Thanks for this forum, very helpful.
I am born in 1979, my story:
I suffered from depression at the beginning of 2019 and took Escitalopram, 10mg/day. The only side effect was difficulty to have orgasms. Switched to fluoxetine in May, with less libido and some ED.
I stopped in September. After 2-3 weeks, sadness came back, with a bonus: persistent difficulties to sleep. And still low libido and some ED (my first PSSD?). Doc gave me 3 months of Mirtazapine, from November to January. Sleep came back. I am not able to tell if my libido rose or if I just got used to it. I stopped while feeling ok.
For no good reason I took Escitalopram again, 5mg/day, then 10mg/day during confinement. After two months, and just after starting hairloss treatment (I don't think this is related, that wasn't finasteride! see viewtopic.php?p=36602#p36602), I felt a sudden loss of libido and strange feeling within my penis. I switch immediately to 5mg/day and stopped 3 weeks later. It was in the beginning of May.
Libido arose a little in May, while starting a one-month affair. This made me feel something was wrong (low libido, mild erection, low pleasure... I was unable to use condoms but, as we were both tested clean for viruses, we did without) but being only "half" me was enough to have fun.
This affair got me Chlamydia and I was cured (tested clean) by antibiotics in the end of June.
From this time, things have been more or less stable (and worse than in June):
1 - Libido: I have very low libido (for the first time in my life, even in my worst depression) - I only feel a very slight desire when kissing / touching a girl
2 - ED: I can have a 50%-erection by thoughts while thinking to my craziest fantasies (before I could get a full erection with any sexual thought). Mechanical stimulation combined with fantasies can get me a 80%-erection, enough to make love, with some difficulties.
3 - Numbness: I feel like my penis skin does not feel anything, but I can feel when contact is though. My orgasms come with low pleasure...
4 - Sleep: I fall asleep but wake up early
I feel less desire and pleasure in general: art, movies, music... except for food (strange? I desire chocolate more than ever) - this came in June.
EDITS: I have seen some people use their topic to log evolution of their symptoms, I find this interesting. So here are my reports.
Note written in August #1: I tried to look back to document early stage. Not very scientific, though... Imaginary report from June 17th:
1 - Libido: 30% - low libido - I felt a slight desire when thinking about sex and had some ideas about it (better than last weeks taking SSRI)
2 - ED: 60%-erection by thoughts / 90%-erection adding mechanical stimulation
3 - Numbness: feelings were wrong, orgasms were ok but not awesome.
4 - Anhedonia: was less interested in arts and didn't feel much. Motivation was lower but ok.
5 - Love: still had some (decreased) feelings for girls and my family
6 - Sleep: ability to fall asleep OK, but some early awakening
NB: at that point I was not aware of PSSD. I just noticed these symptoms and was otherwise very happy in my life. Nothing psychological, I think.
July 11th, 2020
Sex
Libido: 0% (no thrill at all)
Erection by thoughts: 0%
Erection by mechanical stimulation: 50% (not so hard but ok)
Pleasure: 10%
Anhedonia: Pleasure while listening music: 10% (I still have reflexes to dance but I don't feel anything while dancing)
Things have been stable for one month. Was better before (no anhedonia in May, higher sex drive)
Note written in August #2: I was having a psychological crash when writting July 11th report, discovering PSSD. I was much better just before or after, so this report should have been:
1 - Libido: 20% low libido - I had rare moments where I was slightly thrilled
2 - ED: 50%-erection by thoughts / 80%-erection adding mechanical stimulation
3 - Numbness: skin doesn't feel very sensitive, orgasms come with low pleasure...
4 - Anhedonia: able to feel some emotion (still crying when something is sad) but no pleasure, etc.
5 - Love: blunted... but some feelings
6 - Sleep: ability to fall asleep OK, but awakening often 4-5 hours later
*** I started a daily 30-minute run and probiotics and food supplements (vit D) ***
August 16th, 2020
1 - Libido: 10% very low libido - I only feel a very slight desire when kissing / touching a girl
2 - ED: 30%-erection by thoughts / 80%-erection adding mechanical stimulation
3 - Numbness: worsening?
