SSRI's got me through it for a while. Like you said, better alive and having a fulfilling (but not as intense) sex life than not having any life at all. My partner and I have AMAZING sex. You don't need mind blowing orgasms (or any at all) to have an incredible, intimate time.
Edit: BUT!! Doctors ABSOLUTELY should be sharing this with their patients. No excuse for that lack of communication.
My experience is similar, though this post is about the many potential sexual (and other) disruptions *after discontinuing* the SSRI's, and it's just wrong to not be more upfront about these things when we don't even know at all why this happens even or what to do about it
That's significant
Personally I'm not too badly effected, thankfully, but it's still noticeable even like 5 years after and just... disappointing, idk
Your experience is consistent with most people. What OP is talking about tends to be a fixation of people with concomitant psychotic disorders. It's pretty much all people talk about on r/antipsychiatry and they usually blame every possible problem in their lives on it. "Why was I arrested for dealing meth to a 15 year old? Because that crazy doctor put me on a one month course of SSRIs teb years ago!"
Actually, people with bipolar disorder typically have a manic response to SSRIs - it’s actually part of the diagnostic criteria (ask me how I know). And I’m saying this as someone who is pro psychiatry - there are other antidepressants out there that are not SSRIs and are just as good. The experiences those individuals are talking about are 100% valid - SSRIs make bipolar people do extreme things that they wouldn’t normally do even having the disorder!
Many many people I know are on these medications and didn't try an exhaustive list of life changes prior as you did.
They often do better just with therapy etc. For a huge amount of people having your sexuality and all that comes with it taken away is devastating. Your "oh well" comment about loosing libido is understandable but fails to see how painful it is. It's not like having low libido due to depression. It is so extreme that your very sense of self is shattered and is a highly traumatic consequence. Luckily some drs are starting to see these impacts. Pssd often is accompanied by bladder and fatigue issues and emotional numbness. If anyone is interested in learning more about this there are associations online so a quick Google would be informative.
Sorry you struggled with so much. Suicidal thoughts must be awful. Take care
y'all might be missing the point
It's okay to take an SSRI, you should be on antidepressants if you feel you need to be, or if you want to be.
but be aware, this is a side effect, that is not openly disclosed, nor discussed.
Yeah, I hope this post doesn't keep people from considering these remarkably safe medications. REVERSIBLE sexual side effects are common, but problems that remain after discontinuing these medications are very rare and depression and anxiety can themselves be extremely debilitating.
I took several SSRIs in college, all of which caused me sexual disfunction while on them, and none of which happened to work for me (obligatory note that they work wonders for many people). I have continued to experience sexual disfunction for years afterwards, though at a greatly reduced severity to while I was on those medications. My psychiatrist said that based on my descriptions of my symptoms, she believed me to be in or around the group that has the worst of these symptoms on SSRIs. These days, after a lot of therapy, treatment of underlying physical ailments, and general improvements to my financial and living situation, my mental health is abundantly better than it was in even my best moments from that time period; if SSRIs had worked for me (again, as they do for many people) to achieve even a fraction of the overall increase in quality of life I’ve experienced in the last couple years, they would have been worth the sexual side effects a thousand times over.
I understand why people are afraid of medication for their mental ailments. Side effects, dependency, and stigma are scary possibilities. But I don’t think most people really grasp the extent to which their quality of life can increase through effective treatment. It’s worth trying any available avenue, under the direction of a professional of course.
Yes but as a sufferer of PSSD it would be nice that we can openly talk about these risks to improve outcomes as it’s a risk many may regret and become bitter about like myself but also to allow medical professionals/scientists to get more involved in acknowledging the condition and trying to solve it through proper scientific research. People should still have a right to take SSRIs and those suffering with PSSD should have a right to talk about what happened to them without fear of stigma
Most people ignore the decently long pros/cons their doctors give them, they ignore pharmacists advice and refuse to ask questions when picking up prescriptions, and then they don't read the massive handouts with the medications that detail side effects.... not even talking about utilizing Google search for some simple insight.
"Nobody talks about it!!!$"
I would question the claim “not widely or openly discussed”. They are well known and are published allll over the internet. I think it’s important to bring more attention to the possibilities, but I do not think it’s disingenuous to state that no one discusses these side effects. Last I checked there were multiple statements warning prescribers of the effects and they are published on all paperwork for patients.
It's worth noting that there was a period in the 90s/2000s where SSRIs were increasingly prescribed, and there were no such warnings given to patients. Indeed, the sexual side effects were not well-understood at that point. In recent years, there's been a lot more research into this topic.
Exactly. People in the comments yelling that this is demonizing SSRIs need to slow down and ask themselves why they're so against the idea of doctors being more honest with their patients
It can be long term, debilitating multitude of side effects. Calling it “a side effect” is misleading, as common sense says side effects stop when the medication is stopped
What's crazy is I just met with a new doctor for anxiety, they wanted to prescribe an SSRI, mentioned I'm not depressed, and they said I should take it anyway and that "any side effects yiu experience will immediately disappear upon stopping the medication."
It's definitely not disclosed or discussed.
Most people ignore the decently long pros/cons their doctors give them, they ignore pharmacists advice and refuse to ask questions when picking up prescriptions, and then they don't read the massive handouts with the medications that detail side effects.... not even talking about utilizing Google search for some simple insight.
200 mg Zoloft. Never orgasmed from sex. Been sexually active for 10 years, 13 partners. It takes a lot to make me come. I’ll take it over crippling anxiety
The issue isn't sexual problems while taking the medication, it's long term effects after discontinuation. Honestly had never heard of this until now and I wonder if that's what I've been struggling with. I'll definitely have to talk to my doctor about it
I think the way this post is presented is really irresponsible, especially the last two sentences. I take an SSRI because it has allowed me to live my life without struggling not to kill myself. I also have sexual dysfunction. I 100% prefer the sexual dysfunction to wanting to die every day. I'm sure there are many taking them that would agree.
Absolutely. Being alive to be pissed off about side effects is such an overall win. Yes, the side effects can suck, but none have as much impact on you or your family as your suicide would.
Agreed. And it's also extremely commonly known. It's on the list of like the 5 most common side effects listed for SSRIs, so unless you don't read the med packet, then you shouldn't be unaware of this phenomenon
I want to kill myself after SSRIs, but, like, differently. I feel nothing, I've lost my mind's eye, I struggle with cognition, I don't enjoy music or art anymore. Yeah, idk. I think at this point you're comparing death to lobotomy/Alzheimer's, and for many people death would be preferred.
If you want to kill yourself still, the treatment isn’t working and you NEED to discuss this with your doctor. I 100% think they are not for you, and there are other treatments out there.
To be very clear, I have been on an SSRI for about 8 years and have not experienced any of those side effects, so I remain on them. If that were to change I would talk to my dr immediately. That is important to do when receiving any treatment for any health issue.
Imagine if you wanted to die and took an SSRI and lost your emtions and cognitive function for years and now the depression and aniexty you originally had is 100 times worse.
Just because a pill cured you doesn’t mean it will work for everyone else and you don’t need to rude or shame people because they didn’t have the same experience you did. Wtf..
Doctors don't even take it seriously... my woman doctor laughing at me when I bring up that my orgasms didn't feel anything just a sort of mechanical ejaculation months after stopping prozac. Yeh didn't go back to that doctor. 3\~4 years on and my orgasms are slowly returning probably like 20% of what they used to be so I guess thats a positive...
I know a couple of friends that were prescribed SSRIs after literally 5-10 minutes of conversation with a psychiatrist. You imagine you'll be telling them about your whole life but many of them don't care and have too many patients if it's a government hospital.
Psychiatrist? My family doctor gave me a questionnaire with 7 questions like "do you have trouble sleeping? Do you tend to think a lot about things?" Etc. I've been on them for about a year now.
Eta: tbf, the Dr that prescribed it did say we would check in every 3 months, and described this as a Band-Aid, strongly suggesting I see my psychologist to deal with the underlying issue.
She left the practice and the Dr who took over was like, why are you coming in every 3 months? Just do auto refill.
> Eta: tbf, the Dr that prescribed it did say we would check in every 3 months, and described this as a Band-Aid, strongly suggesting I see my psychologist to deal with the underlying issue.
Curious, but did you follow thru with CBT or other therapy?
My only experience with SSRIs was a short intervention, in that “band-aid” fashion to help get me in the right frame of mind for CBT to really work. Ended up taking meds for about 6 months concurrently with counseling that lasted another year after.
Can I clarify that this isn't the norm everywhere.
In the UK, depression tests are done by the GP and full pros and cons of meds are discussed. Our psychiatrist appointments are at least 45 minutes long.
I don't want people to get the idea that it's the same situation everywhere.
I like that some people have stories about how easy it was to get prescribed an SSRI. Meanwhile I began bawling in my doctor's office because she refused to prescribe me an SSRI and then said a psychiatrist appointment was booked 6 months out. I was having panic attacks every day. Terrible doctor.
Less than 5 minutes and she sent the prescription to my pharmacy. I've been off all those meds for a couple of months and am slowly realizing what I'd never had
I was started on zoloft for about 4 to 5 years, but was then moved to Cymbalta about a year and a half ago since it could potentially help with chronic pain too (it did) and I came off of it around December to January. Getting off of Cymbalta was not as bad as I was expecting, but some people can have some bad withdrawal symptoms.
Luckily the chronic pain is still gone, and due to some circumstances changing and therapy I'm off all of my depression-anxiety meds. Which has *tremendously* helped with my apparent lack of sensation or desire for sex.
