Post-SSRI Sexual Dysfunction Is Real and Devastating

Jack M.
25
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I am a 21-year-old man suffering severe sexual dysfunction after taking the SSRI Prozac for five days when I was 17 years old. For the last four years, I have been completely unable to experience sexual pleasure due to a condition known as Post-SSRI Sexual Dysfunction (PSSD.)

I first saw a psychiatrist in April of 2016. I had always been shy and experienced social anxiety and disordered eating. After a brief assessment, I was recommended and prescribed the common SSRI antidepressant Prozac. During this meeting, there was no discussion of side effects of the medication and certainly no warning of long-term problems associated with treatment.

I fulfilled the prescription and took the dosage recommended by my doctor. After only three days I began to experience many symptoms of sexual dysfunction, including difficulty ejaculating, pleasureless orgasms, and a total lack of sensation in my penis. I could still achieve erection and ejaculation with much effort, but experienced no excitement or sexual pleasure. I continued taking the medication for only two more days before stopping. However, the severe sexual dysfunction has persisted in full for the last four years of my life.

Previous to taking Prozac I lived a clean lifestyle. I had never taken recreational drugs and was not a drinker or smoker. I had a normal, functional teenage sexuality and had never had any problems with arousal or erections.

For a full year, I said nothing, hoping the effects of the Prozac would go away on their own. I was shy in all areas of life but particularly so regarding sex, so did not bring up the problem to my doctor and did not revisit the psychiatrist.

The removal of my sexuality took an immense toll on my mental health and emotional well-being. I thought about it constantly. I was angry, sad, and in a far worse state than when I had originally sought psychiatric treatment. I was unable to enjoy masturbation. Still a virgin, I did not pursue relationships with girls and my thoughts became suicidal.

In 2017 I finally sought out another psychiatrist. I attempted to discuss my sexual problems with her but immediately sensed that she was very uncomfortable with addressing sexual matters. Knowing that it could not be ignored I continued to talk to her about it, but all she would say was that the problem must be psychological and ordered me to see a therapist before she would consider treating me.

I saw the recommended therapist once but did not find it helpful. I knew that the source of the pain that needed addressing was my destroyed sexuality, which I have always felt sure was not psychological but chemical. It also did not sit well with me that the therapy was presented as mandatory.

I returned to the same psychiatrist and was this time put on buspirone. I took this for a month and experienced mild improvement in mood but no change in the sexual dysfunction.

It was during this time that I began to experiment with illegal drugs. I was desperate to find something that would give me a sense of normalcy and escape, or to discover something that would revive pleasurable sensation in my body, even just a little.

Over the course of the next year, at ages 19-20, I acquired various illegal drugs.

First it was illegal opioids, which had little effect.

Then a month later, in December 2017, I acquired and experimented with meth. I no longer truly cared what happened to me, I just desperately wanted to feel normal again. I tried it six times in total and found that large amounts allowed me to feel a few seconds of sexual pleasure reminiscent of what I had experienced before Prozac. I would feel several seconds of excitement before climax, but then it would disappear and I would ejaculate without any sensation. Once I took enough to feel a sensation similar to orgasm, except it was emanating from my head and flowing outwards from my body instead of originating in my genitals. Though I would experience euphoric moods the meth could not restore my sexuality. I stopped my experiments with meth after going through awful mood crashes and intense headaches after using, as well as causing myself what I believe was almost a heart attack.

At the end of December 2017 I tried LSD and had a horrible trip with strong feelings of disorientation and frightening identity loss.

In January 2018 I tried smoking black tar heroin. It brought me no real relief, only a vague feeling of being numb and calm.  Over the course of 2018 and early 2019, I experimented several more times with heroin, occasionally mixing it with cocaine, but the highs could not mask the devastation of losing my sexuality.

In the summer of 2019, the death of my beloved family dog awoke me to the fact that I had been repressing all of my emotional pain. I had reached a crisis point where I lost the ability to feign functionality but also stopped running from my problems. I quit the only job I’d ever had and began searching for specialists.

