Hello - my story

[magnilo]

Hello Folks
Im new here, just signed up on this forum. I've been active on numerous other forums, mainly on longecity and on depressionforums in topics related to anhedonia.
My story, short:
fairly depressed teen with social anxiety issues. at about 23yo i decided to start prozac. Took it 8 months, depression was relieved by a lot, at which point i decided i wanted to get off this crap. My dick wasnt working and my GF was pretty aggressive about the situation. I had also never told her until later that i was taking that stuff, probably that was a mistake. The issue is, the genital sensation never came back. I am feeling anaesthetized down there still now, about 10 years later.
I do have a fairly good libido and i masturbate quite a bit, but even then, with my rythm and looking at porn, it can take long. and im speaking one hour long. As i am pretty decent looking and relatively nice to talk to, i have had a decent number of sexual partners over the last years. I am sorry to say that i might have reached orgasm by "normal means" a handful of times in maybe 200 rounds. most of times i dont climax, which is not so pleasurable for me and very distressing for the girls. One thing that i noticed, sorry if its a bit filthy, is that my sensation around perineum, mostly near the butthole, has been left unchanged. It is much easier for me to reach orgasm if a girl licks me down that region.


The symptom list is the following:

genital anaesthesia
anorgasmia
difficulty maintaining an erection - (due to the lack of feeling, my dick goes limp again after 5-10 minutes)
less morning woods and spontaneous erections

Before i proceed into listing the things i tried and what is left for me to try, i would like to speak out one thing that has been in my head for a while.

Could it be that i am still just depressed? We know that anhedonia is a typical symptom of late stage depression, when your brain starts shutting everything down to preserve yourself.
I had trialed nsi 189 lately and while it did not do anything for PSSD, it kicked me out of anhedonia pretty good. the point is, i mostly felt sad. I had good reason at that time because of a pretty fucked up romantic experience, but still, i felt emotional pain to a large extent, and thats all there was to it. NSI189 does not have apparently any sort of SERT MoA.

anyhow, lets proceed, i wanted to keep it short:

diagnosed by my shrink is the following:
Dysthimia with ADD-Pi

THINGS IVE TRIED:

ADs and stims:

Fluoxetine (SSRI, prozac) - good for depression, but kicked off this whole tragedy.
SJW - cant recall exactly, but i dont think it did much
tianeptine (Mu) - nice for memory and noticing colors more.
Reboxetine (NE) - time slowed down, felt weird but somehow relaxed, my penis shrinked as a babys and i would start ejaculating before orgasming. just plain WEIRD.
methylphenidate (ritalin, DA) - good to speed up brainprocessing and to work as a machine
Moclobemide (aurorix, MAOI reversible) - very good for energy levels and enjoyment of life, made the sexual aspects a bit better, but nothing for genital sensitivity)
Bupoprion (wellbutrin, NE/da) - didnt do shit and made me just nervous, no effect on libido even at 300 )
Modafinil - somehow interesting, sort of nootropic effect, nothing for PSSD)
NSI189 - good for anhedonia and creativity and motivation . no effects on sexuality, which is a plus.

Supplements: the list is long im sure im gonna miss some

yohimbine - makes me nervous and sweat a lot, no great effect on libido sadly
pseudoephedrine - this is nice, as i have often issues with swollen nasan canals that impede me from breathing nicely. This fixed that issue, and is a stimulant for the body. I had the impression i could climax easier with it.
maca - this is good in high doses combined with zinc
ginseng - this is nice and helps with energy levels overall
rhodiola rosea - nice for energy levels and motivation, apparently MAO-B inhibitor
bacopa monnieri - surely serotonergic, good for memory and cognition, bad for sex
ashwaghanda - slightly sedative and slight improvement in sensation

Other things:
TRT - numerous hormones panels showed my testosterone was in normal range but on the low side, so i tried testosterone replacement therapy for a while, which made erections much better
Tadalafil - Cialis - helps a lot with maintaining an erection, but does not improve the sensation and i still can not reach climax.
MRI Scans - i did a couple of MRI Scans to assess that my spinal nerves and nerves in the pelvic area are not damaged. The first time i did it nothing came out, now im doing a second one with contrast liquid, results will come soon.

