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

Any other sexual dysfunctions not properly addressed by medical science.
6-Eggs!
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Re: PAPSD (Post Anti-Psychotic Sexual Dysfunction) - Sonny OP

Unread post by 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.
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