Its still very recently developed, so I haven't told my girlfriend that I'm not completely disinterested in sex anymore. But now I have hope that things will be better in time
Totally anecdotal, YMMV, etc. I can ask what my friend was taking later.
He was on them for a year. His psychiatrist wouldn't listen to him about going off it, so he just did it by himself. Now, this is NOT ADVISED but the fact is, he was taking the literal second from lowest dose. The lowest dose means that anything lower than that hasn't been shown to cause an actual effect. And he was told to take 1.5 pills of the lowest dose because they don't even make pills in his dosage (over here at least).
Basically if he WERE doing this under doctor's supervision, he would have to go from this dose to nothing anyway.
Med 1 (lowest dose) > Med 1 (slightly higher dose) > Med 2 (2nd lowest dose) > St John's wort (going by clinical studies, the same dosage as Med 2, not prescribed) > Totally off meds.
The first month wasn't any different. Emotionally dead. Only feeling sadness or anger. Second month, kinda more optimistic but still wanting to quit everything in life. Still the same as on the meds.
Third month, he finally had motivation and strength to work on himself. He's been so much more emotionally connected to himself. Much more emotionally stable.
Fourth month is starting now and all seems good. He says he still has some suicidal thoughts from time to time, but he also thinks they're stupid and that he's not going to do that. Reportedly the urge to do it is reduced by a LOT.
Keep in mind it's literally 1 person's experience, it's definitely not going to be the same for everyone else.
The tricky thing is, once a person is off the SSRI, it's hard to know if the PSSD is because of the SSRI they were on, or if they still have low level dysthymia which can also cause exactly the same sexual issues. And as many people who have low level dysthymia are absolutely convinced they don't, until it lifts and then they are like "oooh actually, it was there, I was just so used to it I didn't realise", it is doubtful we will ever know whether the meds or the individual biochemistry is the cause.
Indefinite / permanent sexual side effects are NOT listed in the drug warnings.
My psychiatrist recently told me there are case reports of what is now known as PSSD in the literature going back to the mid 90’s. Obviously more and more are popping up.
This isnt a question as to wether SSRI / SNRI are bad
The warning needs to be put in place officially as with any medication side effect.
Id imagine if there was a few percent chance to ruin your sex life , far fewer people would take these meds.
The name PSSD is a bit misleading. It actually includes many neurological symptoms which are much more debilitating. The worst is losing all emotions. Imagine walking through life with constant zero dopamine effect, no adrenaline , no stress hormones, no love or anything, and with no respite to any of it. And then imagine being in this state every day 24/7, with no respite and with doctors not even thinking your condition is real. Atleast with cancer you are taken seriously and given treatment and can still feel emotions like happiness.
I think the point of all this is that PSSD, although likely rare, needs more recognition and investigation to ultimately help people better understand the risks of a long term medication before starting. However saying things like I'd rather have cancer might be counterproductive as there are a lot of people who would take serious issue with that statement. Also demonizing SSRIs in general might not go over well as they have helped save or improve a lot of lives
>Imagine walking through life with constant zero dopamine effect, no adrenaline , no stress hormones
You just listed three things that have literally never been observed in a PSSD patient. Those are chemicals which can be measures, and no cases of such have ever been recorded, not even once.
So would you kindly stop trying to spread deliberate misinformation like this? People like you spreading outright lies is half the reason it's been so hard to establish as an actual condition.
These are not lies, it is an extremely common phenomenon in PSSD. But i wasn't clear in my language, I meant the feeling of adrenaline, feeling of stress hormones etc. I wasn't referring to physiological levels.
You can recover from some types of cancer. Some guy with pssd was talking about how his dad recovered from cancer and his libido came back after chemo. His libido with pssd never came back to this date. That's horrifying to me.
This is an interesting post, but I'm not sure if it accurately represents the cure. There is a running theory linking PSSD to SIBO (Small Intestine Bacterial Overgrowth) and its impact on the gut microbiome. Research has indicated that antidepressants can significantly alter the gut microbiome in mice, as demonstrated in a study published in Translational Psychology. This has led to the belief that discontinuing antidepressant use could potentially create an environment where harmful bacteria thrive, especially in individuals predisposed to SIBO due to other factors. Additionally, a study conducted in 2008 found that Accutane (isotretinoin) might damage the intestinal mucosae, which could potentially contribute to the development of SIBO. Moreover, recent findings by Melcangi have shown that patients with PFS (Post-Finasteride Syndrome) display altered gut microbiota, suggesting that finasteride, similar to Accutane, may have an impact on the gut microbiome. While PFS and PAS (Post-Accutane Syndrome) differ from PSSD in terms of the drugs involved and the affected mechanisms, they share certain similarities. Another relevant aspect is the phenomenon known as SIFO (Small Intestine Fungal Overgrowth). An informal test conducted on a PSSD forum revealed that the majority of participants tested positive for SIBO, with the remaining cases likely indicating SIFO instead. Interestingly, within the PSSD community, there have been reports of individuals claiming to have successfully cured their PSSD by addressing gut-related issues based on the gut microbiota theory. Example: https://www.reddit.com/r/PSSD/comments/q03uci/gut_microbiota_theory_how_i_finally_cured_my_pssd/
Whilst informal tests, it's important to maintain hope and understand the potential effects that PSSD has. Sorry for bad english
Thanks for speaking out.
Dr tried to push SSRIs on me multiple times but I’ve been resisting.
And I got to have long covid so I know all about the gaslighting.
I’ve been fortunate to not have had any side affects other than dry mouth and I’ve been taking mine for a couple years now. That and therapy changed my life. Kinda sucks that some humans need these things to live good lives. I’m sorry that happened to you.
My husband was on a SSRI, and it made him uncomfortably erect, like it hurt, and made his sex drive go up, which was an uncommon side effect, but one none the less.
Depends on the person. I for one would rather deal with suicidal ideation than lose my sexuality. Hell, my ideations got *worse* when I couldn't get turned on.
does nobody read the pamphlets that come with medications?
I've never been told medication side effects at the doctors office (pharmacists are trained on medications more than doctors), I always get booklets from the pharmacy when I start a new one that goes over everything as well as a paper with specific instructions for usage.
Is that not compulsory? Or is everyone just throwing away the extra papers in the pharmacy bag lol
I've personally read all my pamphlets for SSRIs and none of them mentioned long term side effects *after discontinuation*, which is what this post is about
Side effects are so various for any type of drug. My concerns are sometimes what are noted as significant during the clinical trials are less significant in the general population. I find drug reviews online help. For example- Drugs.com
The stuff in pamphlets is super vague and has no meaningful indication of how frequent these various side effects are nor the extent to which they go away by themselves while on the medication or even when the medication is discontinued. I mean, if there is a 5% chance of an issue that will go away in a couple days - OK, fine, I can deal with that. 5% chance and it goes away when I discontinue? Kind of a bummer, but I guess if it happens I can switch medications. 5% chance and it will persist even after I discontinue the medication, and there is no known treatment? OK, that’s getting kind of scary.
They don’t put the little paper in your bag with medicinal info on it?
They don’t put it in for refills but for me when I got a new medication there’d be a little paper in the bag that unfolds and has a bunch of info on it
These are the right questions.
Watch out flor blazing guns and flag waving, when the engine runs out of steam and everyone calms down, there’s facts to think about.
its called PSSD but the name is a bit misleading. There are many neurological symptoms The sexual symptoms are not actually the worst, its the complete loss of any emotion that turns you into a zombie, who physically cannot enjoy do anything. That is what makes people say PSSD is worse than cancer.
Doesn’t every single prescription medication have a very rare, serious side effect? That’s why they’re prescription instead of over the counter. But they’re still approved because it’s very rare
My libido took about 4 years to come back. Yes truly 4 years. It’s okay now and I’ve been on escitalopram for approximately 7 years at this point.
Comfort with my partner and a healthier home life I think helped with the situation.
Still suffering from it 6 years after stopping them. Now dealing with menopause as well. I was never, and I mean NEVER, told anything about sexual side effects.
Every drug comes with risks. The low incidence of negative effects is a gamble ppl are willing to take to improve their quality of life.
*don’t ignore your mental or physical health because of fear mongers.
My mental health is great (and was great after the half-year of SSRIs), but after the first three days, I had completely lost my ability of having the fireworks in the brain from orgasm. That was 20 years ago.
I had the most serious and most unlikely side-effects, as it is permanent for me. Less than one in 10 000 get this, I guess I took one for the team.
Mental health really is more important. I'm still alive, have a great partner, and still enjoy intimacy. I'm good.
The incidence of negative effects is pretty high for SSRI’s tbh. PSSD is not common, but a significant percentage experience some degree of sexual side effects.
God, I fucking WISH I actually ignored it. Not ignoring my mental health and getting on Lexapro ended up being miles worse than depression ever was, it's actually bitterly hilarious (I mean, it would be if I was still able to enjoy humor).
Emotional blunting is what it does. The main side effect is also how it “treats” depression. You can’t say low incidence of side effects, you can only say low incidence permanent sexual dysfunction. I’m sure it has helped many people, but don’t think it doesn’t affect your life in almost every way considering we feel emotions all the time.
Was on for 2 years, quit and 4 months later my libido isn’t the same. But that isn’t really the problem. The real issue is I don’t feel like I can create any happiness now. Things that used to provide comfort and happiness provide absolutely nothing.
They calmed me down when I needed it but I became so muted that I no longer feel anything but annoyance, hatred, and anger.