In July, I went to the Mayo Clinic and saw a respected urologist. He told me there was some evidence stimulants increase sensation, so he prescribed me 5 mg of instant-release Adderall. However, he also told me that my problems weren’t that big of a deal, since sex or masturbation only last a few minutes anyway and I shouldn’t be upset. Like all the drugs I’d tried before it, the Adderall did not restore sensation.

Since then I have also seen an endocrinologist who found nothing wrong with my hormones and a sex therapist who said they have encountered SSRI-induced sexual dysfunction before and think it’s quite common, but have no way to treat it. I have had doctors repeatedly tell me it’s all psychological or that I need to take Acceptance Therapy.

I began phoning up university research departments asking if anyone was working on studying Post-SSRI Sexual Dysfunction. Some refused to listen and none of them got back to me. Then, finally, I managed to get in touch with Amy Pearlman at the University of Iowa who is collecting data for PSSD. It was great to hear that someone out there is working on it, but the research is still in its infancy. PSSD has been recognized by the European Medical Association but is not yet officially acknowledged anywhere in North America.

I am now searching for ways to share my story with a wide audience with the hope of warning the public about the risks of SSRIs and garnering interest in researching treatments. I am deeply angry that this was allowed to happen to me. I was never warned that chemical castration was a risk of SSRI use and therefore had no way of giving my informed consent. I was a mentally vulnerable teenager who was robbed of his sexuality after only five doses of a common medication.

The mental anguish of my chemical mutilation causes me to self-harm by punching myself in the face, chest, torso, and neck. I bite myself so the pain can distract me from my misery. I think about suicide constantly. The loss is just too overwhelming, even four years in.

To add insult to injury, sex is everywhere in our society- music, movies, advertising. It is impossible to escape triggers. Almost every social scenario for young adults involves a sexual element, which makes it difficult for me to relate to other people. I have no real friends, no job or higher education, and spend most of my time in my bedroom in my family’s home.

I was never this sad or this depressed before those five doses of Prozac. This is the worst thing that can be done to someone apart from physically mutilating their genitals. It does something to you that nothing else can. If you wouldn’t be okay with having your penis or your clitoris cut off then do not belittle the trauma of people experiencing Post-SSRI Sexual Dysfunction.

 

 

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Mad in America hosts blogs by a diverse group of writers. These posts are designed to serve as a public forum for a discussion—broadly speaking—of psychiatry and its treatments. The opinions expressed are the writers’ own.

25 COMMENTS

  1. I’m very sorry for what happened to you, at such a young age. I’m very sorry the psychiatrists, and mainstream doctors, have been going around handing out the psych drugs like candy, when so few of them know anything about the common adverse effects of the psych drugs. Although this doesn’t prevent them from fraudulently claiming they’re “experts” who “know everything about the meds.”

    I will say I had rather the opposite experience, after being prescribed Wellbutrin, for smoking cessation. Another name for that drug is Bupropion, which does seem to be different than buspirone. It might help you, but I don’t personally recommend people take psych drugs.

    However, if you do choose to try it, I’d recommend taking it for only about a month. Don’t expect any results while on the drug. Do expect to suffer from all the common symptoms of antidepressant discontinuation syndrome once you go off it, in my case seemingly for the rest of my life (it’s been over 20 years, and I still have brain zaps). And do expect the “experts” will misdiagnose these symptoms as the flu, pneumonia, etc., and eventually as “bipolar,” so stay away from the “experts.”

    It was about six to seven months after I was abruptly taken off the Wellbutrin, when I started orgasming, without even touching myself. I’ve read others have also run into this bizarre issue as well, although I don’t think it’s all people. And the maker of Wellbutrin was sued a while back for illegally, albeit possibly truthfully, marketing Wellbutrin as the “happy, horny, skinny drug,” or something like that.

    It’s up to you, as I’ve said, I’m not recommending it. And I’m not a doctor, just an expert by experience, and decades of research. Do your own research. Oh, and I do believe Dr. David Healey has/is doing research into PSSD, you might consider looking into his research. Here is his website:

    https://rxisk.org/sexually-confused-or-chemically-imbalanced-cosmopolitan/

  2. Thank you for the blog Jack.

    I think what we are referring to are not “side effects” but rather effects of the chemical.
    If they could knew more about brains, they would obviously not create such chemicals.
    They do so because they have gotten away with calling everything unwanted as a “side effect”.

