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Antidepressants/SSRIs Experiences And Sexual Side Effects

Altair

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Have you gone through therapy with a licensed mental health counselor that specializes in compulsive disorders?

Are you experiencing performance anxiety now? Can you achieve and maintain an erection now?

What is the surgery your having?
Yes I was seeing one of the best psychiatrist in Manhattan but couldn’t afford it for long. It was costing me $500 per hour to see her out of pocket.

No performance anxiety. I can achieve and maintain an erection but nothing close to when I was using grams of test, especially when tren was in the mix. I had to go on trt for life after my liver tumor ruptured.

I’m currently on 200mg test cyp a week split into 5am Monday and 5pm Thursday with 1mg of adex per shot but I honestly barely feel much. Sex drive is ok but can’t get full hard erections and orgasms are nothing special.

I’m having bloodwork done next week but my prior bloodwork came back at testosterone 720 ng/dL and estradiol 27 pg/mL.

I’m having my whole abdominal wall reconstructed due complications from prior surgery
 

ripriot

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Yes I was seeing one of the best psychiatrist in Manhattan but couldn’t afford it for long. It was costing me $500 per hour to see her out of pocket.

No performance anxiety. I can achieve and maintain an erection but nothing close to when I was using grams of test, especially when tren was in the mix. I had to go on trt for life after my liver tumor ruptured.

I’m currently on 200mg test cyp a week split into 5am Monday and 5pm Thursday with 1mg of adex per shot but I honestly barely feel much. Sex drive is ok but can’t get full hard erections and orgasms are nothing special.

I’m having bloodwork done next week but my prior bloodwork came back at testosterone 720 ng/dL and estradiol 27 pg/mL.

I’m having my whole abdominal wall reconstructed due complications from prior surgery
Therapy with medicine will help you manage the compulsions over time the best since it is a brain-based disorder. It’s the most effect treatment possible as it with a lot of disorders.

As you know it can take trying different medications before finding the right one. In addition to adjusting dosages. However, finding the right medications can be life changing. If you have libido problems now then an SSRI isn’t a guarantee that it will make it worse. If your ocd correlates with anxiety it could improve sexual function. Delayed or blocked orgasm is common. Impotence or post SSRI importance is rare. Impotence can be fixed with medication change. Some men report that orgasms are more pleasurable with an SSRI. I would try one and listen to your body to make adjustments as needed.

what’s your OCD centered around?
 

Altair

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Therapy with medicine will help you manage the compulsions over time the best since it is a brain-based disorder. It’s the most effect treatment possible as it with a lot of disorders.

As you know it can take trying different medications before finding the right one. In addition to adjusting dosages. However, finding the right medications can be life changing. If you have libido problems now then an SSRI isn’t a guarantee that it will make it worse. If your ocd correlates with anxiety it could improve sexual function. Delayed or blocked orgasm is common. Impotence or post SSRI importance is rare. Impotence can be fixed with medication change. Some men report that orgasms are more pleasurable with an SSRI. I would try one and listen to your body to make adjustments as needed.

what’s your OCD centered around?
Thanks for the feedback, your post gives me hope.

I will give SSRIs a shot hopefully after my surgery and hope for the best, at this point got nothing to lose and only to gain.

My OCD is for the most part contamination OCD. It has always revolved around that.
 

OuchThatHurts

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Yes I was seeing one of the best psychiatrist in Manhattan but couldn’t afford it for long. It was costing me $500 per hour to see her out of pocket.

No performance anxiety. I can achieve and maintain an erection but nothing close to when I was using grams of test, especially when tren was in the mix. I had to go on trt for life after my liver tumor ruptured.

I’m currently on 200mg test cyp a week split into 5am Monday and 5pm Thursday with 1mg of adex per shot but I honestly barely feel much. Sex drive is ok but can’t get full hard erections and orgasms are nothing special.

I’m having bloodwork done next week but my prior bloodwork came back at testosterone 720 ng/dL and estradiol 27 pg/mL.

I’m having my whole abdominal wall reconstructed due complications from prior surgery
I have been listening to similar anecdotes as in this thread for decades and it is likely that you will experience sexual side effects. There is no getting around it. The opposite has been occasionally true for those where depression itself was causing the ED or anorgasmia but even in those cases, there was a gradual improvement in the symptomatic depression or other condition with a simultaneous drop off in general libido and onset of ED and/or anorgasmia anyway.

Another user put it well when they said that it came down to feeling in a fix as to whether they wanted (a) improvement in GAD/panic/clinical depression/OCD etc and just dealing with the sexual sides or (b) having their sex life back and dealing with the neurological disorder(s). Often I heard people say, in various ways, while they enjoyed the improvement in the neurological condition(s) they felt "empty" or "sterile" which prevented them from being truly happy or satisfied with the treatment.