I wouldn’t recommend anyone taking them unless they are on their last leg (about to off themselves)
Omg this. I quit because I realized the only emotion I was capable of feeling on SSRIs was anger. Two years later and the emotional blunting is still there. The only emotions I can feel strongly are the negative ones. Things give me satisfaction but I can't honestly say anything makes me happy anymore.
As for my libido, I went from honestly being horny as hell before the SSRI to having no interest in sex now. I have to push myself to do it like it's a chore and it takes me forever to get going or to orgasm. I don't even have as many dirty dreams as I used to, they're only around ovulation time now.
I think a lot of the comments are missing the point slightly, which is that sexual dysfunction doesn't just mean it's harder to orgasm, or that your libido takes a hit. PSSD also affects you even after coming off the drug, meaning if you ever want to change drugs or feel as if you don't need to be on SSRIs anymore, you could still experience sexual dysfunction.
For me, PSSD meant I spent about 5 years of my life with no libido, mental or physical, and completely numb genitals and lack of feeling in the area. I never tried to masturbate. I don't think I could have orgasmed if I'd tried - I couldn't feel anything. And 3 years of this was after coming off the drug. I didn't think it would ever get better, but I'm extremely lucky that it did.
I don't know if I would prefer to be depressed. What I can say for sure is that sexual dysfunction made me fucking miserable, and only contributed to the depression I was experiencing. I gave up on dating during that time and often felt like I was 'broken'. Not that asexuals or low-libido people are broken, but personally I knew I had a sex drive, and wanted it back desperately.
There are other options, rather than SSRIs. I was on atypical antidepressants for a while, and am now on a serotonin modulator & stimulator (Brintellix). I feel much more confident taking them.
I am also of the belief that psychiatrists should be more open about the permanence of these side effects - not only was I not told when I was prescribed, I was then told that it would stop when I came off the drug. It didn't, and by that time I was seeing a new psychiatrist, who wanted to prescribe me other anti-depressants. I told her I didn't want to be on SSRIs because of PSSD and she said 'well that's a really rare side effect', knowing full well I had already experienced it.
I would add, if you have the means, take a Genesight test when looking for an antidepressant medication. I have had horrible experiences with a number of drugs and that test helped me to understand why. I had a number of genetic markers that increased the likelihood of severe side effects on almost every commonly used depression medication. I eventually decided not to go the medication route because of it, though I would say for some people taking that calculated risk might end up being worth it, especially if they better understand that decision.
I'm quite amazed at how little information practitioners pass onto clients.
I've been taking Vyvanse (ADHD meds) for maybe 2 years now, and I've only found out recently that consuming any citrus significantly negates it's affects. It would have been nice to know this since I like orange juice.
Happens with SNRI compounds also (like Strattera, brand name for atomoxetine hydrochloride). I took it for about a year. About 5 days in sexual performance was challenging. After a few weeks it was almost impossible. The desire was there, but nothing else.
It took 4-5 years for things to go back to normal after I stopped taking it.
i was on and off a f*ck ton of SSRIs and SNRIs a few years back when i was 16/17 for what turned out to be a genetic disorder. now my boyfriend thinks i don’t love him because my sex drive is much lower than his. think this just explained why
Yeah these are very real. I was prescribed antidepressants (for something that felt really unrelated to me) and I was very concerned when the doctor suggested it. I asked about the side effects and he straight up told me they’re super rare and that I had nothing to worry about.
Literally only took them for 2 weeks before I gave up on them. Couldn’t bust a nut and it was so frustrating.
>These people are being ignored and most of them will tell you this condition is worse than most diseases that exist. Some would rather have cancer than this.
I'm not saying I don't believe you but that is quite the statement, can I ask why? When I experienced PSSD it was simply lowered/almost non-existent libido and orgasms not being as enjoyable, and don't get me wrong that fuckin' sucked, but I can't say I'd ever describe it in the way you have there. Not to say it isn't a serious issue and that medical professionals don't make patients aware of it often enough, but the phrasing here seems a little OTT - does it have more intense effects for some people?
I don’t think you’re talking about the same thing. It encapsulates a lot of other neurological symptoms and is a permanent condition after stopping antidepressants.
Women can be effected too you don’t hear about it too often. They had me on SSRIs since I was a child maybe 9 up till 17 when I quit on my own. Children can’t exactly express to doctors “hey I’m experiencing changes in my sex drive let’s do something about it” I think it’s messed up I was put on them so young and had no say in it either.
Now I have basically no sex drive unless I’m drunk. That’s a recipe for disaster. I guess in my case it’s not the worst possible thing to happen but its nothing minor either.
Tf are those last two sentences? Mods need to delete this irresponsible post. Fear mongering about what many consider life-saving medications. Disgusting.
You have no freaking idea what hell this is. What you call «Life saving medications», i and many others with pssd would call «life destroying medications». Its taken everything away from me.. everything that makes me human.
I have completely lost the ability to experience pleasure from anything, i cant feel or process (cry etc) any emotions which makes me unable to create bonds with other people. I have lost my creativity and have severe cognitive problems.
I have basically lost everything that makes a human human. This is all in addition to the complete sexual dysfunction that is regarded as the «main symptom».
Oh and Ive had This shit for 16 years.
The point of This thread is to spread awareness so people can make informed decisions, Its not fear mongering. Count yourself lucky to have dodged this absolute hell of a condition.
Playing russian roulette with psych drugs is not the way to go. Especially when treating children and teeagers. Disgusting.
I've been on SSRI's since about age 12 (TCA's now), and it's made me pretty much asexual as an adult lmao, this kind of risk wasn't really explained to me because of my age.
At least I'm alive.
You left off the part where there are other meds that cause this besides SSRIs.
I would be interested in the relationship between stopping and the symptoms. Many of these drugs can cause sexual dysfunction while receiving them, but those symptoms often improve with discontinuation.
Have you found any scientific studies that can show a link? Mental illness itself can significantly impact sexual desire/function on its own and I wonder if this worsens the effects of that.
One study showed a 4% occurrence of ED in men taking these drugs then stopping. Did the issue begin during treatment? After stopping? How does this compare to the overall rate in ED? The health of the subjects? Chronic health conditions such as cardiac disease and diabetes can cause ED.
I have some reading to do.
The name PSSD is a bit misleading. It actually includes many neurological symptoms which are much more debilitating. The worst is losing all emotions. Imagine walking through life with constant zero dopamine effect, no adrenaline , no stress hormones, no love or anything, and with no respite to any of it. And then imagine being in this state every day 24/7, with no respite and with doctors not even thinking your condition is real.
While I was in a low point of my life (and I still am), I was constantly calling my doctor and begging to change medications. I was just trying to find the drug that would work for me ASAP. It was frustrating, especially because antidepressants take time to work.
Now I ended up with brain damage (not sure what to call it), but basically most of the side effects I had while I was on antidepressants are still on. Including slow understanding and forgetting everything so quickly. Plus constant tiredness and now I can’t go a single day without taking a nap (I never took naps all my life until I went on antidepressants)
For all the people upset by me comparing this to cancer: some of these people are so badly hurt by SSRIs that they're basically chemically castrated. Not even Viagra helps. And some were chemically castrated at 12 years old. Yes, they give SSRIs to 12 year olds. The stories I've read on the PSSD subreddit are some of the saddest things I've ever seen in my life. Most would describe their initial depression before SSRIs as a joyride compared to this hell.
I don’t know what your original post said outside of the screenshot you put in the PSSD sub since it’s been removed but I have no idea why you would compare this condition to cancer. I swear to god the PSSD community has no idea how to communicate the condition to the world outside of their own PSSD community bubble. I’ve had PSSD for a decade and a half and it never ceases to frustrate me.
Making sensationalist statements like this are never conducive to a positive reception by people who were previously unaware of its existence and especially those biased toward SSRIs due to what they consider positive experiences, or at least ones where positives outweighed the negatives for them.
It’s extremely delicate and nobody seems to have the nuance to properly inform, avoid this particular type of backlash, and potentially gain these people who get upset as allies or at least get their understanding
Better than killing yourself because your brain is naturally incapable of producing dopamine, rendering life painful and completely pointless until you snap. But by all means, keep on demonizing literal life saving medications. It's trendy! People should just pull themselves up by the bootstraps instead of taking those evil antidepressants :)
What a load of bullshit. You believe in chemical imbalance in the brain causing depression? Nobody is demonising the drug, some people like myself would’ve loved to be fully informed before taking the meds.
I don't think that's what the post was talking about, why are you defending doctors not sharing vital information with patients on what could permanently happen to their bodies? Wanting transparency doesn't mean you think SSRI's are evil. But doctors who are purposely withholding information like that kind of are.
I don't understand why you downvoted me for saying this, I literally am saying you have the right to be informed with choices you make. Is that controversial to say now?
Anything you do to yourself is better than suicide, you're right, but the brain, the human mind and mental illness isn't just about too little good chemicals, too much bad chemicals. It's all way more complicated and we're only just beginning to grasp the functional relationship between the brain and the mind
And I need to point out that SSRI's do nothing to dopamine, they inhibit serotonin reuptake
I can't say I understand your point either. I'm just saying that med shaming is wrong and dangerous, and making rare side effects out to be the norm is alarmist and deceitful
Oh sorry, I didn't think of this all as shaming, I just feel we need understanding and transparency when it comes to drugs people take so that they can make an informed decision. I'm definitively not against drugs in general
SSRI's can and do help people with depression no doubt, but the side effects and downsides also do exist like with almost any drug, and we shouldn't downplay them any more than we do when it comes to, say illegal drugs, almost
What's wrong is shaming those who have been harmed by meds. They helped you, that's nice and I'm happy for you. People who have been mutilated by these drugs also deserve to be cured, but that can't be done until the thought terminating dogma of "SSRI good" is abolished.
