Afx PSSD intro - multiple ADs (SSRIs, atypical,..) at young age

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How did you find this forum (Google search – if so, what search terms? Via link from a forum or website – if so, what page? Other?)
PSSD forum
What specific drug did you use (finasteride, dutasteride, saw palmetto, isotretinoin/Accutane, fluoxetine, sertraline, citalopram, leuprorelin, etc…)?
Venlafaxine (PSSD), mirtazapine, trazodone, escitalopram, moclobemid, other SSRIs (paroxetine, fluoxetine, fluvoxamine,…), atypical ADs, benzodiazepines
What dose did you take (eg. 1 mg/day, 1 mg every other day etc.)?
(shortly 75mg) 150-300 mg/day (shortly maxdose 375mg) - Venlafaxine
What condition was being treated with the drug?
Panic attacks, generalised anxiety disorder, depression
For how long did you take the drug (weeks/months/years)?
Venlafaxine - in summary cca 2 years
Mirtazapine - in summary cca 2 years
Benzodiazepines - in summary cca 1 year
Trazodone - in summary cca 6 months
Escitalopram - in summary cca 6 months
Moclobemide - in summary cca 3 months
Other - each for cca 1 month

How old were you, and WHEN (date) did you start the drug?
I was 17 years old when I started with ADs

Check the boxes that apply. You can save your post first, then interactively check/uncheck the boxes by clicking on them. If your symptoms change, please update your list.

Sexual
[X ] Loss of Libido / Sex Drive
[X ] Erectile Dysfunction
[X ] Loss of Morning Erections
[X ] Loss of Spontaneous Erections
[X ] Loss of Nocturnal Erections
[X ] Watery Ejaculate
[X ] Reduced Ejaculate
[X ] Inability or Difficulty to Ejaculate / Orgasm

Mental
[X ] Emotional Blunting / Emotionally Flat
[X ] Difficulty Focusing / Concentrating
[X ] Memory Loss / Forgetfulness
[X ] Stumbling over Words / Losing Train of Thought
[X ] Lack of Motivation / Feeling Passive / Complacency
[X ] Severe Depression / Melancholy
[X - not considering this “option” anymore ] Suicidal Thoughts

Physical
[X ] Testicular Pain
[X ] Genital numbness / sensitivity decrease
[X ] Weight Gain
[X ] Muscle Weakness
[X ] Joint Pain

Misc
[X ] Prostate pain
[X ] Persistent Fatigue / Exhaustion

If you have pre or post-drug blood tests, what hormonal changes have you encountered since discontinuing the drug (please post your test results in the “Blood Tests” section and link to them in your post)?
All blood results come back always perfect

Tell us your story, in your own words, about your usage and side effects experienced while on/off the drug.

Introduction
I took ADs for mostly panic attacks, GAD, depression - it all probably started with teenage marijuana usage (after initial pleasure marijuana period after couple months time it gave me paranoia and anxiety while on it). I always was very hypersexual and probably more emotional than other people. Venlafaxine was the AD that gave me PSSD, mirtazapine worsened some aspects of it and made PSSD worse in general I think after time. I statered treatment on escitalopram and benzos. I will skip some details. Then I was on venlafaxine. Everything was good no PSSD until the point when I lowered venlafaxine from stable 150mg after almost a year (everything was great on it and sexually normal) to 75mg and experienced extreme serotonine withdrawal symptoms with very severe untreatable all day long unbearable anxiety. Nothing helped neither direct benzo shots neither going back to 150mg or switching to different Ssris. From desperation I took 300mg of venlafaxine and suddenly experienced abnormal total super hypersexuality from that day on (in sex all way super above perfect except for total very low ejaculate volume and anxiety was lingering between normal and even more extreme severe. I would call orgasms in this period literally euphoric). I decided to stay on this dose but it all faded after approx. 2 weeks to non sexuality. To be more precise it switched on and off during these 2 weeks and then did not switch back on in the end. I was after these cca 2 weeks in short summary left without pleasure in sex, numbness, prolonged reaching orgasm, low libido and anhedonia. It did not go fully back. After that I was on trazodone (already had PSSD - but I did not know what that was even called back then neither I understood what is wrong with me or that it will persist). Then I took mirtazapine after some time and I was very hypersexual once again! (in ways more than normally before ADs) Super libido horny all day everyday, super sex sensation, pleasure, orgasms (but very low ejaculate again). It stayed hypersexually like this for many months (a much lower level of hypersexuality compared to venlafaxine hypersexual period but still very significant) but it eventually slowly went to totally lowered sexuality and anhedonia. I was later again on venlafaxine as well as on mirtazapine again, even combos (played with time and doses - but PSSD was already stable and unmoved, no hypersexuality, only the opposite). After quitting all meds (I was once again on solo venlafaxine when I cold turkeyed it and decided to stop with all ADs for good) I experienced everything coming back to normal for 2 weeks and was happy. After that I crashed. Pleasureless sex, numbness, prolonged orgasms, anxiety, morning stomach aches and diarrhea and pleasureless anhedonia “feelings”, blunted effect. Stomach aches and morning diarrhea - probably stress related - went back to normal after cca 2 months. Anxiety lessened. Only then I learned about term PSSD and realised what happened. Time of cca 2-3 years gave me back some sensitivity and some minor libido and very small “pleasure”, some anhedonia reduced. Following more years were trial and error and looking for quickfix - without any lasting success. Only lately I am working on improving my health in general as well as some new ideas - I believe I will get a lots of answers (hopefully only positive) somewhere within a year. Ironically cruel on this all is that me more or less as a kid without any initial knowledge I even believed ADs are prosexual (due to my hypersexual periods on them) and that is another reason why I played so much around them once I already got PSSD and I believe that this deep misunderstanding further contributed even much more on my PSSD alteration in a bad way. But…, I am not giving up, the fight is not over (and never will until I will solve this puzzle!) :wink:

