, but this attraction fades after getting to know the object of attraction.
Grey-(a)sexual: sometimes, occasionally, or rarely experiences sexual attraction. The attraction they experience may be weak, or it might be infrequent.
And the identity slicing and dicing goes on and on – and on – for further reading. https://www.oulgbtq.org/acearo-spectrum-definitions.
It’s bespoke identity tailoring. And it’s fluid, as advised on reddit: ‘.. you never have to constrict to a type or microlabel, you’re just here in the ace spec and that’s ok : )) there’s an ace spec flag you can look up, it’s very pretty’.
We used to carve our social identities from mostly external badges, the building blocks of old school social identity theory. But it seems far more convoluted now – a process of laying bare the most personal, inner feelings about ones sexuality and state of mind – then packaging them up in externally created social constructs.
Ofc it must be therapeutic to reveal and share ones inner self with others who feel similarly – especially when in a previous world, those inner selves of ‘lack of sexual/romantic attraction’ were perceived in negative and stigmatising ways –‘sexless’, ‘undesirable’ ‘neuter’, ‘spinster’, ‘nun-like’ (not sure about that one).
But you have to wonder what happens to a person, psychologically, when their deepest feelings have to be put through an externally constructed filter – before they can feel them. Is this the same distancing – some might say alienation from self – that encourages people to talk about ‘my depression’, ‘my anxiety’, rather than the more simple human truth of ‘I feel …’? Perhaps the same distance from self that leaves the gaps where the drugs get in.
One clear implication imo is that Rxisk needs to consider more linguistic precision when warning of the effects of SSRIs etc. on sexuality. Asexuality doesn’t really cut it. Perhaps ‘desexuality’ or ‘desexualising ‘ comes closer? Or even Drug Induced Desexualisation (another way of saying PSSD) – DID to match the already established acronym DIND, Drug Induced Neurological Disorders.
desexualized; desexualizing; desexualizes
1: to deprive of sexual characters or power
2: to divest of sexual quality
(Websters)
susanne says
Imagine what fun the Coders would have with this Harriet. Another money making opp for some but also with serious implications for those people whose records are being mis -coded whether deliberately or otherwise, Again very few people are aware that their information is being Coded and that they have the Right to Opt Out.
Extract from Guardian some years ago. There’s loads of info on simple google search which show what a mess it’s been. The latest is the use of a Chat box to replace human coders to do the coding – we are being reduced to becoming the ghosts in a machine to nic a phrase from Koestler.
My job mainly consists of reading through patients’ medical records – that’s everything that documents their hospital stay, from admission to discharge – and converting the information into alphanumeric codes using the ICD-10 and OPCS-4 classifications that the NHS then uses to set resource-management targets and receive reimbursement for treatment and care
. I try to remember there’s a real person behind the masses of disorganised paperwork.
Early afternoon brings a few simple episodes – chest pain, vomiting, a bronchoscopy, and another complex case; this time poor handwriting and conflicting accounts by clinicians make it difficult to determine whether my patient has a malfunctioning tracheostomy or if it’s her artificial voice box playing up. I settle for the trachy but ask my colleague for her opinion. She disagrees and we debate for a while. I stick with my original idea but fire off an email to the discharging clinician.
A business manager arrives and asks me what the code is for a gastrostomy insertion. I give him a few differentials. He asks which one will make the most money. “We code for information, finance is a by-product,” I tell him, pointing to a poster that makes the same point.
Harriet Vogt says
A classic, Susanne. Will store, “We code for information, finance is a by-product”, in the memory bank, for future use.
Some error must be inevitable in Europe’s largest ,most complex and/or at times most confused business, the NHS.
I did have a revealing conversation with a team of ophthalmologists the other day. There is a category of harm called ‘Never events ‘– those genuinely rare errors that never should have happened – like surgically removing the wrong body part . So I asked these guys, who were themselves utterly scrupulous – how can this possibly happen? Of course pressure of work was part of the answer. But the real Insight was, ‘when you’re working as a team, everyone tends to think that the other team members know what they’re doing.’