I've just recently decided to go "the PSSD way", instead of focusing mainly on ADD and depression. the feeling is like being there but not feeling anything, like being anaesthetized mentally and phisically. I perceive things but they dont affect me as they should. I also have difficulty listening to people and understanding what they say, often. Its like my brain is disconnected very easily.

anyway, the last list, things i would like to try:
trazodone - this is what im on as of now. got prescribed by my shrink after i got heartbroken and couldnt sleep more than two or three hours straight. also causes priapism and an improvement on erections, which i still have to see honestly... It causes great somnolence and drowsiness upon waking up, which is why im tritating slowly. now at 100mg and its getting better. aiming for 200mg a day. Also, please if someone is still reading and can be bothered, i think that trazodone has partially an opposite binding profile for some subreceptors compared to fluoxetine. could this mean it could reverse the situation?

mirtazapine - this is what id like to try next, as apparently for some people it lowers the threshold for reaching orgasm. could be exactly what i need. the irony is that the girl that gave me all these issues lately was named exactly mirta... that would be pretty stupid if the med would fix my issues!

Inositol - ive been reading that doses from 12 to 18g a day could help. i had tried inositol before but at dosages of idk, 2g a day?

going back on some SSRI that is not fluoxetine - this is something ive read around the internet, couple of people with PSSD reporting that it helped them a lot. I was thinking of brintellix (vortioxetine) as it is supposed to give mental clarity and intellect back to the user. This is the most strong aspect of my actual depression, the impression that i am becoming growingly more stupid in terms of understanding abstract concepts, memory, interest.

As you can see i am pretty serious (for the most critic - obsessed) about this. Not only the PSSD, but the persistent lack of motivation, energy, and ghastly anhedonia.
If anyone has any other ideas for things i could try, PLEASE tell me! Sadly my cerebral capacity is being heavily impacted over the last year or two and i have difficulty understanding all that receptors mumbo jumbo, altough i would really love to as i believe it is necessary to try and predict where it makes sense to focus efforts, and time. What should come first and what last. Ive already wasted 10 of the best years with a half limp dick. Ive got about 10 left. It is a serious situation as there wont be another chance.

[Ghost]

Welcome to the forum! Glad that you are here!

[jaiho]

Have you tried Ketamine? That worked for me. But long term use is difficult.

There are some people trying microdose of SSRI. Personally i went back on normal doses of SSRIs, with augmentation to stop sexual side effects. (Nortriptyline or mirtazapine)
Thats the only way ive been able to get my erections, sensations & libido back.

But everyone elses experience will be different, important to note. Just letting you know what worked for me.

I also tried NSI-189 which is great for anhedonia but doesnt improve sexuality.

[Jaxx]

Thanks for your elaborate story! There is a nice topic about SJW here, which actually helped me for a short window. I still think there is definately something there, might try it again later myself.
For anhedonia (and shrinkage) ginkgo somehow seems to help me, also a safe and cheap thing to try maybe.

Hope this community will help you further!

[magnilo]

Hi all and thanks for the warm welcome!

@ghost: glad to be on board

@Jahio: Hi, thanks for the suggestion about ketamine. Have you had first hand experience with this? maybe there are some university studies on that i could partake, or i will ask my shrink. I live in a big city in a pretty research-happy country, that could help...
I remember you from the other forums i think, you have a jacktorrance image on df and some hooded-thing on longecity, if that is the case, i think you have claimed many times to have found something that works for you, but i keep seeing you around messing with other stuff Im just trying to understand, why? Which one would be your "FINAL" reccomendation, disconnected from time and space and only in retrospective? I am also thinking of trying the SSRI + mirtazapine way. or nortryptiline (i really dont need the sedation bit).... which one would be a better augmentation? Do you have experience with many ssris?

@jaxx: Thanks for the gingko tip, i had completely forgotten about that one! it was one of the first supplements i trialled, together with gingseng, as apparently they are synergistic. I did notice it had some cerebral impact, but i cant recall anything for the genital issues... back then i wasnt paying attention to that bit so much. But it did improve my cognition a bit. that is sure! and about SJW, i gave it quite some trials like 5 years ago, but again, wasnt paying too much attention to aspects other than depression/cognition etc etc... oh man the list of "what next" is becoming long again

[magnilo]

Started vortioxetine 10mg today, quit trazodone 3days ago

[magnilo]

6 July update:

Meanwhile ive quit vortioxetine, i took it for 5 days at a 10mg and after i noticed i was feeling number down there, ive tried to cut back on the dose and see what happened, so i took 5mg a day for another 5 days. Nothing changed so ive stopped taking it fearing it would do more damage to my partially recovered system... of course it was very naive to expect reversal in 5 days considered the halflife is 66h... anyway.... I have to admit i did feel better cognitively, more fluent and snappy.