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DIAGNOSTICS EFFORT
Off charts finding via various methods

-STOOL DNA SEQUENCING AND COMPREHENSIVE TESTING (btw, usual stool cultivation method shows “normal microbiome”. Based on found ethanol in blood (I do not drink) I decided to get this comprehensive stool test) - Low diversity, Putrefaction flora - high off charts, Histamine producers - high off ch., Funghi - high off ch., Mucin degradation - low off ch., Mucosal protection - low off ch., Acetate/Propionat producers (high off ch.), Firmicutes (low off ch.), Bacteroidetes (high off ch.), Verrucomicrobia (low off ch.), Tenericutes (low off ch.), Mucin degrading bacteria (Akkermansia muciniphila and Provotella spp. - low off ch.), Mucosa protective (Akkermansia and Faecalbacterium prausnitzii - low off ch.), Neuroactive microbiome (Bifidobacterium dentium, Lactobacilus brevis, L. plantarum, L. paracasei and Alistipes spp. - low off ch.), LPS-positive bacteria (Esterichia spp., Providencia spp., Pseudomonas spp., Serratia spp. - high off ch.), Immunomodulation (Esterichia spp. - high off ch., Enterococcus - low off ch.), Fiber degrading microbime (Ruminococcus spp. - low off ch.) , Lactate-producing/saccharolytic bacteria (Enterococcus spp. and Lactobacillus spp. - low off ch.), Clostridiaceae (Clostridium spp. - low off ch., Clostridium difficile - high off ch. (NOTE - it was explained to me that it is more-less common finding and not high enough in my case to produce toxin), Clostridium scindens - low off ch.), Other (Oxalobacter formigenes, Anaerotruncus colihominis and Streptococcus spp. - low off ch.), Funghi (Saccharomyces cerevisiae - high off ch., Moulds - positive).
Summary of molecular stool diagnostics, indication of - Detection of reduced biodiversity, reduced colonisation resistance, disrupted mucosal protection, minor microbiome-associated suspectibility to inflammation, microbiome-associated tendency towards Leaky Gut, possible bacterial miscolonisation of the small intestine (SIBOS), microbiome associated health risks (written from chart - High risk - Non-alcoholic steatohepatitis, Colonisation resistance, GI susp. to infections; Medium risk - Leaky Gut syndrome, Histamine intolerance, Food intolerance, SIBOS, Chronic inflammatory bowel diseases, Dysbiosis, Psoriasis, Coeliac disease, Allergy/Asthma, Type 1 diabetes mellitus). [My sidenote - Saccharomyces overpopulation may be producing excess Glutamate]

-OFF CHARTS LOW - Bile Acids, DAO, DAO (function), Lithium, Soluble transferrin receptor, Potassium (urine analysis), Vitamin D, Oxygen Hemoglobin

-OFF CHARTS LOW TEMPORARILY (on retest or after some interventions was normal) - Estradiol, Bilirubin, Lipase

-OFF CHARTS HIGH - HbA1c, IFAB, Fructosamine, NSE, Haptoglobin, Ethanol (Yes, actual alcohol, although I do not drink for at least 2 years), Aminoacids - Histidine, Ornitine, Glutamate, Aspargine, Phenylalanine), Gastrin, DHEA, Adrenaline, LDL cholesterol, Cholesterol, Triacylglycerol, Lipoprotein A, Urine analysis (Sodium, Magnesium, Calcium, Pyrilinks), CO2 Hemoglobin, Progesterone, 17-OH-Progesterone

-OFF CHARTS HIGH TEMPORARILY (on retest or after some interventions was normal) - Albumin, Sodium, Glucose, GMT

-NOTE - there are many other values that are in range on very low end and others on very high end, but I listed only off chart values

-GENETIC - MTHFR C667T homozygous

-USG - Non-alcoholic fatty liver (NAFLD), Sclerotization/Calcification of Kidneys

-MRI - Normal findings. Brain damage and tumors ruled out (also via other tests)

-HAIRTEST - (I actually did it at the same time in 2 different European labs to minimize outcome differences. I did it inspired from mentioning it from one doctor (not from a forum, I was looking more into forums only later) to run out of all possibilities of possibly getting a better picture, not as a conclusive diagnostic tool. I am not promoting it, I understand it has caveats, I did not follow suggested supplements program) Off charts LOW - Chromium, Potassium, Germanium, Iodine, Cobalt, Silicon, Lithium, Manganese, Copper, Selenium, Sodium, Silver, Vanadium, Iron, Natrium, Magnesium, Molybdenum. Off charts HIGH - Sulfur

-PREVIOUSLY - Kidney stones (Calcium Oxalate)

-DIAGNOSTICS PLANNED - 23&Me Genetic test, Dexa scan

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my friend,how do you feeling?