    The chemicals are pathetic experiments and revolve around the word “mental health”
    They are well known to cause sexual problems, but they would tell people that the “side effects” simply vanish once the chemicals are not taken.

    How would they know that? There is no knowledge that went into making the drug, not true knowledge.
    And so, away they go into more research to make people think they are trying to “fix” it by creating another drug. WHICH i’m sure the drugmakers will eventually cash in on.

    How can they fix something when they have no knowledge what was broken or how the drug broke it?

    But you are doing something important here by getting it out there as to the dangers of Psych chemicals. Which I cannot refer to as “medications”.
    There are most likely many more affected, yet few want to talk about it, or they don’t even recognize the difficulties and simply think they lost interest.
    Most shrinks will simply steer it away from the drug and chalk it up to part of “clusters” of “disorders”.
    It’s all just shop talk, completely false.
    They do so because they are not that concerned if someone gets hurt on these chemicals.

    Then there is you left. I have a feeling you might just keep being passed on to new people with no one knowing much or anything, and you feeling more hopeless.

    I completely understand how sexuality is huge in our identity. I doubt “acceptance” therapy is the answer, at least not coming from someone who has gone to “acceptance” therapy school.
    I think you really have to weed through who and what will be helpful.
    I know you probably need to find at least interest in something. Hopefully.
    If your parents could support you in any way to at least busy yourself with the outside environment.
    Things like extended wilderness trips, planting trees etc.

    I hate advice, I hate giving it. But I really hope something or someone comes along who is interested in not just fixing one thing, but providing a different landscape or environment.
    And within that, I can see why you tried other drugs. To provide a different landscape and existence, through which you hoped things would somehow change.

    There is crap that happens to us that gives us suffering and pain. We sure need support during sometimes long stretches in life.

    I know it is so very difficult to muddle along, or through. It really overwhelms when we want something to not be the way it is.

    I feel silly in responding because I really have no magic, nor wisdom. You probably have more than I do.

  3. It is very brave of you to share your story here.

    I had a similar experience with Paxil in my late 40s– I took the drug maybe a dozen times, and my sex drive changed completely, for years, even after I stopped the medication. The best way I can describe it was that I no longer found women (I happen to be heterosexual) attractive in the same way– I might be fascinated by someone’s sense of humor, or find their physical appearance appealing, but it became a purely aesthetic appreciation. It was like looking at art in a museum– a huge component of physical arousal disappeared instantly. In my case, sex was possible, the physiological functions occurred pretty much as they always had, but they required more effort, as you say, and were devoid of pleasure. It was just bizarre, unexciting– less fun than eating, about as gratifying as ingestion or excretion– so obviously I had little interest in it.

    By absolute dumb luck, while I was earning my masters in clinical psychology, I took my group therapy class with 20 women, all of whom I respected and found engaging and attractive in one way or another. My story is very unusual, because for some reason, after one particularly powerful group session, my sex drive returned abruptly and immediately. I never had any sexual interaction with my classmates whatsoever beyond the kind of innocuous, low-level flirting that might occur between friends in many other social contexts. The nightmare was over, and it literally ended pretty much in a split second. You can only imagine what I felt like that day, staggering around campus, and the streets of Los Angeles, flooded with feelings and emotions that had been absent for years.

    For the last 10 years, I have been wondering if– and how– some group process might be devised that could help some people with PSSD. I corresponded with a local Center for Sexual Health many times from about 2012 through 2015, but it was logistically too complicated to set up a group. Maybe it’s time for me to try again.

    I wish you the best in your journey. My experience of recovery might be very unusual and very difficult to replicate. The program I was in was a very immersive one, and the people I was studying with were really a rare and special group of people; I am still close friends with many of them.