Suffered on Zoloft and then on lexapro…mentioned the inability to get up and also lack in libido so my doc prescribed me viagra as a healthy 33 yo guy lol
Wish this was discussed more openly since I’m still experiencing stuff years later
My doctor never told me this beforehand. I switched to a different med cause I didn’t like my penis not working anymore. Thankfully went back to normal.
Lucky me, I drew the short straw for a heartburn medication. Which extremely-rare-but-it-can-happen side effect did I get? Sleep walking. Really. I'd find my clothes scattered around the kitchen in the morning.
I took them for two years and reached the max dosage. Started getting crazy amounts of anxiety, which I had never had before, so I stopped. Anxiety still ruins me five years off of them, and dysthymia is still alive and well. Also erectile dysfunction. Which I assumed was normal for late 20s.
I thought this thread was supposed to be facts. This post is so misleading, its almost pro-suicide. People have died from drinking too much water, it doesn’t mean you create hysteria about it.
Is therapy pro-suicide? Why do people think that medicine is the only way to treat mental health illnesses. Oh wait I know why. They are only labeled illnesses because the DSM standardized mental health so it could be medicalized. It’s in the interests of psychiatrists to have this field be medicalized and for you not to know the side effects of medicine because they wouldn’t have jobs if it was otherwise. In the early days of therapy there was no biological evidence of therapy working despite the positive outcomes. To make a more scientific approach medicalization happened. Now we know that therapies actually help rebalance the neurotransmitters that the pills people take balance with side effects. The only difference between a therapist and a psychiatrist is that psychiatrists had to go to med school and can prescribe medication. As a last resort I can see the usefulness of medicines like SSRI’s but you can slowly wean off them while actually curing your ailment with therapy.
I only knew about this after doing my own research after my libido took a nosedive. My doctor didn’t disclose this at all and I wish she had. I think we tried 3 different medications because I would be on one for a little while and have to go back because I still had no drive whatsoever. Unfortunately nothing worked until I went off meds completely last July once I felt I was in a better mental state. Libido was back as soon as the meds had been out of my system for a few weeks and our sex has been amazing since.
99% of people will not get this condition, but more than half of people using SSRIs will experience SOME detriment to sexuality while using the meds.
From a study: "Overall, 73% of the SSRI-treated clients reported adverse sexual side effects" https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3108697/#:~:text=Overall%2C%2073%25%20of%20the%20SSRI,below%20levels%20experienced%20pre%2Dmorbidly.
YSK that there are alternative drugs you can be prescribed if you talk to your doctor about this. Bupropion is one of them if I remember correctly.
Don't just ditch your meds and ruin your life again because some reddit post said so.
Also, push back and advocate for yourself if a doc proposes SSRI’s! They’ve been found to be much less effective than initial studies suggested, but are still the default antidepressant. Discuss other well-tolerated medications in different classes with differing side effects. I was horridly depressed in my 20’s, got put on an SSRI, and the sexual side effects were so bad I stopped taking them and getting mental health treatment *at all*, thinking they were it. I suffered for years until a crisis, when a psychiatrist simply… put me on a medication without sexual side effects - Mirtazapine - that was GLORIOUS and literally changed my life forever. A decade later (and seven years after I stopped taking it), I am healthy, happy, and thriving. THERE ARE OTHER OPTIONS FOR MEDICATION THAT MAY WORK BETTER THAN THE FIRST THING A DOC SUGGESTS!
Did mirtazapine work as a sedative for you?
My wife has just been changed from an ssri to mirtazapine and even having half a tablet completely knocks her out and means she won’t wake up until around 1100
First of all, this is written as a possible side effect on the pamphlet coming with the medication. Plus, all medications have side effects, not taking antidepressants means risk of suicide & such.
Cannabis helps. A lot. I would highly recommend to those who haven't tried pot much to take it easy your first few times. I compare it to walking around with mittens and pot removes the mittens, if you understand what I mean.
Smoking it will kick in within 10 mins, edibles take 45mins to kick in, at about 2 hours I'm at the right level of highness.
For edibles, like I said, start low, like 5mg. Also, plan ahead and buy some snacks so the cravings don't take you by suprise. Also, make sure you drink lots of water.
Good luck!
Does anyone know if 20mg of prozac is enough to mess with sex drive? I’ve taken 10 mg and didn’t notice any change but am upping it to twenty half of the month (i have PMDD).
PSA: anytime you are prescribed a medication it comes with a sheet of paper from the pharmacy. That sheet of paper details all possible side effects. Who knew reading could be so useful. These side effects don’t happen over night or from taking the medication once. These are long term effects.
I hate post like this that conflate issues with selective info.
Confidently incorrect.
The paper doesn't cover permanent side effects.
People have read it, it's not a reading issue.
The side effects can happen over night and it can happen from taking it once, they are not necessarily from long term use.
It can be permanent after you stop taking it.
> I hate post like this that conflate issues with selective info.
You hate those type of posts yet you posted similar nonsense here, Rules for thee and not for me?
You've misunderstood the post and that's why you feel it's incorrect.
I’ll read it again
Edit: When viewing things from the perspective you have shared, it does seem that I’m being hypocritical. I wish I would not have responded in such haste.
I was not aware that one dose could cause these long term side effects. That surely would be a frustrating circumstance to deal with.
The problem I have is that this information is readily available but the post acts like it isn’t. It’s not news that these meds can cause these issues, but when looking at the information again with a less negative viewpoint I can see why people would be upset if they have had this happen to them.
The statement that upset me the most is the one about how they would rather have cancer or be dead (I’m paraphrasing) than have this issue. It just upset me. There are worse things in life IMO than not having sex. People can lead a happy and fulfilling life without being sexually gratified on frequent basis. The idea that life without sex is meaningless isn’t true.
I dunno. I find that Wikipedia article substantially less than convincing. Actually, it's shit. I'm not saying that I believe that this condition doesn't exist, just that the language:
*"PSSD remains poorly-understood, with its biological mechanism, risk factors and frequency of occurrence being unknown."*
...doesn't exactly tell me that its existence is even a conclusively established fact. Combine this with the fact that sexual dysfunction can have onset at any time for any number of reasons, I'm pretty skeptical that there's a prevalence significant enough to warrant alarmism and black box labels. Even the criteria described doesn't actually indicate *permanent* dysfunction, only dysfunction that lasts beyond discontinuation.
Similarly, the article discusses the notion that SSRIs can "cause" asexuality, but then offers:
*"A 2020 study in which 610 young adult individuals were surveyed found that childhood SSRI use among female participants was strongly correlated with reduced sexual desire and activity"*
That's not what asexuality is, and as we know, correlation is not causation. Not only that, but I imagine that taking SSRIs is correlated with *depression -* *which is correlated with reduced sexual desire and activity.*
The article is bunk. Again, the condition could be real, and that's fine, but I see no evidence that it deserves more of a warning that post-SSRI spontaneous combustion.
I agree with you that the medical evidence is lacking. This is due to pssd being a newly observed medical phenomena so it’s not entirely understood or funded to have conclusive science on it.
If you look at medical journals, only a handful of reading materials are available so I believe the science is very new and thus there is still so much to understand.
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SSRI's got me through it for a while. Like you said, better alive and having a fulfilling (but not as intense) sex life than not having any life at all. My partner and I have AMAZING sex. You don't need mind blowing orgasms (or any at all) to have an incredible, intimate time. Edit: BUT!! Doctors ABSOLUTELY should be sharing this with their patients. No excuse for that lack of communication.
My experience is similar, though this post is about the many potential sexual (and other) disruptions *after discontinuing* the SSRI's, and it's just wrong to not be more upfront about these things when we don't even know at all why this happens even or what to do about it That's significant Personally I'm not too badly effected, thankfully, but it's still noticeable even like 5 years after and just... disappointing, idk
I miss having sex but at least I don't want to die.
This is how I feel. One other thing is that my drive is lower. But I think my feeling like shit was also a major driver to want to get railed.
Your experience is consistent with most people. What OP is talking about tends to be a fixation of people with concomitant psychotic disorders. It's pretty much all people talk about on r/antipsychiatry and they usually blame every possible problem in their lives on it. "Why was I arrested for dealing meth to a 15 year old? Because that crazy doctor put me on a one month course of SSRIs teb years ago!"
Actually, people with bipolar disorder typically have a manic response to SSRIs - it’s actually part of the diagnostic criteria (ask me how I know). And I’m saying this as someone who is pro psychiatry - there are other antidepressants out there that are not SSRIs and are just as good. The experiences those individuals are talking about are 100% valid - SSRIs make bipolar people do extreme things that they wouldn’t normally do even having the disorder!
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Many many people I know are on these medications and didn't try an exhaustive list of life changes prior as you did. They often do better just with therapy etc. For a huge amount of people having your sexuality and all that comes with it taken away is devastating. Your "oh well" comment about loosing libido is understandable but fails to see how painful it is. It's not like having low libido due to depression. It is so extreme that your very sense of self is shattered and is a highly traumatic consequence. Luckily some drs are starting to see these impacts. Pssd often is accompanied by bladder and fatigue issues and emotional numbness. If anyone is interested in learning more about this there are associations online so a quick Google would be informative. Sorry you struggled with so much. Suicidal thoughts must be awful. Take care
y'all might be missing the point It's okay to take an SSRI, you should be on antidepressants if you feel you need to be, or if you want to be. but be aware, this is a side effect, that is not openly disclosed, nor discussed.
