Going back to SSRI?

[brian6211]

Hey Felipe,
You said you take Mirtazapine at night. Every night? Dose? Anyone here that took Mirtazapine and got their function back again while on it? I started experimenting with Mirtazapine(7.5mg) last Saturday and I felt my functioning getting better, anxiety vanished as well as my OCD. But yesterday I didn't take it as I felt that it was making my PSSD worse when it was getting better.

It's like I'm stuck on having to take anti-anxiety meds but at the same time I want to cure my PSSD! Any advise? I have my apt. Friday with my Psyhiatrist and I will ask him for a Dopamine agonist. I will take 3.5mg of Mirtazapine tonight.

[brian6211]

Btw, Hi everyone, I'm new here.

[felipekj]

Hey, im taking Mirtazapine 15 mg since 2 weeks ago, my libido is a little better, but almost the same. I personally think that Mirtazapine will not have such influence on PSSD after you stop.

[brian6211]

What do you mean after I stop? I don't plan on stopping this med as it is one of the few anti-anxiety med with a lower sexual side effects profile. Do you mind telling me for what you take it for? And how's your pssd? You take anything else?

[Octopus]

if all you need is something on an as-needed basis, sure, beta-blockers are useful for some, although they only rid one of some of the physical symptoms of anxiety, albeit not all, and don't touch the mental symptoms. that aside and back to the as-needed use -- why not get a script for benzodiazepine and use that here and there when you need to? the benzodiazepines would, i imagine, work much better for you than the beta-blockers for as-needed anxiolysis lest you be an outlier.

also, i took remeron and didn't gain any weight. i'm aware that weight gain is a pretty prevalent side effect, although it doesn't happen to everyone. if you do decide to give the drug a try, you can always discontinue should you begin to gain weight without significant changes to your diet and/or workout routine(s) as you'll know pretty quickly per anecdotes whether or not the drug is going to start to pack on the pounds or be weight neutral.

I’ve taken benzos in the past and they didn’t help me, unfortunately. I’ve taken Klonopin, Xanax, and I think Valium and none of them helped me—just made me a little tired. I’ve heard of beta-blockers being used for performance anxiety and since I’m a musician I thought maybe they might help with performances and auditions. But you’re right—that is only one small part of my anxiety, and so probably wouldn’t help much overall.

I guess I could give benzos another try because it’s probably been 5 years or so since I last tried them so maybe it would affect me differently now? I don’t know. It’s always seemed weird to me that people act like benzodiazepines are the holy grail of anti-anxiety drugs and when I took them I was just like, “meh.”

I guess maybe I should keep an open mind about remeron… I know different drugs affect different people differently—a lot of people gain weight on Prozac and I actually lost weight on Prozac, for example. But I gained some weight after I quit taking Prozac and even though I’m not overweight, I still feel fat and I am very, very scared of gaining more weight. Weight gain is just one of those things that has always scared me a lot and it makes me very sad. So maybe I’ll end up giving Remeron a try if my doctor brings it up or if I get desperate enough, but I don’t know…it’s hard for me to overcome that fear. I’ve also heard of remeron causing sexual side effects for that matter, but I probably wouldn’t even notice a difference at this point… Why don’t you take Remeron anymore if you don’t mind me asking? Did it quit working for you?

When I first started researching PSSD, I was active on the "Paxil Progress" forums.

There were 2 users who stated that going back on an SSRI (not the ones that gave them the problem) brought them back to their pre-PSSD situation.

One of them said that he tapered off slowly and had been off all medications/supplements for 3 months while keeping his gains.

The other one never replied to that thread after claiming to be cured so I assume he didn't have problems after that.

So it's not unheard of that going back may help with the symptoms.

i've read about this, too.

Does anyone have any guesses as to why this happens? Seems very weird to me.

[felipekj]

What do you mean after I stop? I don't plan on stopping this med as it is one of the few anti-anxiety med with a lower sexual side effects profile. Do you mind telling me for what you take it for? And how's your pssd? You take anything else?

I mean that If you stop someday, the PSSD in my opinion, will be the same, since it hits the neurotransmitters differently of SSRI's. I am taking 15 mg before sleep, with some benzo, for anxiety and depression too. My PSSD depends on the day, but generally is a little better, but almost the same when i was not taking mirtazapine. I was on clomipramine before, but I don´t take it anymore.

[brian6211]

What do you mean after I stop? I don't plan on stopping this med as it is one of the few anti-anxiety med with a lower sexual side effects profile. Do you mind telling me for what you take it for? And how's your pssd? You take anything else?

I mean that If you stop someday, the PSSD in my opinion, will be the same, since it hits the neurotransmitters differently of SSRI's. I am taking 15 mg before sleep, with some benzo, for anxiety and depression too. My PSSD depends on the day, but generally is a little better, but almost the same when i was not taking mirtazapine. I was on clomipramine before, but I don´t take it anymore.