    But I can’t believe that this couldn’t happen for someone else. Best of luck on your journey. I hope you do not give up hope. And as a licensed therapist, I do everything I can within the limits of my scope of practice to warn patients about the long-term risks of SSRIs and SNRIs. I have treated hundreds of people, but I have only had one or two who actually seemed to realize any benefit from this class of medication.

  4. Since you received counseling, I think I might chip in with a few questions probably peculiar to me.
    1. Do you have white spots in your fingernails?
    2. Do you remember your dreams?
    3. Do your fingernails seem soft?
    The reason I’m asking is that I’m looking for signs you might be low in the mineral zinc, which is deeply involved in sexual functioning. Although you should see a professional interested in true biological medicine (not this tacky drug stuff- “pseudo-biological” drugging), if the items are true, a suggested program should definitely involve zinc supplementation, with B6 to help its absorption, if necessary, and maybe B100’s on general principles. Your first aim should be to remember dreams, if you don’t now, and titer the B6 until you do.

  5. I’m so sorry to hear your story. I’m 39 and two years ago after suffering with post natal depression I also took a SSRI. After only a week or so I felt so internally numb and lost all interest in sex. I had no sexual desire whatsoever. This feeling of emotional numbness, disconnection, and loss of libido caused me to go off the drug after only a few weeks thinking I would return to how I felt prior. Months went past and now 2 years later nothing has changed except I feel worse. I feel rage and anger, sadness, emptiness, loss of all happy emotions, loss of passion, motivation and a general loss of feeling alive. I still have physiological sensation but it takes effort and feels like I’m just going through the motions with my partner (who I am still very attracted to) which then makes me feel more empty, I feel guilt and shame. It’s absolutely horrible and any doctor I’ve mentioned it to doesn’t say another thing about it. They kinda glaze over and bring it back to a depression or psychological problem which is infuriating. It has caused so much emotional upheaval in my relationship to the point of almost breaking up. Before I researched and came across this problem I was so confused and thought I was going crazy or not ‘feeling’ it with my partner anymore. I really hope some kind of solution is found. Thank you for spreading awareness

    • I have suffered from PSSD for almost 2 years after stopping Sertraline (Zoloft). I agree with you that this condition is terrible and the medical system is completely negligent for pretending that is doesn’t exist. However, I have found a possible solution that I would like to share with other PSSD sufferers. It’s a marijuana vape pen called Dosist Arouse. I tried it twice in states where it’s legal (not on the same trip but on two different trips a year apart). It helped temporarily restore my genital sensation, libido and ability to orgasm. The second time I tried it, my genital sensation wasn’t boosted immediately and I was worried that it wasn’t working. I believe that it took an hour for my genital sensation to be ‘activated’. It seemed to work better when I inhaled a smaller amount. Also, the libido boosting effect lasted into the next day even after the high wore off. I’m really not sure why it works, but other marijuana products definitely didn’t have the same effect on me. The Dosist pens have different terpene blends and this is supposed to give each of them their unique effects. If you’re ever in a state where Dosist is sold (California, Nevada, all of Canada), give it a try and let me know if it works for you. See link to this product below. If this works for other PSSD sufferers, we could be on the verge of a big scientific discovery.

  6. Mate, your story is terribly upsetting but, indeed, it is important that researchers, doctors and FDA stop turning a blind eye to this disastrous side effect of antidepressants. In fact, this is something I am going through right now while being on an SSRI – not sure whether or not and for how long it will persist after I quit it (fingers crossed it will not), but I just wanted to share with you my own observations. Long story short, I have had a misfortune to try different SSRIs and SNRIs and noticed that all of them cause the loss of libido to some extent, however the latter at the same time do actually improve the quality of orgasm (not erection though) once you manage to get there. I wish I were a scientist to be able to research that captivating phenomena in detail but, alas, I am not. What I did realize however after going through a multitude of medical research papers, is that it may be norepinephrine/noradrenaline that improves sexual sensations. Indeed, SNRIs work both on serotonin and norepinephrine and so my contradictory experience of having stronger orgasms while losing libido appears to make some sense… Dopamine is another neurotransmitter that is said to be involved in the sexual function/dysfunction, and so people suffering from the loss on libido while on SSRIs are often additionally prescribed bupropion as someone else has already mentioned – it is an NDRI and thus it affects both dopamine and norepinephrine at the same time. Not a medical advice of course but I hope it might be a point in the right direction.