4 - Anhedonia: no change
5 - Love: no change
6 - Sleep: ability to fall asleep OK, but awakening 3-4 hours later every day
*** I started a daily 7-minute HIIT ***
August 23rd, 2020
4 - Anhedonia: improvement? I liked a TV-show and felt something (slightly - but not only sadness) watching it and listening to music
Other: nothing new
September 10th, 2020
1 - Libido: thinking about sex without any arousal / no desire but I feel some "need" for sex
2 - ED: 20%-erection by thoughts / 70%-erection adding mechanical stimulation
3 - Numbness
A: skin doesn't feel very sensitive, less sensitive to heat than the rest of the body
B: orgasms come with very low pleasure
4 - Anhedonia: I have some feelings watching movies/shows but they feel blunted - I still love dark chocolate and sugar, otherwise food tastes less good than before
5 - Love: no relevant circumstances
6 - Sleep: worsened, awakening 1-2 hours later then some short moment of sleep...
*** I started a low carb diet***
*** I started oxazepam (10mg) to improve sleep ***
September 29th, 2020 - after 10 days of oxazepam
1 - Libido: thinking about sex again with slight desire / arousal (20%? more?)
2 - ED: 50%-erection by thoughts / 80%-erection adding mechanical stimulation
3 - Numbness
A: skin doesn't feel very sensitive, less sensitive to heat than the rest of the body
B: orgasms come with very low pleasure
4 - Anhedonia: sad / strong feelings are back, joy / pleasure can happen but bluntted. I can have some pleasure while listening to music (great news!) but it doesn't last.
5 - Love: no relevant circumstances
6 - Sleep: improved a lot (that was the point of taking oxazepam), 3-5 hours of sleep (with some interruptions)
*** I switched from oxazepam (10mg) to hydroxyzine (25mg) and melatonin (2mg) ***
*** I reduced carb a little more (almost keto)***
October 30th, 2020
1 - Libido: I would say it is low but could be within a normal range - difficult to assess as I am alone in my house all day...
2 - ED: none
3 - Numbness
A: Skin doesn't feel very sensitive, not sure about that
B: Orgasms come with low pleasure (within normal range? difficult to tell, alone...)
4 - Anhedonia: all emotions are back (hello sadness!), but I still don't enjoy music as much as when I was on SSRIs (which one is my normal "me"? I don't remember)
5 - Love: no relevant circumstances
6 - Sleep: troubles to fall asleep (customary when I am sad), no awakening during the night, but I am still awake way before the clock rings despite of the drugs...
*** I had an injury and reduced sports ***
*** I increased carb ***
December 1st, 2020
I am feeling "low but normal" on these issues:
4 - Anhedonia
5 - Love
6 - Sleep
Stopping my report about them.
Regarding sexual function, it had ups and downs this month, from my "october 30th" state to my "september 10th" state. This can change in one day... I don't see any explaination.
December 21st, 2020
I must admit I have been stuck in the "low" state for one month...
1 - Libido : I don't think about sex, except when with one partner. Low drive, low fantasies.
2 - ED : 80% OK
3 - Numbness : low pleasure, week orgasms
6 - Sleep : I tried to reduced hydroxyzine and I can tell sleep is still bad without medication
January 13th, 2021
*** I started a daily 7-minute HIIT ***
*** I switched from hydroxyzine (25mg) to buspirone (15mg), still on melatonin (2mg) ***
January 20th, 2021
I am still in my low state and getting tired of it. Starting my supra-healthy life again.
1 - Libido : I don't think about sex, except when with one partner. Low drive, low fantasies.
2 - ED: 30%-erection by thoughts / 70%-erection adding mechanical stimulation and some difficulties to have sex.