I have never heard of any great success with buspirone and improvement in sex drive either. In short, it just simply appears to be a trade-off. Now, there are exceptions. And rather notable exceptions so all hope is not lost.

The considerations depend highly on outside factors. You can try different medications but is often impractical due to the duration of time required to adequately assess if the medication is having a positive effect. You don't want to medicine hop for what may be many years. How understanding will your partner be? Or if you tend to have some degree of promiscuity, how important is that to you? Does the OCD prevent you from maintaing your basic living requirements? These are the considerations you'll have to reconcile should you decide to begin treatment. These are not easy questions and there are no easy answers.

Good luck and best wishes.

OTH
 

ripriot

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I have been listening to similar anecdotes as in this thread for decades and it is likely that you will experience sexual side effects. There is no getting around it. The opposite has been occasionally true for those where depression itself was causing the ED or anorgasmia but even in those cases, there was a gradual improvement in the symptomatic depression or other condition with a simultaneous drop off in general libido and onset of ED and/or anorgasmia anyway.

Another user put it well when they said that it came down to feeling in a fix as to whether they wanted (a) improvement in GAD/panic/clinical depression/OCD etc and just dealing with the sexual sides or (b) having their sex life back and dealing with the neurological disorder(s). Often I heard people say, in various ways, while they enjoyed the improvement in the neurological condition(s) they felt "empty" or "sterile" which prevented them from being truly happy or satisfied with the treatment.

I have never heard of any great success with buspirone and improvement in sex drive either. In short, it just simply appears to be a trade-off. Now, there are exceptions. And rather notable exceptions so all hope is not lost.

The considerations depend highly on outside factors. You can try different medications but is often impractical due to the duration of time required to adequately assess if the medication is having a positive effect. You don't want to medicine hop for what may be many years. How understanding will your partner be? Or if you tend to have some degree of promiscuity, how important is that to you? Does the OCD prevent you from maintaing your basic living requirements? These are the considerations you'll have to reconcile should you decide to begin treatment. These are not easy questions and there are no easy answers.

Good luck and best wishes.

OTH
Your a retired Phd psych that thinks trying different medications is impractical for a chronic disorder for a patient that is just starting medication therapy?... That’s just wrong. Medication adjustments are common when first starting medication management.
 

ripriot

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Thanks for the feedback, your post gives me hope.

I will give SSRIs a shot hopefully after my surgery and hope for the best, at this point got nothing to lose and only to gain.

My OCD is for the most part contamination OCD. It has always revolved around that.
Contamination is a potent trigger of the mind. At some point find a therapist to work with. It will dramatically increase the effectiveness of medications.

Do you think you get contaminated during sex or intimacy?
 

OuchThatHurts

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Your a retired Phd psych that thinks trying different medications is impractical for a chronic disorder for a patient that is just starting medication therapy?... That’s just wrong. Medication adjustments are common when first starting medication management.

I understand. Perhaps you misinterpreted what I said or I did not express it clearly enough. It is true that dosages of a drug are commonly adjusted if side effects are immediately experienced. In fact, very common. But in practice, the specialist is usually hesitant to switch medications outright inside 6-12 months unless serious side effects occur. Specialist appointments of 90 days apart are not uncommon. A specialist does not normally take recommendations from the patient in regards to "trying different medications".

This is not a matter of a retired psychologist "who thinks trying different medications is impractical". It is a matter of what happens in reality. My point was that it can take years to determine the right medication in the right dosage even for chronic disorders.

I have very often heard complaints from patients who would like to switch medications instead of working with and adjusting dosages of a drug they feel is not right for them. I have heard that complaint in different forms for many years and have placed many a phone call to a patient's specialist to relay that information.

Please keep in mind that while I have dealt closely with a patient's specialist, ultimately it is up to the specialist to assess those complaints/reports and make changes if he or she deems it appropriate; not on the advice of a patient's therapist nor the patient's determinations. We may not like that reality but it is nonetheless true.
 

Altair

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Contamination is a potent trigger of the mind. At some point find a therapist to work with. It will dramatically increase the effectiveness of medications.

Do you think you get contaminated during sex or intimacy?
No not at all, it has nothing to do with germs so to speak it’s total irrational contamination.
 

Altair

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I have been listening to similar anecdotes as in this thread for decades and it is likely that you will experience sexual side effects. There is no getting around it. The opposite has been occasionally true for those where depression itself was causing the ED or anorgasmia but even in those cases, there was a gradual improvement in the symptomatic depression or other condition with a simultaneous drop off in general libido and onset of ED and/or anorgasmia anyway.