    You have been very unlucky to have faced all those useless doctors that could not help, but hopefully sooner or later you find a really good one out there who would be able to help you solve this puzzle, just do not give up, man.

  7. I have had a similar experience, I was on the SSRIs ten years and the sexual dysfunction was only part of the damage done. I have used Hypnosis to help adjust to the aftermath. I wrote a book about my experience Happy Hypnosis & the Twelve Steps. It has been over ten years since I stopped the SSRIs and my sexual functioning is still not right. Hypnosis really can help us adjust to and accept where we are. If the author would like to know more about how I have dealt with it contact me I have a private practice and help people have better lives though hypnosis and other drug free self help practices. email donross@happyHypnosisSedona.com

  8. I agree with the zinc recommendation for sexual disfunction. I believe it and other things helped mine. Higher doses can cause nausea, but 25-30mg per day is usually ok. If you wanted to bump it up to 50mg per you could try 25mg twice a day. I always used zinc citrate. It can take many months for this tactic to work. I don’t think b6 helps with sexual disfunction but it does increase dream recall though some have more anxiety dreams. They say p5p is the preferred form. My nutritional doctor doesn’t recommend going over 50mg a day. Again, I don’t think it helps with sexual disfunction. A complete nutritional supplement program probably helped me with many things beside sexual disfunction. Working with a professional is best. I emphasize the zinc too! Thank you for your article!

  9. This is a tragedy. You’re brave for speaking out about it. Thank you for doing that, even as you continue to struggle with this.

    There is no easy answer, as someone above said, I don’t pretend to have more knowledge than you or anything to offer other than admiration for your bravery… and outrage at what has been done to you and others.

    I think a lot about how chemical castration of children is a theme in our society right now. In the name of helping kids struggling with gender issues, we are seeing lots of kids chemically castrated right now. In a generationn or two, what will these kids be returning to say to us? What message will they have for us? Why do we think that damaging functioning bodies and brains is “help”–just because it, like illicit drug use, can cause numbing of emotional pain, or help us push negative thoughts and images of ourselves away, or suppress pain.. for now?

    it’s scary what psychiatry is willing to do to people. It’s scary what they believe we should endure, without ever mourning it, to become an inch or two closer to “normal.” It’s not normal. Normal is not normal. Asking people to undergo mutilation–accidental or purposeful–is asking something very wrong.

  10. Jack,

    There might be hope. I have found a possible solution that I would like to share with other PSSD sufferers. It’s a marijuana vape pen called Dosist Arouse. I tried it twice in states where it’s legal (not on the same trip but on two different trips a year apart). It helped temporarily restore my genital sensation, libido and ability to orgasm. The second time I tried it, my genital sensation wasn’t boosted immediately and I was worried that it wasn’t working. I believe that it took an hour for my genital sensation to be ‘activated’. It seemed to work better when I inhaled a smaller amount. Also, the libido boosting effect lasted into the next day even after the high wore off. I’m really not sure why it works, but other marijuana products definitely didn’t have the same effect on me. The Dosist pens have different terpene blends and this is supposed to give each of them their unique effects. If you ever go up north to Canada, give it a try and let me know if it works for you. See the link for this product below. If this works for other PSSD sufferers, we could be on the verge of a big scientific discovery.

  11. By the way, I wanted to write more about the unique terpene blend that I mentioned above. Dosist Arouse contains Farnesene, Linalool and Limonene. From what I have read, terpenes are essential oils and they are in a lot more plant based products than just marijuana. I’m really not sure what the ingredient was that helped me. It could also have worked for me because it contains cannabis oil and not cannabis flower.