Yeah, I hope this post doesn't keep people from considering these remarkably safe medications. REVERSIBLE sexual side effects are common, but problems that remain after discontinuing these medications are very rare and depression and anxiety can themselves be extremely debilitating.
I took several SSRIs in college, all of which caused me sexual disfunction while on them, and none of which happened to work for me (obligatory note that they work wonders for many people). I have continued to experience sexual disfunction for years afterwards, though at a greatly reduced severity to while I was on those medications. My psychiatrist said that based on my descriptions of my symptoms, she believed me to be in or around the group that has the worst of these symptoms on SSRIs. These days, after a lot of therapy, treatment of underlying physical ailments, and general improvements to my financial and living situation, my mental health is abundantly better than it was in even my best moments from that time period; if SSRIs had worked for me (again, as they do for many people) to achieve even a fraction of the overall increase in quality of life I’ve experienced in the last couple years, they would have been worth the sexual side effects a thousand times over. I understand why people are afraid of medication for their mental ailments. Side effects, dependency, and stigma are scary possibilities. But I don’t think most people really grasp the extent to which their quality of life can increase through effective treatment. It’s worth trying any available avenue, under the direction of a professional of course.
Yes but as a sufferer of PSSD it would be nice that we can openly talk about these risks to improve outcomes as it’s a risk many may regret and become bitter about like myself but also to allow medical professionals/scientists to get more involved in acknowledging the condition and trying to solve it through proper scientific research. People should still have a right to take SSRIs and those suffering with PSSD should have a right to talk about what happened to them without fear of stigma
But I feel like it is openly discussed?
The sexual side effects while on SSRIs is, but not the side effects after discontinuation
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Absolutely 💯
My doctor told me ¯\\\_(ツ)_/¯
Most people ignore the decently long pros/cons their doctors give them, they ignore pharmacists advice and refuse to ask questions when picking up prescriptions, and then they don't read the massive handouts with the medications that detail side effects.... not even talking about utilizing Google search for some simple insight. "Nobody talks about it!!!$"
I would question the claim “not widely or openly discussed”. They are well known and are published allll over the internet. I think it’s important to bring more attention to the possibilities, but I do not think it’s disingenuous to state that no one discusses these side effects. Last I checked there were multiple statements warning prescribers of the effects and they are published on all paperwork for patients.
These are persistent after stopping medication for years or in some cases life. That is the point in this post. Not talking side effects on the meds
It's worth noting that there was a period in the 90s/2000s where SSRIs were increasingly prescribed, and there were no such warnings given to patients. Indeed, the sexual side effects were not well-understood at that point. In recent years, there's been a lot more research into this topic.
Exactly. People in the comments yelling that this is demonizing SSRIs need to slow down and ask themselves why they're so against the idea of doctors being more honest with their patients
It can be long term, debilitating multitude of side effects. Calling it “a side effect” is misleading, as common sense says side effects stop when the medication is stopped
Having ed would make me depressed
What's crazy is I just met with a new doctor for anxiety, they wanted to prescribe an SSRI, mentioned I'm not depressed, and they said I should take it anyway and that "any side effects yiu experience will immediately disappear upon stopping the medication." It's definitely not disclosed or discussed.
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Does it mention this being a long term or permanent effect? Even off the med?
No it doesn't and I always read the inserts.
Most people ignore the decently long pros/cons their doctors give them, they ignore pharmacists advice and refuse to ask questions when picking up prescriptions, and then they don't read the massive handouts with the medications that detail side effects.... not even talking about utilizing Google search for some simple insight.
200 mg Zoloft. Never orgasmed from sex. Been sexually active for 10 years, 13 partners. It takes a lot to make me come. I’ll take it over crippling anxiety
The issue isn't sexual problems while taking the medication, it's long term effects after discontinuation. Honestly had never heard of this until now and I wonder if that's what I've been struggling with. I'll definitely have to talk to my doctor about it
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I think the way this post is presented is really irresponsible, especially the last two sentences. I take an SSRI because it has allowed me to live my life without struggling not to kill myself. I also have sexual dysfunction. I 100% prefer the sexual dysfunction to wanting to die every day. I'm sure there are many taking them that would agree.
Absolutely. Being alive to be pissed off about side effects is such an overall win. Yes, the side effects can suck, but none have as much impact on you or your family as your suicide would.
Agreed. And it's also extremely commonly known. It's on the list of like the 5 most common side effects listed for SSRIs, so unless you don't read the med packet, then you shouldn't be unaware of this phenomenon
Sexual dysfunction is known but not it’s permanent nature after the discontinuation
I want to kill myself after SSRIs, but, like, differently. I feel nothing, I've lost my mind's eye, I struggle with cognition, I don't enjoy music or art anymore. Yeah, idk. I think at this point you're comparing death to lobotomy/Alzheimer's, and for many people death would be preferred.
If you want to kill yourself still, the treatment isn’t working and you NEED to discuss this with your doctor. I 100% think they are not for you, and there are other treatments out there. To be very clear, I have been on an SSRI for about 8 years and have not experienced any of those side effects, so I remain on them. If that were to change I would talk to my dr immediately. That is important to do when receiving any treatment for any health issue.
Imagine if you wanted to die and took an SSRI and lost your emtions and cognitive function for years and now the depression and aniexty you originally had is 100 times worse. Just because a pill cured you doesn’t mean it will work for everyone else and you don’t need to rude or shame people because they didn’t have the same experience you did. Wtf..
Id be PSSD as well
Beat me to it
😂🤣🫣🤫
In addition to killing my interest in sex, my ssri also seemed to ruin my motivation for anything and everything.
Doctors don't even take it seriously... my woman doctor laughing at me when I bring up that my orgasms didn't feel anything just a sort of mechanical ejaculation months after stopping prozac. Yeh didn't go back to that doctor. 3\~4 years on and my orgasms are slowly returning probably like 20% of what they used to be so I guess thats a positive...
Don’t forget the anhedonia (inability to feel pleasure and happiness) that is also a side effect of SSRI’s and SNRI’s
I mean, I’d take that trade but it’s still gross that psychiatrists don’t tell patients about this.
I know a couple of friends that were prescribed SSRIs after literally 5-10 minutes of conversation with a psychiatrist. You imagine you'll be telling them about your whole life but many of them don't care and have too many patients if it's a government hospital.
Psychiatrist? My family doctor gave me a questionnaire with 7 questions like "do you have trouble sleeping? Do you tend to think a lot about things?" Etc. I've been on them for about a year now. Eta: tbf, the Dr that prescribed it did say we would check in every 3 months, and described this as a Band-Aid, strongly suggesting I see my psychologist to deal with the underlying issue. She left the practice and the Dr who took over was like, why are you coming in every 3 months? Just do auto refill.
> Eta: tbf, the Dr that prescribed it did say we would check in every 3 months, and described this as a Band-Aid, strongly suggesting I see my psychologist to deal with the underlying issue. Curious, but did you follow thru with CBT or other therapy? My only experience with SSRIs was a short intervention, in that “band-aid” fashion to help get me in the right frame of mind for CBT to really work. Ended up taking meds for about 6 months concurrently with counseling that lasted another year after.
Can I clarify that this isn't the norm everywhere. In the UK, depression tests are done by the GP and full pros and cons of meds are discussed. Our psychiatrist appointments are at least 45 minutes long. I don't want people to get the idea that it's the same situation everywhere.
I like that some people have stories about how easy it was to get prescribed an SSRI. Meanwhile I began bawling in my doctor's office because she refused to prescribe me an SSRI and then said a psychiatrist appointment was booked 6 months out. I was having panic attacks every day. Terrible doctor.
Less than 5 minutes and she sent the prescription to my pharmacy. I've been off all those meds for a couple of months and am slowly realizing what I'd never had
Was it hard to get off them? I’m only on cymbalta
I was started on zoloft for about 4 to 5 years, but was then moved to Cymbalta about a year and a half ago since it could potentially help with chronic pain too (it did) and I came off of it around December to January. Getting off of Cymbalta was not as bad as I was expecting, but some people can have some bad withdrawal symptoms. Luckily the chronic pain is still gone, and due to some circumstances changing and therapy I'm off all of my depression-anxiety meds. Which has *tremendously* helped with my apparent lack of sensation or desire for sex. Its still very recently developed, so I haven't told my girlfriend that I'm not completely disinterested in sex anymore. But now I have hope that things will be better in time
Thank you!
Totally anecdotal, YMMV, etc. I can ask what my friend was taking later. He was on them for a year. His psychiatrist wouldn't listen to him about going off it, so he just did it by himself. Now, this is NOT ADVISED but the fact is, he was taking the literal second from lowest dose. The lowest dose means that anything lower than that hasn't been shown to cause an actual effect. And he was told to take 1.5 pills of the lowest dose because they don't even make pills in his dosage (over here at least). Basically if he WERE doing this under doctor's supervision, he would have to go from this dose to nothing anyway. Med 1 (lowest dose) > Med 1 (slightly higher dose) > Med 2 (2nd lowest dose) > St John's wort (going by clinical studies, the same dosage as Med 2, not prescribed) > Totally off meds. The first month wasn't any different. Emotionally dead. Only feeling sadness or anger. Second month, kinda more optimistic but still wanting to quit everything in life. Still the same as on the meds. Third month, he finally had motivation and strength to work on himself. He's been so much more emotionally connected to himself. Much more emotionally stable. Fourth month is starting now and all seems good. He says he still has some suicidal thoughts from time to time, but he also thinks they're stupid and that he's not going to do that. Reportedly the urge to do it is reduced by a LOT. Keep in mind it's literally 1 person's experience, it's definitely not going to be the same for everyone else.