3 - Numbness :
A: Daily numbess is back (20% ok)
B: Low/no pleasure, week orgasms
6 - Sleep: 4-5 hours / night, with a wake-up around 3am
*** I will try to have some 30-minute runs again ***
*** I reduced carb again ***
*** Increased buspirone (20mg), switched to melatonin (2mg) extended release ***
January 28th, 2021
1 - Libido : 20% - thinking about sex again, with some slight arousal. Low drive, low fantasies.
2 - ED: 50%-erection by thoughts / 80%-erection adding mechanical stimulation
3 - Numbness :
A: Random daily numbness (50% ok) - or is it better after buspirone? Don't know
B: Low pleasure, week orgasms
6 - Sleep: ~5 hours / night, with some wake-ups... interestingly, I feel tired in the morning for the first time in months
*** Switched back to hydroxyzine (25mg) - instead of buspirone+melatonin ***
February 9th, 2021
1 - Libido : 10% - very slight arousal when thinking about sex.
2 - ED: 30%-erection by thoughts / 70%-erection adding mechanical stimulation
3 - Numbness :
A: Some numbness is back
B: Low pleasure, week orgasms
5 - Feeling quite sad these days
6 - Sleep: has been horrible for a week and can explain my global worsening, hence the switch to hydroxyzine
*** Switched back to oxazepam (10mg) and added Magnesium (300mg/day) ***
*** low sugar diet ***
February 19th, 2021
1 - Libido: low but existing, thinking about sex again with slight desire / arousal
2 - ED: low but normal?
3 - Numbness
A: skin doesn't feel very sensitive
B: very low pleasure, but I had my first good / normal sex experience in months one hour after 5mg of buspirone
4 - Anhedonia: sad / strong feelings are back, joy / pleasure can happen but bluntted.
5 - Love: no relevant circumstances
6 - Sleep: 4-5 hours of sleep (with some interruptions)
*** Switched back to hydroxyzine (25mg) - instead of oxazepam ***
No difference
March 15th, 2021
*** Added ginkgo biloba extract for 15 days ***
Tremendous improvements in everything (I cried watching Kung Fu Panda
)... after few days... then going back to previous state so I stopped. Interestingly, sleep seems to stay improved after stopping, so I reduced hydroxyzineMarch 31th, 2021
*** Decreased hydroxyzine (12,5mg) ***
April 27th, 2021
1 - Libido: low but normal (50%?) : having fantasies again and being slightly thrilled about them
2 - ED: quite random... best: 100% erection but I feel like I need stronger stimulation and refractory period is longer - worse: I need strong stimulation without reaching 100%
3 - Numbness
A: skin feels ok
B: I feel again! Still with low pleasure, and it is very hard to come
4 - Anhedonia: feelings are back but blunted - I still haven't felt any real pleasure listening to music or watching a movie for a year (except Kung Fu Panda
)5 - Love: no relevant circumstances
6 - Sleep: 4-5 hours of sleep (with some interruptions) - which is quite good with such a low amount of hydroxyzine
June ~15th, 2021
*** Added rhodiola (250mg/day) ***
*** Decreased hydroxyzine (12,5mg / 2 days) - with sometimes 1mg melatonin ***
August 6th, 2021
1 - Libido: low but normal (50%?) : having fantasies again and being slightly thrilled about them
2 - ED: I hadn't had any trouble during one month - but it is decreasing now
3 - Numbness: numbness had been gone for one month (after starting rhodiola) - but some numbness has come back for one week
4 - Anhedonia: sad feelings are fully back - I still haven't felt any real joy / pleasure
5 - Love/mood: I was quite sad these last days
6 - Sleep: not an issue anylonger - I will stop hydroxyzine
*** Stopped hydroxyzine ***
Décember 7th, 2022
Big time with no updates, I haven't taken anything this year. Status:
1 - Libido: between low and very low (10-30%?)
2 - ED: an issue when libido is very low, otherwise ok
3 - Numbness: no memories of what is "normal" feeling
4 - Anhedonia: this is the real issue, I don't feel anything
5 - Love/mood: idem
6 - Sleep: not an issue anylonger