  12. Here is a story for you on a blind person.
    “One explanation, that B.T. was “malingering,” or lying about her disability, was disproved by an EEG test. When B.T. was in her two blind states, her brain showed none of the electrical responses to visual stimuli that sighted people would display — even though B.T.’s eyes were open and she was looking right at them.”

    https://www.washingtonpost.com/news/morning-mix/wp/2015/11/24/the-blind-woman-who-switched-personalities-and-could-suddenly-see/

    • Well Mark, as far as I know, their EEG’s can’t even tell when brains are still working.
      It seems something simple as brain activity could be detected, yet many have NDE’s while the EEG’s show nada.
      And yet they scamper around, trying to impress the public with their little lit up pictures. Does the public ever think what it will be like 2000 years from now? And how very wrong everything will have been? It was really just yesterday we bled people. For some crazy reason, there are people that think we advanced, when all they did was create very toxic chemicals and practiced on poor monkeys to try and get dosages that would not kill them.
      I’m afraid we will only get much further away, and regress terribly, since it all started off with a complete misinterpretation of human experience.
      I believe though that quite likely, it will be to their own demise, since that is a logical outcome.

  13. this condition is real. Had numb genitals for 8 years. Not a single morning erection. Practically occurred overnight as well from Cymbalta. Describing this to anyone is dangerous because you will be set up for it’s all in your head type responses. Doctors are recently becoming validating of the condition. More and more people will speak out as time progresses. Men are hit especially hard by this and have immense social pressure to never reveal this type of information to anyone , and that’s not to downplay it effect on women , it’s saying women seem to at least discuss stuff like this more openly. Besides the symptomatic damage the psychological burden and shame associated with it are difficult to comprehend.

  14. Jack it is very brave of you to publicly share your story regarding PSSD. I’m sadly not quite that brave, and very few people know I suffer from the condition. I’ve been suffering from PSSD since 2008 when I quit Zoloft. From 2007-2008 I took Effexor and Zoloft and has sexual dysfunction while I took them. Afterwards things never returned to normal, not even 12 years later. I was 23 when I started the drugs, I’m now 36. It is crushing for a young man to not only lose sexual function but also the desire. For a long time it made me substantially more depressed. I tried supplements, I went to various doctors, most of whom didn’t believe in the condition at all. Even when I found someone who was familiar with it, they couldn’t do much.

    For me Cialis helped some. Also, this was extremely hard for me, but trying to go on with life and have a normal relationship helped. I regained some function, although not all, and not close to what it was like before. It was scary to date with the condition, but it isn’t impossible. The rejection hurts if someone cannot accept your reduced function. However, I think the excitement of a new relationship helped my brain a little bit as I do recall it being worse pre-2012 when I started dating again. Also working out helped. Again, I’m probably at 40% or less of what my pre-SSRI function was, but it used to be 10%, so I’ll take it. I’m still hoping for a cure, but I also decided to just try to live life. I hate that a GP prescribed me SSRIs when I went through a crisis of a breakup and was feeling temporarily depressed and had suicidal thoughts. My mother freaked out when I had those and took me to get the medication. It is the worst decision of my life that I’d take back and will probably always be one of my biggest regrets, but I have found other things in life that bring me at least some meaning. I hope you can too. Maybe someday someone will find something that helps reset us, but who knows.

    • Hopefully, I have found something that helps with this condition. I don’t know if it’s able to ‘reset’ us, but I was able to temporarily feel the pleasurable sensations in my brain when I rubbed my penis and had sex that I used to feel before PSSD. I tried this product Dosist Arouse on three separate occasions and it is the only thing that works for me. I would like to see if it works for other PSSD sufferers. If that is the case, I will try to invest in working with a chemist to find out what the active ingredient is, seeing if brain scans can determine what part of the brain is being activated and eventually making a product with optimal dosing. As far as I can tell, the pharmaceutical industry isn’t working on anything that could help with this condition. It’s up to PSSD sufferers to try things and share what works.

  15. Jack my heart goes out to you
    Your a beautiful person and your story will touch many lives
    Everyone deserves to know what happened to you – could happen to them
    Your life has purpose beyond the devastating loss and pain they caused you
    it totally beyond words sucks
    Best wishes

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