This seems to add another dimension to David’s military framing – soldiers in an army.
annie says
Le Figaro –
High on Sky…
Mark Horowitz
@markhoro
Good to see the issue of the difficulty stopping antidepressants being covered in France by
@Le_Figaro
https://sante.lefigaro.fr/social/sante-publique/le-syndrome-d-arret-des-antidepresseurs-touche-de-nombreux-patients-20240301
MAINTENANCE- The work of neurobiologist Mark Horowitz has led to the development of a protocol for withdrawal from psychotropic drugs in the United Kingdom. He explains the importance of an approach that is still ignored by many doctors.
The observation is known, and was brought to light during Covid: the consumption of psychotropic drugs – antidepressants, anxiolytics and sleeping pills – is high in France. It is more prevalent in women and increases with age. But it’s often overlooked that it can be difficult to stop these treatments. About half of patients experience withdrawal-related symptoms, such as nausea, dizziness, irritability, crying spells, anxiety, etc.
Their severity and persistence vary. They can be very debilitating. Mark Horowitz, a neurobiologist and researcher at the National Health Service in London, studies this difficult stop syndrome and leads a specialist consultation at his clinic opened three years ago in north London. He has just published a guide (not translated) on the “deprescribing” of benzodiazepines and antidepressants for doctors who are often too unfamiliar with this phenomenon.
MARCH 2, 2024
“
Yet another dog-eared anti-psych trope”
An influential British mental health professional recently stated this in relation to the potential risk of dependence and withdrawal from psychiatric drugs:
“To suggest that taking prescribed medication is somehow a ‘dependence’ shows an ignorance of how medication works and implies a moral weakness on the part of the patient. Yet another dog-eared anti-psych trope”
I have been physiologically dependent on a psychiatric drug for nearly 3 decades. The consequences of this have been harmful to both myself and my family. I know that my dependence on this drug has nothing to do with moral weakness. It is a physiological consequence of repeated use of the SSRI that I was prescribed for anxiety. This has also been the experience of many, many other people. For a health professional to use such derogatory terms in relation to people who have been open about their experiences of medication does nothing to address the stigma that persists around issues related to mental health.
https://holeousia.com/2024/03/02/yet-another-dog-eared-anti-psych-trope/
tim says
Agreed Annie.
Also good to read detailed and courageous feature on PSSD in the Guardian On Line (UK) yesterday.
https://www.theguardian.com/society/2024/mar/02/ssri-antidepressants-sexual-dysfunction-side-effects-consequences-libido
Are we moving a little closer to the tipping point?
annie says
A Real-Time Moon-Landing – with Military precision…
Dr Aseem Malhotra reposted
PSSD Network | Post-SSRI Sexual Dysfunction
@PSSDNetwork
·
13h
The @guardian published a great article today on Post-SSRI Sexual Dysfunction (#PSSD). We would like to thank the journalist @DrDavidACox , sufferer @ROSIE_PSSD , as well as the scientists (@DrDavidHealy @abcsoka and @RMelcangi) quoted in the article.
‘It feels like we’ve been lobotomised’: the possible sexual consequences of SSRIs
Long-term sexual dysfunction is a recognised side-effect for some patients who take these widely prescribed antidepressants, and can leave sufferers devastated. So why is there so little help available?
https://www.theguardian.com/society/2024/mar/02/ssri-antidepressants-sexual-dysfunction-side-effects-consequences-libido
During Melbourne’s strict lockdown of 2020, Rosie Tilli, a then 20-year-old nurse living and working in the city, began to experience growing anxiety and depression.