Another user put it well when they said that it came down to feeling in a fix as to whether they wanted (a) improvement in GAD/panic/clinical depression/OCD etc and just dealing with the sexual sides or (b) having their sex life back and dealing with the neurological disorder(s). Often I heard people say, in various ways, while they enjoyed the improvement in the neurological condition(s) they felt "empty" or "sterile" which prevented them from being truly happy or satisfied with the treatment.

I have never heard of any great success with buspirone and improvement in sex drive either. In short, it just simply appears to be a trade-off. Now, there are exceptions. And rather notable exceptions so all hope is not lost.

The considerations depend highly on outside factors. You can try different medications but is often impractical due to the duration of time required to adequately assess if the medication is having a positive effect. You don't want to medicine hop for what may be many years. How understanding will your partner be? Or if you tend to have some degree of promiscuity, how important is that to you? Does the OCD prevent you from maintaing your basic living requirements? These are the considerations you'll have to reconcile should you decide to begin treatment. These are not easy questions and there are no easy answers.

Good luck and best wishes.

OTH
First of all thanks for the feedback OTC.

Seeing that your really experienced in this matter, how would you approach my situation?

I still don’t see a way around taking SSRIs though so I will have to deal with whatever sides as they come.
 

OuchThatHurts

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First of all thanks for the feedback OTC.

Seeing that your really experienced in this matter, how would you approach my situation?

I still don’t see a way around taking SSRIs though so I will have to deal with whatever sides as they come.
It's very difficult for me to solidly assess your situation online but I can give you some things to feel positive about. Armchair psychology is not a good practice so generally I like to leave any diagnosis, treatment, and therapies to your doctors and therapists.

What I can tell you is that SSRIs have assisted millions of people with a very high degree of success. Combined with therapy, success rates are very high. In other words, I believe your problems are treatable. You can sometimes learn through cognitive behavioral mechanisms to control your disorder(s) and with a much better success rate than medication alone.

Tell your doctors exactly what you've said here. Do not leave out anything. Detail you drug history. They'll likely ask you to have bloodwork to determine your thyroid, sugar levels, hematocrit are within normal range. If they do decide to prescribe medication, listen to them. I don't know if they will do a full psyche eval but they may. They may then suggest a medication that is targeted and tailored to your condition.

The prognosis is very positive. There may be some side effects but if you're surrounded by understanding people, make them aware of what you're experiencing. Many side effects disappear within a few weeks with some meds so give it time and give the medication time to work. Quote post me with updates and let me know how things are going. I have no reason to believe you won't be fine. But listen to them. Too many people take matters into their own hands and try to work the system. Don't do that.

If you do have side effects that concern you, tell your doctor. Often they can tweak and make adjustments on the fly without having to wait for your next sit-down office visit. Keep me posted and best wishes for continued success.

OTH
 

Altair

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It's very difficult for me to solidly assess your situation online but I can give you some things to feel positive about. Armchair psychology is not a good practice so generally I like to leave any diagnosis, treatment, and therapies to your doctors and therapists.

What I can tell you is that SSRIs have assisted millions of people with a very high degree of success. Combined with therapy, success rates are very high. In other words, I believe your problems are treatable. You can sometimes learn through cognitive behavioral mechanisms to control your disorder(s) and with a much better success rate than medication alone.

Tell your doctors exactly what you've said here. Do not leave out anything. Detail you drug history. They'll likely ask you to have bloodwork to determine your thyroid, sugar levels, hematocrit are within normal range. If they do decide to prescribe medication, listen to them. I don't know if they will do a full psyche eval but they may. They may then suggest a medication that is targeted and tailored to your condition.

The prognosis is very positive. There may be some side effects but if you're surrounded by understanding people, make them aware of what you're experiencing. Many side effects disappear within a few weeks with some meds so give it time and give the medication time to work. Quote post me with updates and let me know how things are going. I have no reason to believe you won't be fine. But listen to them. Too many people take matters into their own hands and try to work the system. Don't do that.

If you do have side effects that concern you, tell your doctor. Often they can tweak and make adjustments on the fly without having to wait for your next sit-down office visit. Keep me posted and best wishes for continued success.

OTH
Thanks again for the great feedback OTC.

I’m actually planning on seeing a Columbia trained Psychiatrist that specializes in OCD after my surgery for a second opinion.

