I have hit the wall. My depression and constant rumination on PFS have become unbearable.
I think I am ready to try psych meds (SSRIs). Is this a bad idea? Is there any chance it might help my brain fog?
Many patients are on this forum from SSRIs alone, as it’s been observed to cause a similar syndrome. If you are in a really bad way, and looking for something to get through the worst of the crash, benzos seem to be one the few anti-anxiety/anti-depressant medication that are consistently safe for patients.
If you could also help out our research efforts by completing the survey when you get a chance, that would be much appreciated.
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I would avoid SSRIs. Based on user reports I think Bupropion (Wellbutrin) is a bit safer and has a much more favourable track record, though there are guys who have gotten worse on it too.
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I was going to suggest the same thing stay away from selective serotonin reuptake inhibitors and stick with either not going down this path at all or try the dopamine/norepinephrine reuptake inhibitor
Who got worse that you aware of from Bupropion?
I wouldn’t do benzodiazepines either unless they are the only possible way you can sleep . I wouldn’t take benzodiazepines for anxiety . Yes it seems to be true that we have no one getting PFS type disorders from benzodiazepines of benzodiazepines making peoples PFS worse . But at the same time benzodiazepines have not made anyone better . So personally I wouldn’t take them unless I’m literally on the 3rd night in a row of an insomnia stint of zero sleep
If you want to try something, and Tianeptine is available in your country. Go for it. BUT dont ever exceed the recommended dose of 3x12.5mg
Benzos would be safe in regards to interactions with PFS symptomology. But benzo addiction has been documented to happen rather quickly, and to persist for a long time, even for people who only used it as the doctor prescribed it. There are people who have been addicted to both opiates and benzos who say that the benzo withdrawals were worse.
I also don’t want to scare you away from something that might help. As a one off, they absolutely work to calm anxiety or to get some sleep. But you should only take benzos every once in a while; or maybe only for ~1 week max when you’re trying to get a bout of awful anxiety or insomnia under control.
Also, benzos very easily cause you to black out. DO NOT drive on them or put yourself in situations where blacking out and making a fool of yourself would be a concern. This is more of an issue if combined with alcohol, even if only a small amount.
Source: Years ago, I once took a benzo pill while hanging out and having a few drinks with some friends. I didn’t even feel intoxicated. I only had a few beers. I drove home. The next morning I found vomit on the inside of my car window. I didn’t even know enough to roll the window down. I only vaguely remembered anything about it. I am very lucky that nothing bad happened.
You could also try Mirtazapine …I’m lucky I never really had brain fog too bad , just mild so can’t say if it helps it, but I can say I just feel way better than I was before taking this .
These things aren’t right for everyone though , but I would definitely avoid any SSRIs or SSNRIs
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Personally I would opt for “Agomelatine” if I ever were to try antidepressants.
Most antidepressant affect monoamine uptake but this one doesn’t. While it may be effective, the monoamine uptake is a way for the brain to protect itself. Long term exposure to monoamine reuptake inhibitors can cause cell death in certain areas in the brain.
Also Agomelatine seems to be very effective for enhancing sleep, which in a PFS sufferer might be greatly beneficial to improve both depression and cognition.
Unlike many other anti depressants it’s actually a antagonist of the 5HT2 receptor, aka it blocks the Serotonin receptor.
Also it will increase Dopamine release in the pre frontal cortex. This should in theory lead to more “drive” and increased executive function.
I suggest you read the pharmacology on the wiki page here to get your own opinion. I am not a doctor nor have I ever tried the drug myself. https://en.m.wikipedia.org/wiki/Agomelatine
My 2nd line of choice would be Mirtazapine. It’s pharmacology is way different from Agomelatine, hovever it will also not affect monoamine uptake (not by much atleast). I think this is key to not hurt your brain in the long term.
Again I suggest you read the pharmacology. https://en.m.wikipedia.org/wiki/Mirtazapine
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How do you react to benzodiazepines and a couple beers post PFS compared to pre PFS? Have you tried and did you notice a difference ?
I have drank a handful of times over the last 7 going on 8 years. Averaging 1-2 beers per year . I have also taken no drugs .
Recently I needed a prescription of benzodiazepines to help temporarily with nasty amino acid and SAMe induced relapse insomnia. They did help with the insomnia and with the odd overly stimulated state I was in but the benzodiazepines made me feel more normal then anything opposed to “high” or “good”
And then even more recently as an experiment while no longer being stuck in the overly stimulated state I took 2MG’s of the Xanax and had two beers. I could feel it . But NOTHING compared to how I would have felt back when I was seventeen years old when I drank and took Xanax on a few different occasions . I mean even back then and having a high tolerance if I took 2MG’s of Xanax and had a couple drinks I was heavily buzzed and feeling fantastic for several hours . This time all these years later and ten years into sexual side PFS and seven years into more extreme PFS I felt the benzodiazepines and alcohol 80 percent less then I did pre PFS all those years ago even with a 17 year old weekend binge drinking level tolerance
This how I know my GABA receptors are “off” and not working properly. And then I see high GABA agonists such as Allopregnanolone and 3a-diol in my urine and in others. I’m confident there is a link
I haven’t taken any benzos since I developed PFS symptoms, no.
But I do drink quite a lot. 6+ drinks per night. I never noticed any difference with how it effects me before or after PFS. I also never noticed any diminished alcohol craving after PFS, as others have.
I suggest water fasting for brain fog. Only 3 days helped me a lot. -there are dangerous sides too, make your own search and decide-