What are post-SSRI sexual dysfunction treatment options?

Question

Hello doctor,

I am a 23-year-old male, and I took Lexapro for two months when I was 20 years old. And then quit abruptly, because every time I would sleep for a very long time without dreaming, and also wake up feeling bad. It has been three years now, and my sexual functioning and libido have gone down; it is called post-SSRI sexual dysfunction (PSSD).

I was the horniest, sexually explorative, and a creative guy. It is like I am an entirely different person now. My ambitions, sexuality, zest, desires, and emotions, everything has gone. The lack of all this does not even trouble me, which is the strangest thing. I am intellectually troubled by this, but cannot feel it, and I feel like a potato.

I had tried one dose of Selegiline before, which kind of felt good, but I dropped it due to long-term safety concerns and the possibility of interactions with high tyramine foods. After researching on the internet, and keeping in mind dependence risks and effects on receptors, I was thinking of trying Rasagiline.

I would be very grateful if you could guide me and suggest some possible cure.

Thank you.

Answer 1

Hello,

Welcome to icliniq.com.

I can understand your concern regarding your symptoms and the side effects of the medications. The symptoms you mentioned above are showing that you are suffering from dysthymiaand moderate depression. Depression itself is a cause of poor sexual drive.

Lexapro, which is Escitalopram, may cause loss of libido and sexual dysfunction, as you have already stopped this medicine long ago. Depression is the primary cause of your symptoms. I will suggest you try taking newer invented molecules like Vilazodone.

This drug has no daytime somnolence or sexual dysfunction. It will help you in early recovery. Take it for at least three months, and then stop slowly by tapering. Consult your specialist doctor, discuss with him or her, and start taking medicine after their consent.

Within a couple of weeks, you will feel better, and these drugs have fewer chances of withdrawal depression when they are stopped and tapered slowly. Behavioral therapies like CBT (cognitive behavioral therapy) or DBT (dialectical behavioral therapy) and counseling will help you to cope with your stress and will help you to maintain a happy state of mind.

Visit a nearby psychiatrist for a proper prescription and counseling. Your symptoms are curable, 20 % of the population spend some part of their life in depression, and half of them overcome with this illness.

Hope my answer helped you. Thank you.

Answer 2

Hi,

Welcome back to icliniq.com.

Thank you for your detailed feedback.

No such evidence suggests that SSRI (selective serotonin reuptake inhibitor) would affect people after such a long time. Patients have taken this medication for long durations, along with some other medicines. Single doses will unlikely cause such symptoms after stopping the same drug.

As Escitalopram caused drowsiness in you, I suggested a better drug which is not have such side effects. Anxiety and depression both are because of low levels of serotonin in the brain and disturbances in norepinephrine levels. SSRI drugs are equally effective in both cases.

Kindly follow my advice, and I am sure you will recover from emotional blunting and other symptoms.

Thank you.