Worst offenders for PSSD and things to avoid taking

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Meso
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Worst offenders for PSSD and things to avoid taking

Unread post by Meso »

Here's a list of the worst offenders when it comes to PSSD.

Antibiotics:
Avoid a class of antibiotics called fluoroquinolones. They can trigger a chronic syndrome (google 'floxed antibiotics') of neurotoxicity and can loosen up your tendons (seriously, they can even injure your achilles tendon).

It's a generally good idea to avoid antibiotics that can trigger neurotoxicity unless necessary. Here's a list of them:
Image

Antifungals:
Avoid Ketoconazole since it has hormonal side effects. Itraconazole, Nystatin, and Flucoconazole are all safe alternatives. Topical antifungals are OK.

Pain-killers:
Avoid Paracetamol/Acetaminophen as there are a few reports of it causing a crash. It inhibits neurosteroid synthesis and it's an endocannabinoid 'facilitator' for a lack of a better term. Opt for NSAIDs instead, but avoid Indomethacin since it may have endocannabinoid effects.

Avoid mu receptor agonists unless absolutely necessary to control pain. MOR agonists are known to give you limp dick. You can use low doses of Tramadol. It isn't a strong MOR agonist so it's safe to use in low doses.

Anesthetics:
Although there are no reports of crashing from these, I'll use this chance to tell you to opt for Ketamine if possible since it can help with both depression and PSSD for a short duration after it's out of the body due to neurogenesis and a NMDA receptor rebound activation facilitating erectile functions.

Cannabis, nicotine, alcohol, and caffeine:
Cannabis: The main active constituent is THC, which acts as a partial agonist at CB1 receptor. I've written an entire thread on why I think cannabis is the worst offender for PSSD here:
https://www.pssdforum.org/viewtopic.php ... 2&s#p38352

Nicotine: It can have potent vasoconstrictive effects in many people and can impair your erectile function when used chronically. Better avoid it.

Alcohol: It's OK in moderation when it comes to PSSD. Avoid excessive chronic intake though as it can downregulate your endocannabinoid receptors, same as what cannabis does, since it increases your endocannabinoid production (anandamide & 2-AG).

Caffeine: Adenosine antagonism is a potent endocannabinoid potentiator. Avoid mixing it with THC.

Antidepressants:
It goes without saying to avoid any antidepressant that inhibits SERT function (i.e. Certain tricyclic antidepressants, SSRIs, Trazodone, Vortioxetine ... etc) or messes with neurosteroids (i.e. Mirtazapine). There are reports of post-AD syndromes similar to PSSD from that.

NMDA antagonists like Ketamine and Ketamine analogues (intranasal Esketamine) are excellent alternatives. There are some countries and states that allow psychedelic treatment for depression, this is also an excellent option.

Herbal antidepressants like 'Chai-hu' or 'Xiao Chai Hu Pian' are readily available options. Rhodiola rosea is a good option.

Please avoid curcumin extracts since it messes with testosterone. (weak evidence though).

Please avoid experimenting with Ashwagandha since there are a couple of crash reports from it. It downregulates 5HT1A autoreceptors, maybe that's why idk.

Ginger has worsened some people's PSSD temporarily and there's a report of permanent crashing. Better to avoid.

MAO-inhibitors can cause sexual dysfunction but there are no reports that they can trigger a syndrome similar to PSSD as of yet. Be cautious.

Avoid 5-HTP as it crashed a couple of people here.

Methy-donors:
There are a few reports that methyl-donors (i.e. supplements containing two or more methyl molecules) can cause a terrible crash. Please avoid SAM-e and Betaine/trimethylglycine.

5-alpha reductase inhibitors:
This goes without saying to avoid a similar post-drug syndrome (PFS). There are some supplements that can be weak 5ARI, those are fine and don't cause a crash as people tried them. Avoid the "big ones" basically, like Finasteride and Saw Palmetto.

Panax ginseng can also be a potent 5-alpha reductase inhibitor but this is limited to extracts that use the rhizome part of the herb. Most, if not all, supplements use the root's extract so they are safe. Make sure it's a root extract.