After that ive let a week without trying anything.

I have now been taking St Johns Wort for 10days at a 650mg a day pace, and plan to double that for the coming week, and then maybe triple that. I think its Ghost who pointed out that people who "lost the magic" for MDMA use SJW to regain it. That imho is a pretty solid checkpoint to see if it has an effect. Personally I did MDMA years ago and i always tought i got left a bit braindamaged from the substance, in form of impaired memory. What if its not permanent brain damage but just a receptors thing? Anyway, i did try MDMA again three months ago (which i really did not want to but GF and my friend were really pushy), and i did not feel any euphoria. I was just extremely forgetful and i lost my cellphone twice, which had not happened once in the past two or so years.
So i think this was really a good reason to start SJW! And i do not plan to do MDMA after that to doubleproof

Anyway: Yesterday or so, at about day 8, I did feel a bit more emotional when reading a book. There was a sentence building up to the point where the main characters eyes started to get veiled in tears and i was surprised to feel moved by the whole crescendo once i had finished reading the sentence.

I personally would love to believe that im not influenceable or prone to placebo effect, but if i think back to all the things ive tried and to how many times i tought i had finally found a panacea, and to the fact that i am still here looking, I fear it might not be the case. I fear i am really just very eager to try and combine new things, without giving those things time to work on their own properly and muddying up the results.
So now I will be trying hard to stick only to my actual stack for a while. Which is:

"maintenance stack":
-Zinc+Magnesium
-Maca
-2.5mg testosterone gel every 2nd day
-1300mg total SJW/day
-3g Inositol


other thoughts:
I am also trying to cut down on masturbation and on porn consumption to see if it does have an impact. AFterall the whole "yourbrainonporn" mumbo jumbo has a fair number of "disciples" who swear it changed their life around. And also, i have to admit, ive been consuming a lot of porn for a lot of years, masturbating quite a lot. In all honesty its not something I can simply dismiss in good conscience.

Also, In retrospective, i am considering that if this stack does not help me maintain an erection for long enough, i might considering adding a microdose of trazodone. i am thinking 25mg a day. 50 already has too much sedative effects...
Could anyone be bothered to investigate its interaction with SJW?

I've realized that maybe it if worth investigating more into gingseng, gingko and other more uncommon supplements which i had already tried in the past but without paying too much attention on the PSSD, as i was way more concerned about the depression i had at that time. Others that can be interesting are in my opinion forskolin, gotukola, (yohimbine i will mention but for me its way too agitating)

I've also been thinking of trying to quit the pharmaceutical side and stick to over the counter medication for a while. This is because I've met a girl that i really like and i want to be honest with her, but i also dont want to mention the plethora of "psychiatric medication" that ive been on. that sounds terrible right? the stigma is still huge.

[Miguel29]

Magnilo,

Can you tell me more about the Testosterone gel that you're taking? What were your T levels at before starting with the gel? Do you believe that taking an external source of Testosterone is likely to shut down your natural ability to produce T?

I recently went to an Endocrinologist because my T levels were quite low (9nmol or 260ng/dl) and he believed that even at this low level it was not advisable. Mostly because it would mean that it would likely suppress natural T production and also because t would mean a lifetime of treatment if once I started. He also suggested that it might not improve any symptoms like low libido or ED. But clearly this has not been your experience.

You said you noticed an improvement in erectile strength, did you notice anything regarding libido?

[magnilo]

Not much regarding libido, but that has never been a problem for me. I get horny very easily, its just the functional part that has issues..
Informations about endogenous testosterone suppression are scarce and unprecise. I used to take 50mg gel (5mgT) a day for a while, then realized it wasnt that helpful FOR DEPRESSION and, afraid it would suppress my own production, i stopped.
then i went back to the doc a year later and asked if it was possible to take it at a constant low dose so that it does , like day on day off, and i tried that and had my blood drawn on a morning where i did not take it since a couple of day, and it was apparently in a good shape. In all honesty i have no clue how fast it flushes out or if that blood sample was meaningful in any way, but my doc seemed to be happy and tought i might continue as an adjunct treatment for dysthimia and ed...

In all honesty i am also very skeptical and am not very convinced about continuing this...
apparently you get a shot of hCG at the end that should kickstart it once again in the eventuality it stops, but from what ive gathered the least you do it the better.

[Glitch]

Hey man, we all sympathize with you here. Welcome to the forum!