Visiting her GP, she was quickly prescribed escitalopram, a commonly used drug from a class known as selective serotonin reuptake inhibitors (SSRIs). These medicines attempt to treat depressive symptoms by boosting the levels of the hormone serotonin in the brain and rank among the most widely prescribed drugs. In the first 11 months of 2023 alone, more than 80m prescriptions for antidepressants were issued by the NHS.
Tilli was nervous about escitalopram but, reassured by a psychiatrist, she began taking the tablets. However, rather than experiencing relief, she soon noticed a worrying drop in her libido combined with an inability to feel any sexual sensations at all.
A quick Google search alerted her to a condition known as post-SSRI sexual dysfunction (PSSD), where both men and women who have taken various SSRIs have been left with sexual problems, persisting for years or even decades. Alarmed, she began tapering off the medication after four months, but there was no change.
“I reassured myself that I would be fine as soon as I fully ceased the medication, but I wasn’t,” she says. “Now nearly four years on, I’ve learned to put on a sunny disposition, but internally I am riddled with psychological grief and anguish. I can’t experience any physiological sexual response. No arousal even when physically touched. It’s as if the entire electrical hardwiring of the sexual system has been short circuited. My clitoris feels like my elbow now, and there’s nothing I can do to reverse it.”
While the first reports of persistent sexual side-effects in response to SSRIs began emerging in the early 1990s, PSSD as a condition was not recognised by the European Medicines Agency until 2019. A patient organisation called the PSSD Network has been launched, and its affiliated Reddit community has amassed more than 10,000 members around the world.
Psychiatrist David Healy, founder and CEO of the company Data Based Medicine, which is dedicated to making medicines safer, is particularly concerned because the majority of patients who are treated with SSRIs are not the most severe cases of depression. Instead, he says, they tend to be individuals with milder symptoms, often teenagers and young adults. “They’re being handed out without much thought these days,” he says. “Now absolutely, people who are at high risk of suicide do need treatment. But the average family doctor is handing SSRIs out to people who are anxious or mildly depressed. They need to realise that if you cause PSSD, you’re going to lead to suicide cases because people feel they can’t live this way.”
Tilli describes herself as “completely broken” due to the effects of PSSD, and like many with the condition she fears being perpetually alone because it has made sexual intimacy and romantic relationships impossible. Another sufferer told the Observer that it feels akin to having been “lobotomised”.
“I know of other women with PSSD who are now speaking of getting artificial insemination [to have a child] because all of their relationships have failed due to the condition,” says Tilli.
Now Healy and other researchers around the world are working to try to understand why PSSD occurs, and whether it may be possible to reverse the symptoms.
Possible brain alterations
There is no precise consensus regarding the prevalence of PSSD, but when SSRIs were launched clinically, their initial labels stated that less than 5% of patients in clinical trials had reported sexual dysfunction.
However, in some unpublished phase 1 trials of the drugs, more than 50% of healthy volunteers developed severe sexual problems, which in some cases persisted after treatment stopped. One post-market research study found that between 5% and 15% of patients developed sexual impairments after taking SSRIs, and Healy and other doctors are now concerned that the prevalence could be greater than previously thought.
SSRIs have been marketed to patients for more than three decades, yet the PSSD Network says patients’ suffering is being ignored by mainstream psychiatry. Few doctors, it says, have attempted to delve into why this side-effect occurs, and why some people are especially vulnerable.
Through testing in male rats, some studies have indicated that these drugs may cause toxicity to the testicles. Last year researchers from São Paulo found that the SSRI paroxetine can cause testicular changes in lab animals, including impaired sperm production, which persisted after the drug was stopped. However, the few scientists who have dedicated themselves to this topic believe that the root cause of the genital numbness, lack of libido and plethora of other sexual side-effects that PSSD sufferers experience happens in the brain.
“I believe that PSSD is primarily a neurological disorder relating to altered brain functionality,” says Prof Roberto Melcangi of the University of Milan, who has been researching the condition for the last three years and has also spent more than a decade studying sexual dysfunction caused by the drug finasteride, which is taken for male pattern baldness.