Hormonal disruptors:
Androgen receptor antagonists or things that lower testosterone or dihydrotestosterone can cause worsening of PSSD (i.e. Minoxidil). Xenoestrogens (i.e. many plastic types) and phytoestrogens (i.e. Berberine, soy products). Please avoid these hormonal disruptors.

Vitamin A and its derivatives:
Those can cause a post-drug syndrome similar to PSSD and can cause PSSD patients to crash (i.e. vitamin A supplements, Isotretinoin, etc.).

Hyperbaric oxygen therapy (HBOT):
There are few reports of people crashing from HBOT permanently. Please take antioxidants while doing HBOT or avoid altogether.

hCG:
Although many patients use it without a problem, there are a couple of reports of PSSD crashing severely after hCG use. Tread carefully here.

Please remember: Things to avoid doesn't mean it hasn't helped anyone, or that it will 100% cause crashes. It's not black and white. For example, inositol helped some people but crashed others.
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Naczoz
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Re: Worst offenders for PSSD and things to avoid taking

Unread post by Naczoz »

And what about recovery from such crash? I took one pill of trazodone 4 months ago. One user suggested me that I will help my mood without makeing pssd worse and well...I got severe crash. Will I go back to my previous baseline or now I have two pssd's?
Tree
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Re: Worst offenders for PSSD and things to avoid taking

Unread post by Tree »

Please add ginger to the list. I've been preaching for two years on this forum that it has permanently worsened my baseline. Crashed one day from the next after eating ginger for about eight days.
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Meso
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Re: Worst offenders for PSSD and things to avoid taking

Unread post by Meso »

Naczoz wrote: Wed Dec 30, 2020 4:54 pm And what about recovery from such crash? I took one pill of trazodone 4 months ago. One user suggested me that I will help my mood without makeing pssd worse and well...I got severe crash. Will I go back to my previous baseline or now I have two pssd's?
Best option for crashing is to wait and see if you can recover naturally from it. Taking anything right after crashing could potentially make the crash even worse. Give your body some time to recover.
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Naczoz
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Re: Worst offenders for PSSD and things to avoid taking

Unread post by Naczoz »

It was only one pill (50mg) 4 months ago. Nothing changed. Im scared and suicidal.
Leb89
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Re: Worst offenders for PSSD and things to avoid taking

Unread post by Leb89 »

Is ketamine safe for pssd? I never tried, but I heard it can help a lot with depression. My girlfriend is a big keta fan so I might try it, if it won’t fuck me up further
PsychoGenesis
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Re: Worst offenders for PSSD and things to avoid taking

Unread post by PsychoGenesis »

"Avoid mu receptor antagonists"

is this a mistypo?

PS: the antibiotic img is not loading


Thank you for taking time to put this together
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Meso
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Re: Worst offenders for PSSD and things to avoid taking

Unread post by Meso »

PsychoGenesis wrote: Wed Dec 30, 2020 6:47 pm "Avoid mu receptor antagonists"

is this a mistypo?

PS: the antibiotic img is not loading


Thank you for taking time to put this together
Yes, it was a typo. Nice catch. I'll upload the img somewhere else.
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Gameclay
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Re: Worst offenders for PSSD and things to avoid taking

Unread post by Gameclay »

Could you add 5-HTP please? It caused my PSSD after 5 days. Also a few others around here have it from it too
naiverat
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Re: Worst offenders for PSSD and things to avoid taking

Unread post by naiverat »

This should really be pinned. Almost every “severe” case is a result of a crash or multiple crashes after the initial PSSD onset.

Good list, but by no means should people consider this exhaustive.

Once your condition is pretty bad, it appears the body becomes ultra sensitive to any hormonal fluctuations and or neurotransmitter fluctuations, and in this fragile state, practically anything can cause crashes.

For example, after abstaining from all drugs/supplements for quite a while, I had a few drinks socially and experienced a major decrease in my baseline + permanently dried out skin on my face (red/flaking) that requires constant moisturizing. This was months ago. Be careful.
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