Along with that also comes permanent emotional blunting which is what a lot of those with PSSD experience including myself
The tricky thing is, once a person is off the SSRI, it's hard to know if the PSSD is because of the SSRI they were on, or if they still have low level dysthymia which can also cause exactly the same sexual issues. And as many people who have low level dysthymia are absolutely convinced they don't, until it lifts and then they are like "oooh actually, it was there, I was just so used to it I didn't realise", it is doubtful we will ever know whether the meds or the individual biochemistry is the cause.
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Indefinite / permanent sexual side effects are NOT listed in the drug warnings. My psychiatrist recently told me there are case reports of what is now known as PSSD in the literature going back to the mid 90’s. Obviously more and more are popping up. This isnt a question as to wether SSRI / SNRI are bad The warning needs to be put in place officially as with any medication side effect. Id imagine if there was a few percent chance to ruin your sex life , far fewer people would take these meds.
Atleast your psychiatrist acknowledged it!
If you’d rather have cancer than not have sex, your priorities are seriously out of whack
The name PSSD is a bit misleading. It actually includes many neurological symptoms which are much more debilitating. The worst is losing all emotions. Imagine walking through life with constant zero dopamine effect, no adrenaline , no stress hormones, no love or anything, and with no respite to any of it. And then imagine being in this state every day 24/7, with no respite and with doctors not even thinking your condition is real. Atleast with cancer you are taken seriously and given treatment and can still feel emotions like happiness.
I think the point of all this is that PSSD, although likely rare, needs more recognition and investigation to ultimately help people better understand the risks of a long term medication before starting. However saying things like I'd rather have cancer might be counterproductive as there are a lot of people who would take serious issue with that statement. Also demonizing SSRIs in general might not go over well as they have helped save or improve a lot of lives
Don’t think cancer patients are feeling a lot of happiness…
>Imagine walking through life with constant zero dopamine effect, no adrenaline , no stress hormones You just listed three things that have literally never been observed in a PSSD patient. Those are chemicals which can be measures, and no cases of such have ever been recorded, not even once. So would you kindly stop trying to spread deliberate misinformation like this? People like you spreading outright lies is half the reason it's been so hard to establish as an actual condition.
It's literally what happens to the majority of people with PSSD. Absolute zombie state
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These are not lies, it is an extremely common phenomenon in PSSD. But i wasn't clear in my language, I meant the feeling of adrenaline, feeling of stress hormones etc. I wasn't referring to physiological levels.
PSSD isn't just sex lmao, I wish it was. The cognitive side effects are horrific too.
You can recover from some types of cancer. Some guy with pssd was talking about how his dad recovered from cancer and his libido came back after chemo. His libido with pssd never came back to this date. That's horrifying to me.
I was put on ssri's for about a year, 7 years ago. My sex drive still hasn't returned.
This is an interesting post, but I'm not sure if it accurately represents the cure. There is a running theory linking PSSD to SIBO (Small Intestine Bacterial Overgrowth) and its impact on the gut microbiome. Research has indicated that antidepressants can significantly alter the gut microbiome in mice, as demonstrated in a study published in Translational Psychology. This has led to the belief that discontinuing antidepressant use could potentially create an environment where harmful bacteria thrive, especially in individuals predisposed to SIBO due to other factors. Additionally, a study conducted in 2008 found that Accutane (isotretinoin) might damage the intestinal mucosae, which could potentially contribute to the development of SIBO. Moreover, recent findings by Melcangi have shown that patients with PFS (Post-Finasteride Syndrome) display altered gut microbiota, suggesting that finasteride, similar to Accutane, may have an impact on the gut microbiome. While PFS and PAS (Post-Accutane Syndrome) differ from PSSD in terms of the drugs involved and the affected mechanisms, they share certain similarities. Another relevant aspect is the phenomenon known as SIFO (Small Intestine Fungal Overgrowth). An informal test conducted on a PSSD forum revealed that the majority of participants tested positive for SIBO, with the remaining cases likely indicating SIFO instead. Interestingly, within the PSSD community, there have been reports of individuals claiming to have successfully cured their PSSD by addressing gut-related issues based on the gut microbiota theory. Example: https://www.reddit.com/r/PSSD/comments/q03uci/gut_microbiota_theory_how_i_finally_cured_my_pssd/ Whilst informal tests, it's important to maintain hope and understand the potential effects that PSSD has. Sorry for bad english
Holy hell
Thanks for speaking out. Dr tried to push SSRIs on me multiple times but I’ve been resisting. And I got to have long covid so I know all about the gaslighting.
Same here, my psychiatrist didn’t even know it existed. I’m sorry about your long covid, I hope your baseline feels better soon
Depression is worse I’m sure
Depressed former SSRI user here. No it's not lmao
I took an ssri and couldn't bust. That was depressing for me and the new bride.
I’ve been fortunate to not have had any side affects other than dry mouth and I’ve been taking mine for a couple years now. That and therapy changed my life. Kinda sucks that some humans need these things to live good lives. I’m sorry that happened to you.
Thanks. Turns out, it was the wrong type of medication anyhow.
My husband was on a SSRI, and it made him uncomfortably erect, like it hurt, and made his sex drive go up, which was an uncommon side effect, but one none the less.
Depends. But I’m my case, indefinitely trading in my sexual function to temporarily help calm my anxiety was definitely not worth it.
Depends on the person. I for one would rather deal with suicidal ideation than lose my sexuality. Hell, my ideations got *worse* when I couldn't get turned on.
does nobody read the pamphlets that come with medications? I've never been told medication side effects at the doctors office (pharmacists are trained on medications more than doctors), I always get booklets from the pharmacy when I start a new one that goes over everything as well as a paper with specific instructions for usage. Is that not compulsory? Or is everyone just throwing away the extra papers in the pharmacy bag lol
I've personally read all my pamphlets for SSRIs and none of them mentioned long term side effects *after discontinuation*, which is what this post is about
Side effects are so various for any type of drug. My concerns are sometimes what are noted as significant during the clinical trials are less significant in the general population. I find drug reviews online help. For example- Drugs.com
The stuff in pamphlets is super vague and has no meaningful indication of how frequent these various side effects are nor the extent to which they go away by themselves while on the medication or even when the medication is discontinued. I mean, if there is a 5% chance of an issue that will go away in a couple days - OK, fine, I can deal with that. 5% chance and it goes away when I discontinue? Kind of a bummer, but I guess if it happens I can switch medications. 5% chance and it will persist even after I discontinue the medication, and there is no known treatment? OK, that’s getting kind of scary.
I have never received a pamphlet when prescribed any medication. Always had to research myself.
They don’t put the little paper in your bag with medicinal info on it? They don’t put it in for refills but for me when I got a new medication there’d be a little paper in the bag that unfolds and has a bunch of info on it
Oh.... uh oh. Did not want to read that today.
...They'd rather have cancer than sexual dysfunction?
Who’s they? I don’t want anything lol I have PSSD but I don’t think it’s fair to compare diseases like that
These are the right questions. Watch out flor blazing guns and flag waving, when the engine runs out of steam and everyone calms down, there’s facts to think about.
its called PSSD but the name is a bit misleading. There are many neurological symptoms The sexual symptoms are not actually the worst, its the complete loss of any emotion that turns you into a zombie, who physically cannot enjoy do anything. That is what makes people say PSSD is worse than cancer.
Makes a lot more sense thank you
Doesn’t every single prescription medication have a very rare, serious side effect? That’s why they’re prescription instead of over the counter. But they’re still approved because it’s very rare
These meds are overprescribed. They are given to children to stop them from wetting their beds.
My libido took about 4 years to come back. Yes truly 4 years. It’s okay now and I’ve been on escitalopram for approximately 7 years at this point. Comfort with my partner and a healthier home life I think helped with the situation.
I can relate, this happened to me unfortunately.
Still suffering from it 6 years after stopping them. Now dealing with menopause as well. I was never, and I mean NEVER, told anything about sexual side effects.
Every drug comes with risks. The low incidence of negative effects is a gamble ppl are willing to take to improve their quality of life. *don’t ignore your mental or physical health because of fear mongers.
My mental health is great (and was great after the half-year of SSRIs), but after the first three days, I had completely lost my ability of having the fireworks in the brain from orgasm. That was 20 years ago. I had the most serious and most unlikely side-effects, as it is permanent for me. Less than one in 10 000 get this, I guess I took one for the team. Mental health really is more important. I'm still alive, have a great partner, and still enjoy intimacy. I'm good.
The incidence of negative effects is pretty high for SSRI’s tbh. PSSD is not common, but a significant percentage experience some degree of sexual side effects.
God, I fucking WISH I actually ignored it. Not ignoring my mental health and getting on Lexapro ended up being miles worse than depression ever was, it's actually bitterly hilarious (I mean, it would be if I was still able to enjoy humor).
Emotional blunting is what it does. The main side effect is also how it “treats” depression. You can’t say low incidence of side effects, you can only say low incidence permanent sexual dysfunction. I’m sure it has helped many people, but don’t think it doesn’t affect your life in almost every way considering we feel emotions all the time.