Melcangi and his team have conducted their own research on paroxetine in rodents, which he is now hoping to replicate in a small study of male PSSD patients. Initial results indicated that the drug could alter certain so-called steroid hormones, which act as important regulators of brain function, including sexual behaviour. Further experiments have suggested that paroxetine might also impair the gut microbiome, which interacts with the brain.
Antonei Csoka, a researcher on ageing at Howard University, who has been studying PSSD intermittently since the early 2000s, suspects that as a side-effect of targeting serotonin receptors in the brain, SSRIs drive epigenetic changes, particular DNA modifications, which then affect the activity of genes relating to sexual function. Why this seems to happen in some unlucky patients and not others remains a mystery.
“Various scientists, including myself, have published studies showing that an SSRI can change epigenetics and human cells,” says Csoka. “If that’s happening, then those cells or tissues may not immediately revert back to how they were once treatment stops. It’s as though an imprint has been left there. However, it’s still not known precisely what these epigenetic changes are. So what we need to do is narrow it down – what is happening?”
‘Medical gaslighting’
When Tilli first began experiencing symptoms, she was called neurotic by her GP, who insisted that SSRIs could not cause sexual dysfunction and sent her home to do deep breathing exercises. But far worse would follow.
“When I reached out for help with my local mental health service, I was sectioned and placed involuntarily into psychiatric care as the psychiatrist said I had ‘delusional disorder’, and tried to put me on antipsychotics,” she says. “It shattered my trust in ever seeking help for my mental health again.”
Tilli and other PSSD patients feel they should have been given greater warning of the potential side-effects of SSRIs before commencing the drugs. However, most of all they describe feeling completely abandoned to their fate by the medical community, through cases of what they call “medical gaslighting”, with psychiatrists refusing to acknowledge this source of drug-induced harm.
At the same time, the PSSD Network and researchers say that funding to better understand the cause of these symptoms and further the search for potential treatments remains virtually nonexistent. Much of Csoka’s research into PSSD so far has needed to be covered by grants relating to ageing, while Melcangi’s work is partly crowdfunded by PSSD patients themselves.
“The psychiatry profession and pharmaceutical companies have a moral, ethical and professional responsibility to fund research into the biological pathophysiology and treatments for PSSD,” says Tilli, who is part of the PSSD Network. “They are mocking harmed patients by forcing us to self-fund our own PSSD research. On top of that, many sufferers are teenagers and university students, who either work part-time for minimum wage or not at all.”
When the Observer approached leading SSRI manufacturers GSK and Eli Lilly for comment, neither indicated that they would consider funding PSSD research in future. GSK representatives said: “As with all medicines, SSRIs have potential side-effects. These are clearly stated in the prescribing information and patients should only take these medicines under the direction of a medical professional.”
The Lilly public affairs team issued a similar statement regarding the SSRI fluoxetine, commonly known as Prozac: “Fluoxetine continues to be considered to have a positive benefit-risk profile by regulatory authorities, physicians and patients around the world.
Lilly continues to submit fluoxetine safety data to regulatory authorities around the world.”
Both Melcangi and Csoka believe that potential therapeutic solutions for PSSD are out there, either through repurposing existing drugs or using emerging technologies to target the epigenome. Csoka is aware of case reports where patients have managed to regain at least partial sexual function either through taking various nutraceuticals, using low-power laser therapy, or drugs that attempt to readjust the chemical imbalances in the brain, such as bupropion and vortioxetine. In the coming years, Melcangi hopes to raise funds to conduct a trial using a drug called allopregnanolone, which he believes could modulate the abnormal brain behaviour behind cases of PSSD.
But there are many challenges. PSSD is likely to have many underlying causes, which vary both between individuals and between the sexes. Different therapies may be required for different patients, a level of biological variability that is both challenging and costly to try to understand. But Melcangi is optimistic that even with limited resources, something might ultimately be done to help people with the condition.
