PAPSD (Post Anti-Psychotic Sexual Dysfunction) - Sonny OP

[6-Eggs!]

Just went through my cupboards and drawers and found some of my old medication.

About 2014 I got debilitating CFS and depression and lost my sexual function and libido.

I had been on about 15 different SSRIs, NRIs and SNRIs but I only found 2 old boxes plus one name I recall.

Citalopram
Lovan
Reboxetine.

+ about 10 other SSRIs/SNRIs. All of them made me very unwell so other drug classes were tested as it was apparent that SSRI/SNRIs were intolerable for me. So far no PSSD though.

I was on a new AD that targeted the melatonin system, like placebo. Did nothing being months on them. Valdoxan it was called.

Eventually I opted for moclobemide which worked semi effective but was by far the best. My sexual function returned mostly normal despite still suffering from treatment resistant MDD.

My psych tried a number of mood stabilizers, anti seizure drugs like sodium valporate. Nothing. Placebo.

Then came the antipsychotics. I found an old box of Latuda. I was on that for over a year. Nothing. Placebo.

Then another one or 2 APs, again, nothing. So far nothing after the SSRIs had side effects and only the moclobemide was semi effective and had no side effects.

Then I was put on Rexulti, I saw improvements but then after 18 months on it I got delayed side effects (tardive) including bad sexual dysfunction.

Thinking it was something else as I had not heard of delayed onset side effects. I quite the Rexulti a year later and ended up with severe neurological dysfunction including PSSD like symptoms, Numbness, flaccid glans syndrome, pain etc. Also body wide numbness/burning and movement and function issues as well and odd mental abnormalities that come and go but change all the time.

What I don't understand is all these drugs including the SSRIs (although SSRIs made me sick, side effects always went away after a week on withdrawal) did nothing on withdrawal and didn't cause any long term effects.

Latuda a SGA, similar target profile to Rexulti but not quite the same had such enormously different results, why is what I am trying to understand? Only major difference I can see is Rexulti lists SERT as a target and is very strong occupancy for 5ht-1A, but PET scan studies found Rexulti to be less than 5% occupancy at the higher 4mg dose for both SERT and 5ht-1a. Also the SERT occupancy listed on Wiki which is the only place I even found a SERT listing, displayed it in non standard units and I can't find a way to convert it to the relative Ki (nM) metric.

I was on 2mg so going by that it should be like the study says, negligible occupancy at those 2 sites? Could it be the reasonably strong blockage of 5-ht2a, 2b as well as 7? There is pretty strong partial agonist for D2 and D3 but most of the dopamine withdrawal symptoms went relatively quick and didn't persist like the sensory/sexual issues.

[kaimbre]

Posted by Hades OP
Moved here for clarity purpose
Thu May 18, 2017 4:35 pm

hi all.anyone can tell anything about pasd?i have all the symtoms from pssd,but i used antipsycotics and someone told me that i have pasd?is there any difference?it looks like the same thing to me.or wrost

I have PAPSD from risperidone. I realized that I only get better when I reduce serotonin. Mushrooms and cyproheptadine worked miracles on me. People who have recovered from PSSD have used steroids, herbs like SJW and Inositol, Wellbutrin, and lithium. None of this helped me.

I'm sure MDMA would cure me. But I don't have access to that.

[Titeuf]

Posted by Hades OP
Moved here for clarity purpose
Thu May 18, 2017 4:35 pm

hi all.anyone can tell anything about pasd?i have all the symtoms from pssd,but i used antipsycotics and someone told me that i have pasd?is there any difference?it looks like the same thing to me.or wrost

I have PAPSD from risperidone. I realized that I only get better when I reduce serotonin. Mushrooms and cyproheptadine worked miracles on me. People who have recovered from PSSD have used steroids, herbs like SJW and Inositol, Wellbutrin, and lithium. None of this helped me.

I'm sure MDMA would cure me. But I don't have access to that.

Did you know that certain antipsychotics alter 5 alpha-reductase like SSRIs do?

I don't think there is any difference between PSSD and PAPSD?

[6-Eggs!]

I haven' updated in some time.

I got off the Rexulti nearly 18 months ago,while still tapering Moclobemide.

I finally got off the Moclobemide late last year, so 9-10 months ago. My PSSD and other symptoms improved a lot and much of my PSSD was isolated to more mild waves, but the Moclobemide withdrawals were getting worse and worse, I had full blown of what I imagined were LSD like visual hallucination, I got extreme agitation and fear and anxiety, super depressive moods, suicidal ideas and what not, intrusive thoughts and uncontrollable ear worms of songs I hated for months on end. Brain zaps, seizure like weakness in my right size with surges of goosebumps and electrical prickling sensations, visual disturbances and endless migraines with visual and brain stem auras.

The worst symptoms was the excruciating burning pain in my bits, feet and mouth. The mouth was a new once since the moclobemide end of taper and has persisted since.

Earlier this year, all this improved and my sexual functions improved but started to flip to PGAD and PE, which I never really had for any more than a few days in 2021 right at the beginning of the Rexulti taper. So I am sure the Mocloemide overall was worse than the Rexulti, even through the Rexulti alone set this all off in motion, but it was easier to taper by a long shot. So yeah I agree that APs are nasty and have bad WD in on themselves, I believe most of the dirty work is done silently in the background by ADs, and having both together is a recipe for disaster.

Btw, I never had depression, fatigue or anything that the drugs was suppose to treat like I mentioned in an older post, I now know I have ASD and was just experiencing burnout which is not at all the same as depression, this goes to explain why none of these drugs worked and also why I reacted to badly to many of them.

I know there is lots of ideas what does what in the brain, but from my current and ongoing symptoms, loss of or critically low serotonin production is the best fit. I am sure it is more complicated than that, but years of blocking the brains way to dispose of serotonin can only result in gene expression changes to reduce the production to compensate, all AD's and drugs that stimulate neurotransmitter release or it's activation in it's target receptor is well established to only be very temporary increase said neurotransmitters for about a week or two at most and the brain quickly adapts to reduce to compensate.

I think how strong a drug is and how long one takes it seems to be the biggest factor on how deeply ones brain alters to compensate and WD are just the brain no longer able to function until the changes reverse or alter in a way to achieve the same or similar function as before. One's genes also seem to be at play. I learned that neurodivergent people are not compatible with most drugs, and explains myself as well as many of my family and my partner's family's seemingly intolerance to meds. Apparently, neurodivergent people have brains that are far more plastic than typical and undergo far more extensive adaptation to drugs, which may help explain the issues we have as well as the high incidence of WD syndromes and ADRs. There is evidence that the same people also recover much better from brain injury, so there's hope that WD may be very very bad for us, but recovery should be more possible. I think it is, as I have had many periods where I would have considered myself 90% recovered, but as I know well now, recovery is not even close to linear and normally the worst is typically the 2 years following a successful taper. If you didn't have a suceful taper and triggered PAWS/PWS, then this initial drug free WD period can be much longer.

I personally don't feel like I have even bottomed out yet and I have been drug free for a while now.