David Healy article

[popike27]

David Healy posted an article about PSSD and small fiber neuropathy:

https://rxisk.org/pssd-withdrawal-small ... europathy/

Has anyone tried quantitative sensory testing or skin biopsy ?

[marsupial]

I underwent sensory testing in dr. Goldstein practice. My penis was similarly sensitive to vibrations as my hands but totally numb to heat and cold

[sylv]

Small fiber peripheral neuropathy doesn't fully explain the emotional blunting (incorrectly called anhedonia ) , the symptom which commonly occurs during the SSRI treatment and according to many polls and questionnaires affect 70-80% of PSSD sufferers. It seems that a pure, isolated persistent sexual dysfunction is just an another, rather rare, variation of the primary disease.

To cause the peripheral neuropathy, the SSRIs should have been directly neurotoxic and this effect has never been proved. It would be rather "neuroplasticity goes wrong" in their case

Of course there are some strange sensations ( general and genital anaesthesia, changed nipple sensitivity, sensations in forehead, brain zaps) however it's more convincing that they may have their roots in a higher order region, possibly insular cortex which integrates the sensory and emotional content. It is the region full of the serotonin transporters, very plastic and complex - so easy to disrupt by such a blunt tool like SSRI. And some kind of disruption is already proved by the data from basic research. Partial recoveries and "windows " speaks also against any permanent nerve damage

[hs1312]

I think this c fibre neuropathy can explaon the skin numbness. Dr waldinger also published a paper in which he used laser irradiation to help a patient with anesthesia. But cfibre neuropathy is not the only major cause of pssd. As it does not explaon the loss of libido. Erection problems etc. i think multiple systems are messed up

[Marksanchez397]

If Healy is right this could be the cure:
https://www.google.es/amp/s/www.news-me ... pathy.aspx
https://www.sciencedaily.com/releases/2 ... 155538.htm

[Ghost]

I'm going to look into it more after my exams. I have always had a problem with this theory, but I'll give it a fair chance.

One (minor) critique I have is that he still calls it withdrawal. I know that might seem small, but when I joined the forum in 2014 it was still common to call PSSD "ssri withdrawal". I'd like to think I've helped change that. It was a term from the old sites like paxil progress where a lot of people didn't really know what was going on.

Giving healy benefit of the doubt, maybe it has different connotation in the UK, or maybe he still writes for people who were around the forums a decade or so ago. Either way, I don't believe it's medically correct.

It's not the withdrawal from SSRI that is our problem, it is the changes FROM the SSRI that persist long after we stop.

[hs1312]

I think its a sound theory atleast for loss of skin senstivity and numbness. I know we hve other problems also which leads to lower libido and ed. But atleat for the skin senstivity he makes sense. Dr. Waldinger also told me about this c fibre hypothesis. I am not sure if there are proper treatment options for c fibre neuropathy available . Or does the small nerves heal on their own over time

[JayR]

Rho-Kinase (ROCK II) is involved...we've discussed on HackStasis the best bet may be to use a Growth Factor Peptide or something like GHK-Cu + TGF-beta + Fasudil (a rho-kinase inhibitor studied for severe E.D).
See Studies below!
--> https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4696116/
--> https://www.ncbi.nlm.nih.gov/pubmed/20233282
--> https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4230280/

[Zant808]

I'm going to look into it more after my exams. I have always had a problem with this theory, but I'll give it a fair chance.

One (minor) critique I have is that he still calls it withdrawal. I know that might seem small, but when I joined the forum in 2014 it was still common to call PSSD "ssri withdrawal". I'd like to think I've helped change that. It was a term from the old sites like paxil progress where a lot of people didn't really know what was going on.

Giving healy benefit of the doubt, maybe it has different connotation in the UK, or maybe he still writes for people who were around the forums a decade or so ago. Either way, I don't believe it's medically correct.

It's not the withdrawal from SSRI that is our problem, it is the changes FROM the SSRI that persist long after we stop.

I never liked that the whole "protracted withdrawal" theory. Because at what point in time are you supposed to say you are no longer in protracted withdrawal and that whatever side effects you got are permanent? Is someone who took Prozac back in 1988 and still has sexual dysfunction supposed to be in protracted withdrawal still? I guess it's probably something the moderators of those forums and groups wanted to hold on to in order to stay positive and offer hope because they read Dr. Ashton's manual as if it were gospel.

[JayR]

I'm going to look into it more after my exams. I have always had a problem with this theory, but I'll give it a fair chance.

One (minor) critique I have is that he still calls it withdrawal. I know that might seem small, but when I joined the forum in 2014 it was still common to call PSSD "ssri withdrawal". I'd like to think I've helped change that. It was a term from the old sites like paxil progress where a lot of people didn't really know what was going on.

Giving healy benefit of the doubt, maybe it has different connotation in the UK, or maybe he still writes for people who were around the forums a decade or so ago. Either way, I don't believe it's medically correct.

It's not the withdrawal from SSRI that is our problem, it is the changes FROM the SSRI that persist long after we stop.

I never liked that the whole "protracted withdrawal" theory. Because at what point in time are you supposed to say you are no longer in protracted withdrawal and that whatever side effects you got are permanent? Is someone who took Prozac back in 1988 and still has sexual dysfunction supposed to be in protracted withdrawal still? I guess it's probably something the moderators of those forums and groups wanted to hold on to in order to stay positive and offer hope because they read Dr. Ashton's manual as if it were gospel.

Survivingantidepressants; the Mods there get away with far too much whereas sufferers are often getting treated like shit!