Post SSRI sexual dysfunction. SSRIs cause decrease in sexual function for most people who take them while they're on them, but for some, it's permanent. There is no effective treatment, you are stuck sexually dysfunctional for the rest of your life.
Doctors do not warn you this is a possibility. Just bam, no warning, life ruined forever.
Since we’re being honest, the only effects I’ve noticed are going soft after 20 minutes or so, and more difficulty finishing. Sidenafil helps with the former. As for the latter, it isn’t every time, and I don’t mind it much, but everyone’s different.
I think it’s important to address this issue head on though. The horror stories of sexual dysfunction were one reason I put off trying antidepressants. But (a) you’ll see the effects coming on gradually, (b) it’s not permanent, and (c) for me it wasn’t nearly as intense as people made it seem.
If yours goes away when you stop taking SSRIs, then you aren't suffering PSSD (post SSRI sexual dysfunction) in the first place.
From https://annals-general-psychiatry.biomedcentral.com/articles...
> A 19-year retrospective cohort analysis was conducted using a computerized database of the largest HMO in Israel. ED was defined by phosphodiesterase-5 inhibitors prescriptions. 12,302 males aged 21–49 met the following criteria: non-smokers, no medical or psychiatric comorbidities or medications associated with ED, no alcohol or substance use.
> SAs were associated with an increased risk for ED (cOR = 3.6, p < 0.000001, 95% CI 2.8–4.8), which remained significant after adjusting for age, SES, BMI, depression and anxiety (aOR = 3.2, p < 0.000001, 95% CI 2.3–4.4). The risk for PSSD was 1 in 216 patients (0.46%) treated with SAs. The prevalence of PSSD was 4.3 per 100,000.
4.3 per 100k is lower than the US murder rate (6.8 per 100k). You’re right that it’s a consideration, but it seems pretty rare.
> Out of the 866 subjects of the study group, four subjects (0.46%) met full case criteria for PSSD (see Fig. 1B). These subjects were 32, 34, 37, and 42 years-old. They used antidepressants with at least a partial serotonergic mechanism (escitalopram, paroxetine, imipramine, or nortriptyline) for 4–8 months before initiating treatment for erectile dysfunction with PDE-5 inhibitors (all used tadalafil and vardenafil, but not sildenafil). They continued to have erectile dysfunction after drug discontinuation as evidenced by 3.6–14.8 months of PDE-5 inhibitor treatment at the end of the study period. The prevalence of PSSD in males of ages 21–49 years of the population of the CHS Tel-Aviv district is 4.3 per 100,000 (4 in 92,476).
4 in 866 is pretty good odds, but everyone has different risk profiles. I’ll be sure to mention it next time Prozac comes up.
I got to watch in real time as my libido evaporated, immediately desisted the pills and yet...
I say this as someone who kept his SSRI induced asexuality to himself for 20 years; I was ashamed and humiliated.
Zyban though, somehow that made girls pretty again.
And mushrooms dragged me back from a long bout of suicidality with a single dose.