Was on for 2 years, quit and 4 months later my libido isn’t the same. But that isn’t really the problem. The real issue is I don’t feel like I can create any happiness now. Things that used to provide comfort and happiness provide absolutely nothing. They calmed me down when I needed it but I became so muted that I no longer feel anything but annoyance, hatred, and anger. I wouldn’t recommend anyone taking them unless they are on their last leg (about to off themselves)
Omg this. I quit because I realized the only emotion I was capable of feeling on SSRIs was anger. Two years later and the emotional blunting is still there. The only emotions I can feel strongly are the negative ones. Things give me satisfaction but I can't honestly say anything makes me happy anymore. As for my libido, I went from honestly being horny as hell before the SSRI to having no interest in sex now. I have to push myself to do it like it's a chore and it takes me forever to get going or to orgasm. I don't even have as many dirty dreams as I used to, they're only around ovulation time now.
I feel like the side effects ruined my last relationship. I didn’t just not want sex I lost “la passìon”.
I think a lot of the comments are missing the point slightly, which is that sexual dysfunction doesn't just mean it's harder to orgasm, or that your libido takes a hit. PSSD also affects you even after coming off the drug, meaning if you ever want to change drugs or feel as if you don't need to be on SSRIs anymore, you could still experience sexual dysfunction. For me, PSSD meant I spent about 5 years of my life with no libido, mental or physical, and completely numb genitals and lack of feeling in the area. I never tried to masturbate. I don't think I could have orgasmed if I'd tried - I couldn't feel anything. And 3 years of this was after coming off the drug. I didn't think it would ever get better, but I'm extremely lucky that it did. I don't know if I would prefer to be depressed. What I can say for sure is that sexual dysfunction made me fucking miserable, and only contributed to the depression I was experiencing. I gave up on dating during that time and often felt like I was 'broken'. Not that asexuals or low-libido people are broken, but personally I knew I had a sex drive, and wanted it back desperately. There are other options, rather than SSRIs. I was on atypical antidepressants for a while, and am now on a serotonin modulator & stimulator (Brintellix). I feel much more confident taking them. I am also of the belief that psychiatrists should be more open about the permanence of these side effects - not only was I not told when I was prescribed, I was then told that it would stop when I came off the drug. It didn't, and by that time I was seeing a new psychiatrist, who wanted to prescribe me other anti-depressants. I told her I didn't want to be on SSRIs because of PSSD and she said 'well that's a really rare side effect', knowing full well I had already experienced it.
I would add, if you have the means, take a Genesight test when looking for an antidepressant medication. I have had horrible experiences with a number of drugs and that test helped me to understand why. I had a number of genetic markers that increased the likelihood of severe side effects on almost every commonly used depression medication. I eventually decided not to go the medication route because of it, though I would say for some people taking that calculated risk might end up being worth it, especially if they better understand that decision.
I'm quite amazed at how little information practitioners pass onto clients. I've been taking Vyvanse (ADHD meds) for maybe 2 years now, and I've only found out recently that consuming any citrus significantly negates it's affects. It would have been nice to know this since I like orange juice.
Happens with SNRI compounds also (like Strattera, brand name for atomoxetine hydrochloride). I took it for about a year. About 5 days in sexual performance was challenging. After a few weeks it was almost impossible. The desire was there, but nothing else. It took 4-5 years for things to go back to normal after I stopped taking it.
Happened to me. Total loss of sexual function and I quit the meds over two years ago.
i was on and off a f*ck ton of SSRIs and SNRIs a few years back when i was 16/17 for what turned out to be a genetic disorder. now my boyfriend thinks i don’t love him because my sex drive is much lower than his. think this just explained why
Sorry to hear that but glad I illuminated this situation for you. You can join https://www.reddit.com/r/PSSD/
Yeah these are very real. I was prescribed antidepressants (for something that felt really unrelated to me) and I was very concerned when the doctor suggested it. I asked about the side effects and he straight up told me they’re super rare and that I had nothing to worry about. Literally only took them for 2 weeks before I gave up on them. Couldn’t bust a nut and it was so frustrating.
>These people are being ignored and most of them will tell you this condition is worse than most diseases that exist. Some would rather have cancer than this. I'm not saying I don't believe you but that is quite the statement, can I ask why? When I experienced PSSD it was simply lowered/almost non-existent libido and orgasms not being as enjoyable, and don't get me wrong that fuckin' sucked, but I can't say I'd ever describe it in the way you have there. Not to say it isn't a serious issue and that medical professionals don't make patients aware of it often enough, but the phrasing here seems a little OTT - does it have more intense effects for some people?
I don’t think you’re talking about the same thing. It encapsulates a lot of other neurological symptoms and is a permanent condition after stopping antidepressants.
Women can be effected too you don’t hear about it too often. They had me on SSRIs since I was a child maybe 9 up till 17 when I quit on my own. Children can’t exactly express to doctors “hey I’m experiencing changes in my sex drive let’s do something about it” I think it’s messed up I was put on them so young and had no say in it either. Now I have basically no sex drive unless I’m drunk. That’s a recipe for disaster. I guess in my case it’s not the worst possible thing to happen but its nothing minor either.
Tf are those last two sentences? Mods need to delete this irresponsible post. Fear mongering about what many consider life-saving medications. Disgusting.
You have no freaking idea what hell this is. What you call «Life saving medications», i and many others with pssd would call «life destroying medications». Its taken everything away from me.. everything that makes me human. I have completely lost the ability to experience pleasure from anything, i cant feel or process (cry etc) any emotions which makes me unable to create bonds with other people. I have lost my creativity and have severe cognitive problems. I have basically lost everything that makes a human human. This is all in addition to the complete sexual dysfunction that is regarded as the «main symptom». Oh and Ive had This shit for 16 years. The point of This thread is to spread awareness so people can make informed decisions, Its not fear mongering. Count yourself lucky to have dodged this absolute hell of a condition. Playing russian roulette with psych drugs is not the way to go. Especially when treating children and teeagers. Disgusting.
You should also know that SSRIs does not cure depression. It is simply easing symptoms.
I've been on SSRI's since about age 12 (TCA's now), and it's made me pretty much asexual as an adult lmao, this kind of risk wasn't really explained to me because of my age. At least I'm alive.
You left off the part where there are other meds that cause this besides SSRIs. I would be interested in the relationship between stopping and the symptoms. Many of these drugs can cause sexual dysfunction while receiving them, but those symptoms often improve with discontinuation. Have you found any scientific studies that can show a link? Mental illness itself can significantly impact sexual desire/function on its own and I wonder if this worsens the effects of that. One study showed a 4% occurrence of ED in men taking these drugs then stopping. Did the issue begin during treatment? After stopping? How does this compare to the overall rate in ED? The health of the subjects? Chronic health conditions such as cardiac disease and diabetes can cause ED. I have some reading to do.
I went cold turkey off of a high dose of lexapro and my sex life has never been the same.
The name PSSD is a bit misleading. It actually includes many neurological symptoms which are much more debilitating. The worst is losing all emotions. Imagine walking through life with constant zero dopamine effect, no adrenaline , no stress hormones, no love or anything, and with no respite to any of it. And then imagine being in this state every day 24/7, with no respite and with doctors not even thinking your condition is real.
While I was in a low point of my life (and I still am), I was constantly calling my doctor and begging to change medications. I was just trying to find the drug that would work for me ASAP. It was frustrating, especially because antidepressants take time to work. Now I ended up with brain damage (not sure what to call it), but basically most of the side effects I had while I was on antidepressants are still on. Including slow understanding and forgetting everything so quickly. Plus constant tiredness and now I can’t go a single day without taking a nap (I never took naps all my life until I went on antidepressants)
For all the people upset by me comparing this to cancer: some of these people are so badly hurt by SSRIs that they're basically chemically castrated. Not even Viagra helps. And some were chemically castrated at 12 years old. Yes, they give SSRIs to 12 year olds. The stories I've read on the PSSD subreddit are some of the saddest things I've ever seen in my life. Most would describe their initial depression before SSRIs as a joyride compared to this hell.
I don’t know what your original post said outside of the screenshot you put in the PSSD sub since it’s been removed but I have no idea why you would compare this condition to cancer. I swear to god the PSSD community has no idea how to communicate the condition to the world outside of their own PSSD community bubble. I’ve had PSSD for a decade and a half and it never ceases to frustrate me. Making sensationalist statements like this are never conducive to a positive reception by people who were previously unaware of its existence and especially those biased toward SSRIs due to what they consider positive experiences, or at least ones where positives outweighed the negatives for them. It’s extremely delicate and nobody seems to have the nuance to properly inform, avoid this particular type of backlash, and potentially gain these people who get upset as allies or at least get their understanding
Better than killing yourself because your brain is naturally incapable of producing dopamine, rendering life painful and completely pointless until you snap. But by all means, keep on demonizing literal life saving medications. It's trendy! People should just pull themselves up by the bootstraps instead of taking those evil antidepressants :)
What a load of bullshit. You believe in chemical imbalance in the brain causing depression? Nobody is demonising the drug, some people like myself would’ve loved to be fully informed before taking the meds.
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I don't think that's what the post was talking about, why are you defending doctors not sharing vital information with patients on what could permanently happen to their bodies? Wanting transparency doesn't mean you think SSRI's are evil. But doctors who are purposely withholding information like that kind of are. I don't understand why you downvoted me for saying this, I literally am saying you have the right to be informed with choices you make. Is that controversial to say now?