I wonder if you can help me here Felipe or tell what you think... I mean I tried for 3 days Mirtazapine at 7.5mg and it seemed to help the PSSD and definitely helped the OCD. But on the 3rd day, I felt so medicated that I felt my whole body was cold/numb(hard to explain). So didn't take it for a day and for 2 days now I've cut the pill in 4 to take 3.5mg. I felt no anxiety but made my libido vanish completely. Like worsening PSSD. It's like my brain has become ultra sensitive to serotonin meds.

Now I don't know what to do. I had an appointment today with my psychiatrist. I asked him for a dopamine agonist but he didn't want to and said that it's too risky because of potential side effects. He just told me to wait it out. Fuck it's been 3 MONTHS FFS. I used to want to fuck every girl I see but now there's nothing. Fuck I'm frustrated!

[felipekj]

What do you mean after I stop? I don't plan on stopping this med as it is one of the few anti-anxiety med with a lower sexual side effects profile. Do you mind telling me for what you take it for? And how's your pssd? You take anything else?

I mean that If you stop someday, the PSSD in my opinion, will be the same, since it hits the neurotransmitters differently of SSRI's. I am taking 15 mg before sleep, with some benzo, for anxiety and depression too. My PSSD depends on the day, but generally is a little better, but almost the same when i was not taking mirtazapine. I was on clomipramine before, but I don´t take it anymore.

I wonder if you can help me here Felipe or tell what you think... I mean I tried for 3 days Mirtazapine at 7.5mg and it seemed to help the PSSD and definitely helped the OCD. But on the 3rd day, I felt so medicated that I felt my whole body was cold/numb(hard to explain). So didn't take it for a day and for 2 days now I've cut the pill in 4 to take 3.5mg. I felt no anxiety but made my libido vanish completely. Like worsening PSSD. It's like my brain has become ultra sensitive to serotonin meds.

Now I don't know what to do. I had an appointment today with my psychiatrist. I asked him for a dopamine agonist but he didn't want to and said that it's too risky because of potential side effects. He just told me to wait it out. Fuck it's been 3 MONTHS FFS. I used to want to fuck every girl I see but now there's nothing. Fuck I'm frustrated!

Hey, PSSD is a nightmare, i know how you feel, every time a beautiful girl pass in front of me i become more depressed. Im taking mirtazapine 15 mg, i don´t know whats going on, but i feel sometimes better and sometimes worse with my libido, the thing is that Mirtazapine make me sleep like 12 hours a day and i feel very lethargic on it. Personally i don´t think Mirtazapine will give more pssd, what you can do is take the mirtazapine in combination with some other drug like wellbutrin. I am very sensitive to serotonin also, you can discuss with with your pdoc a combination of drugs, dopamine agonists have a very bad withdrawal, I think it´s better you take some antidepressant that target dopamine and other that target serotonin, note that wellbutrin target more noradrenaline and can make your anxiety rise. There is tianeptine (the best antidepressant, but with extremely low half-life) and moclobemide too, but moclobemide is safer alone because its a MAOI (reversible).

[PeterSv]

hi octopus! i stopped taking remeron because it didn't do anything positive for me sexually nor did it curb my anxiety very much at all; it seemed to have the same effect on me that benzos had on you -- sleepiness and lethargy.

i took it at varying doses for about two or three months and then tapered off it.

and as for why some people regain (some) sexual functioning after returning to an ssri and/or returning and tapering slowly, i have no idea. maybe it's multifaceted, i.e., how long the person was originally on the ssri, what dose, major neurotransmitter imbalances after a very short taper or cold-turkeying the med, etc., and going back on either reestablishes what the nervous system has been used and adapted to after years of use or allows for the nervous system to recover while slowly tapering instead of shocking the system after rapid cessation. those are just layman's guesses, though.

I think it is interesting that people have reported being able to revert PSSD by re-introducing SSRI and then taper off slowly. I am thinking about trying that actually but do not know if I am ready just yet. I have used SSRI three times, the first two times I used Sertraline and the last Paroxetine. I quit cold turkey each time and I only got PSSD the last time, from Paroxetine. So I am thinking about trying sertraline again, and then go off it. What do you think about this? Do you have any idea why it might potentially work? Another thing I observed was that when I quit Paroxetine I actually got my sexuallity totally back for a few weeks, then it disappeared (not entirely though) (PSSD). So it might be that whatever effect SSRI has, the body response by trying to downregulate that effect, and when SSRI is removed the body compensate (vague explanation, I need to do more research).

[Wozzi7]

On this forum, the going theory is that the receptors have been downregulated and that you have to find a way to upregulate them in order to reverse the PSSD.

When I first started experimenting, the first supplement I tried was 5HTP. 5HTP is the precursor to serotonin in the brain so when you take these pills you're basically introducing external serotonin.

For the first week, I took one 100 mg pill at night. After the first day of taking it, my PSSD absolutely disappeared. I was operating at 100%. Back then, however, I didn't understand the concept of cycling and ending up taking 100 mg every night and then 200 mg on the following Sunday. After taking 200 mg, I was returned back completely to my normal PSSD symptoms.

Since then, no supplement has ever reproduced those side effects. Doesn't really make sense in light of the experiences that others have had but we're all different or I suppose we wouldn't be here.