“It will be difficult to find a therapeutic approach … for all the effects of PSSD, but an important step would be to at least counteract some of the side-effects,” he says.
For Tilli and others, having even a glimmer of hope is vital. “Our community has had many suicides,” she says. “Our main goal is to raise awareness so that we can get funding for research to pave a path towards hopeful treatments and prevent the despair that leads many to end their lives.”
Dr. David Healy says
Everything we have thought was a moon-landing so far has toppled over on its side.
We haven’t yet arrived at a hold your breath moment
D
annie says
It is a Lonely Planet for the PSSD folk, and the article might surprise a lot of people who aren’t toppling over, by putting it out there
This is a hold-your-breath moment…
https://twitter.com/recover2renew/status/1764011056244928669
Robots may tip over; call them Rover
Planet of the Japes….
Dr. David Healy says
For the record and this should have been after the guardian article above, I had an email from Peter Goetzsche who gives out to me for saying people who at high risk of suicide definitely need treatment
He says: I get very sad when I see that you, of all people, who know so much about dep pill induced suicide have this view. How is it possible?…. I look forward to your reply, with some trepidation, as I feel this is very difficult to explain.
Well he doesn’t take into account the possibility I never said this. The point being made seems relatively clear to me – the focus is on the pills being handed out to people who have little to gain from them. I very much doubt I expressed my view in the way outlined here but journalists precis things and perhaps thought he was doing me a favor or the article a favor by making me out as not anti-drugs.
The irony here is that PG wants me to endorse CBT only – as he does – despite telling him CBT therapists have been responsible for the Recovered Memory Scandal, the excesses of Trauma Informed Care, and the current as Abigail Shrier calls it Transgender Craze – See Why are the Children Not Growing Up – this weeks post on davidhealy.org.
In Bad Therapy, AS goes way over the top it seems to me, much as Peter does. Anything that can help can harm – therapy not excepted. The safest bet is to stay clear of health completely – stop thinking in terms of health – which seems to have replaced holiness as our focus for attention. We seem to be transitioning into a health universe with cults like the Children of God and the Moonies are now replaced by cults centred on bodily/health concerns.
David
Harriet Vogt says
Big congrats to you, D, and rocket boosted Team PSSD on the Guardian piece – No 1 most read article of the day, reposted by many of the big accounts on X. It made a real impact.
Will it transform insane antidepressant overprescribing – no. Will it ensure PSSD is part of informed consent- unlikely. But it will make it that bit harder to dismiss SSRI desexualised and desensualised patients’ terrible suffering as delusional. That’s a crucial step.
Kind of amazed that anyone would embrace CBT except in the technical sense that it seems to outperform drugs in ‘RCTs’. And is preferable to being poisoned. But, as you know, it’s a hugely mechanistic and ‘atomising’ modality that helps some mindsets manage their distress by checking their mindhabits. And ofc it’s cheap and measurable bureaucratic fodder. Does nothing for others and depends ofc on the therapist. I have seen it once prescribed for someone in acute withdrawal – rather unhelpful – how could they be so stupid. Easily.
Re your wrist slapping – understood exactly why you said what you did. The slap seems based on a literal translation of ‘treatment’. Maybe a better word is ‘care’.
annie says
Author comes under attack
Dr David Cox
@DrDavidACox
Freelance health journalist @guardian @Telegraph @WIRED @TIME & others.
Former @Cambridge_Uni neuroscientist.
https://twitter.com/DrDavidACox
Mar 2
It’s really sad that this is the reaction to my PSSD story from some psychiatrists Plenty of evidence going back 30 years showing that SSRIs can cause long term sexual dysfunction. Yet rather than investigating why this happens, some doctors choose to respond like this
https://twitter.com/DrDavidACox/status/1763984125889826837
We Have a Problem Houston…