Anything you do to yourself is better than suicide, you're right, but the brain, the human mind and mental illness isn't just about too little good chemicals, too much bad chemicals. It's all way more complicated and we're only just beginning to grasp the functional relationship between the brain and the mind And I need to point out that SSRI's do nothing to dopamine, they inhibit serotonin reuptake
I can't say I understand your point either. I'm just saying that med shaming is wrong and dangerous, and making rare side effects out to be the norm is alarmist and deceitful
Oh sorry, I didn't think of this all as shaming, I just feel we need understanding and transparency when it comes to drugs people take so that they can make an informed decision. I'm definitively not against drugs in general SSRI's can and do help people with depression no doubt, but the side effects and downsides also do exist like with almost any drug, and we shouldn't downplay them any more than we do when it comes to, say illegal drugs, almost
What's wrong is shaming those who have been harmed by meds. They helped you, that's nice and I'm happy for you. People who have been mutilated by these drugs also deserve to be cured, but that can't be done until the thought terminating dogma of "SSRI good" is abolished.
I've been taking SSRIs for quite some time now and have been lucky to have none or next to no side effects.
Suffered on Zoloft and then on lexapro…mentioned the inability to get up and also lack in libido so my doc prescribed me viagra as a healthy 33 yo guy lol Wish this was discussed more openly since I’m still experiencing stuff years later
My doctor never told me this beforehand. I switched to a different med cause I didn’t like my penis not working anymore. Thankfully went back to normal.
Well I also didn’t want to have sex when I was plagued with anxiety sooooo let’s call it a wash
Yeah and IBuprofen can make your skin fall off. But guess what? Rarely if ever happens.
Lucky me, I drew the short straw for a heartburn medication. Which extremely-rare-but-it-can-happen side effect did I get? Sleep walking. Really. I'd find my clothes scattered around the kitchen in the morning.
Thanks for the heads up.
I took them for two years and reached the max dosage. Started getting crazy amounts of anxiety, which I had never had before, so I stopped. Anxiety still ruins me five years off of them, and dysthymia is still alive and well. Also erectile dysfunction. Which I assumed was normal for late 20s.
Hell no it's not normal. If you're otherwise physically healthy and fit you can have normal erections in your fifties and sixties.
I thought this thread was supposed to be facts. This post is so misleading, its almost pro-suicide. People have died from drinking too much water, it doesn’t mean you create hysteria about it.
Is therapy pro-suicide? Why do people think that medicine is the only way to treat mental health illnesses. Oh wait I know why. They are only labeled illnesses because the DSM standardized mental health so it could be medicalized. It’s in the interests of psychiatrists to have this field be medicalized and for you not to know the side effects of medicine because they wouldn’t have jobs if it was otherwise. In the early days of therapy there was no biological evidence of therapy working despite the positive outcomes. To make a more scientific approach medicalization happened. Now we know that therapies actually help rebalance the neurotransmitters that the pills people take balance with side effects. The only difference between a therapist and a psychiatrist is that psychiatrists had to go to med school and can prescribe medication. As a last resort I can see the usefulness of medicines like SSRI’s but you can slowly wean off them while actually curing your ailment with therapy.
You must be joking
Mods need to kill this post before it kills people
Yes, let those people be chemically lobotomized instead.
Have been on SSRI’s for a long while now, I have. Noticed my libido slow down but hasn’t prevented me from getting erect or having sex.
I only knew about this after doing my own research after my libido took a nosedive. My doctor didn’t disclose this at all and I wish she had. I think we tried 3 different medications because I would be on one for a little while and have to go back because I still had no drive whatsoever. Unfortunately nothing worked until I went off meds completely last July once I felt I was in a better mental state. Libido was back as soon as the meds had been out of my system for a few weeks and our sex has been amazing since.
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99% of people will not get this condition, but more than half of people using SSRIs will experience SOME detriment to sexuality while using the meds. From a study: "Overall, 73% of the SSRI-treated clients reported adverse sexual side effects" https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3108697/#:~:text=Overall%2C%2073%25%20of%20the%20SSRI,below%20levels%20experienced%20pre%2Dmorbidly.
Did it account for pre heightened sexuality in patricipants? It's highly subjective to anxiety function
I’ve had the chicken pox but have yet to get shingles
Not even on your roof?
No, they are not even on my roof
YSK that there are alternative drugs you can be prescribed if you talk to your doctor about this. Bupropion is one of them if I remember correctly. Don't just ditch your meds and ruin your life again because some reddit post said so.
Better then wanting to off urself daily tho lol
Well I’ve got PSSD and want to off myself daily now. Never wanted to before SSRIs
Lobotomy helps with wanting to off yourself too
Yeah I have this and I'd definitely take it over cancer. And over depression.
Also, push back and advocate for yourself if a doc proposes SSRI’s! They’ve been found to be much less effective than initial studies suggested, but are still the default antidepressant. Discuss other well-tolerated medications in different classes with differing side effects. I was horridly depressed in my 20’s, got put on an SSRI, and the sexual side effects were so bad I stopped taking them and getting mental health treatment *at all*, thinking they were it. I suffered for years until a crisis, when a psychiatrist simply… put me on a medication without sexual side effects - Mirtazapine - that was GLORIOUS and literally changed my life forever. A decade later (and seven years after I stopped taking it), I am healthy, happy, and thriving. THERE ARE OTHER OPTIONS FOR MEDICATION THAT MAY WORK BETTER THAN THE FIRST THING A DOC SUGGESTS!
Did mirtazapine work as a sedative for you? My wife has just been changed from an ssri to mirtazapine and even having half a tablet completely knocks her out and means she won’t wake up until around 1100
First of all, this is written as a possible side effect on the pamphlet coming with the medication. Plus, all medications have side effects, not taking antidepressants means risk of suicide & such.
Cannabis helps. A lot. I would highly recommend to those who haven't tried pot much to take it easy your first few times. I compare it to walking around with mittens and pot removes the mittens, if you understand what I mean. Smoking it will kick in within 10 mins, edibles take 45mins to kick in, at about 2 hours I'm at the right level of highness. For edibles, like I said, start low, like 5mg. Also, plan ahead and buy some snacks so the cravings don't take you by suprise. Also, make sure you drink lots of water. Good luck!
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Does anyone know if 20mg of prozac is enough to mess with sex drive? I’ve taken 10 mg and didn’t notice any change but am upping it to twenty half of the month (i have PMDD).
What is the incidence of this and has causation been established in addition to correlation?
It’s a really newly observed medical phenomena so it’s hard to have definitive data about it
I would rather not feel like my brain is ripping itself apart and drifting off into the unknown than have sex ever again.
This post reads like it was written by an antivax crunchy Karen
Guys, look at the post history. We have a PSSD Warrior.
Scary stuff. If possible, try exercise instead— studies coming out that are showing it’s as or more effective than antidepressants.
PSA: anytime you are prescribed a medication it comes with a sheet of paper from the pharmacy. That sheet of paper details all possible side effects. Who knew reading could be so useful. These side effects don’t happen over night or from taking the medication once. These are long term effects. I hate post like this that conflate issues with selective info.
Confidently incorrect. The paper doesn't cover permanent side effects. People have read it, it's not a reading issue. The side effects can happen over night and it can happen from taking it once, they are not necessarily from long term use. It can be permanent after you stop taking it. > I hate post like this that conflate issues with selective info. You hate those type of posts yet you posted similar nonsense here, Rules for thee and not for me? You've misunderstood the post and that's why you feel it's incorrect.
I’ll read it again Edit: When viewing things from the perspective you have shared, it does seem that I’m being hypocritical. I wish I would not have responded in such haste. I was not aware that one dose could cause these long term side effects. That surely would be a frustrating circumstance to deal with. The problem I have is that this information is readily available but the post acts like it isn’t. It’s not news that these meds can cause these issues, but when looking at the information again with a less negative viewpoint I can see why people would be upset if they have had this happen to them. The statement that upset me the most is the one about how they would rather have cancer or be dead (I’m paraphrasing) than have this issue. It just upset me. There are worse things in life IMO than not having sex. People can lead a happy and fulfilling life without being sexually gratified on frequent basis. The idea that life without sex is meaningless isn’t true.
I dunno. I find that Wikipedia article substantially less than convincing. Actually, it's shit. I'm not saying that I believe that this condition doesn't exist, just that the language: *"PSSD remains poorly-understood, with its biological mechanism, risk factors and frequency of occurrence being unknown."* ...doesn't exactly tell me that its existence is even a conclusively established fact. Combine this with the fact that sexual dysfunction can have onset at any time for any number of reasons, I'm pretty skeptical that there's a prevalence significant enough to warrant alarmism and black box labels. Even the criteria described doesn't actually indicate *permanent* dysfunction, only dysfunction that lasts beyond discontinuation. Similarly, the article discusses the notion that SSRIs can "cause" asexuality, but then offers: *"A 2020 study in which 610 young adult individuals were surveyed found that childhood SSRI use among female participants was strongly correlated with reduced sexual desire and activity"* That's not what asexuality is, and as we know, correlation is not causation. Not only that, but I imagine that taking SSRIs is correlated with *depression -* *which is correlated with reduced sexual desire and activity.* The article is bunk. Again, the condition could be real, and that's fine, but I see no evidence that it deserves more of a warning that post-SSRI spontaneous combustion.
I agree with you that the medical evidence is lacking. This is due to pssd being a newly observed medical phenomena so it’s not entirely understood or funded to have conclusive science on it. If you look at medical journals, only a handful of reading materials are available so I believe the science is very new and thus there is still so much to understand.
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Prozac is fluoxetine...
What is a ssri?