With current treatments out there it seems SSRIs are my best shot right now pharmacologically speaking.
(psilocybin and endocannabinoid system might provide us with better treatments in the future)

I will keep you posted and hopefully can also provide fellow member Sides some more answers down the road.
 

Sides

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Thanks again for the great feedback OTC.

I’m actually planning on seeing a Columbia trained Psychiatrist that specializes in OCD after my surgery for a second opinion.

With current treatments out there it seems SSRIs are my best shot right now pharmacologically speaking.
(psilocybin and endocannabinoid system might provide us with better treatments in the future)

I will keep you posted and hopefully can also provide fellow member Sides some more answers down the road.
Thanks for the kind thoughts, Altair. I wish you luck and success with your psychiatrist, and I hope they will find options that work for you.

SSRI's are certainly the standard treatment of care, but like you I fear the negative effects on libido and sexual function. I wish there were better answers, but every option has the potential for things to get worse instead of better. Of course, there is always the hope that things will get better instead of worse.

For myself, I've always had OCD problems, but they have gotten much worse lately. I think mostly it's because of anxiety and sleep deprivation due to my long-term use of benzodiazepines to get to sleep at night. After 5-6 years of nightly use of Valium to get to sleep, it just doesn't work for me anymore, leaving me chronically sleep-deprived and dependent on stimulants to make it through the day, setting up a never-ending cycle of increasing anxiety and OCD.

My answer probably lies in fighting my way through benzodiazepine withdrawal, but I haven't been able to muster the courage to do that yet. And I'm afraid that an SSRI may make things worse if it decreases my sexual function and libido. Further loss of sexual function would depress me to the point at which I don't feel life would be worth living anymore.

I hope you find the answers for you. I'm starting to lose hope there is any acceptable answer for me, but I try to remain hopeful. This is just the perhaps inevitable outcome of a life spent abusing way too many drugs. Perhaps my only purpose is to serve as an example for others of what not to do. I wish I could change the choices I made in the past, but it's too late for all of that now.
 

Altair

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Thanks for the kind thoughts, Altair. I wish you luck and success with your psychiatrist, and I hope they will find options that work for you.

SSRI's are certainly the standard treatment of care, but like you I fear the negative effects on libido and sexual function. I wish there were better answers, but every option has the potential for things to get worse instead of better. Of course, there is always the hope that things will get better instead of worse.

For myself, I've always had OCD problems, but they have gotten much worse lately. I think mostly it's because of anxiety and sleep deprivation due to my long-term use of benzodiazepines to get to sleep at night. After 5-6 years of nightly use of Valium to get to sleep, it just doesn't work for me anymore, leaving me chronically sleep-deprived and dependent on stimulants to make it through the day, setting up a never-ending cycle of increasing anxiety and OCD.

My answer probably lies in fighting my way through benzodiazepine withdrawal, but I haven't been able to muster the courage to do that yet. And I'm afraid that an SSRI may make things worse if it decreases my sexual function and libido. Further loss of sexual function would depress me to the point at which I don't feel life would be worth living anymore.

I hope you find the answers for you. I'm starting to lose hope there is any acceptable answer for me, but I try to remain hopeful. This is just the perhaps inevitable outcome of a life spent abusing way too many drugs. Perhaps my only purpose is to serve as an example for others of what not to do. I wish I could change the choices I made in the past, but it's too late for all of that now.
Thank you my friend, I will pray for you and keep you in my thoughts. I will let you know how things go with me after my surgery.
 

Sides

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Thank you my friend, I will pray for you and keep you in my thoughts. I will let you know how things go with me after my surgery.

Please do, my friend, and I will pray that God sends his angels to wrap their wings around you and protect you during your surgery and recovery.

If you are anything like me, the recovery and recuperation and time off from training will be harder on you than the surgery itself. I am so OCD that taking any extended time off from training drives me crazy, even after injury.

When I tore the left distal bicep tendon off the bone and had it surgically repaired, I was back in the gym the next day, with my arm in a cast and a sling (and later a Bledsoe Brace), doing planks and one-armed presses and leg presses/extensions/curls, anything to keep training. It drove me crazy to just sit at home and feel myself atrophy. Body dysmorphia and orthorexia and OCD all seem to go together to one degree or another in this wonderful activity and state-of-mind we call bodybuilding LOL.

Lifting weights and other training is the best medication for OCD that I've ever found, and I always feel better after a good workout. I missed that terribly after my surgery, and I'm sure that you will as well. Just try to give your body time to physically recover, stay safe, and then you can tackle the mental issues when your body and mind are ready.

Prayers for your successful recovery, mind and body and heart and soul.
 

Altair

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Please do, my friend, and I will pray that God sends his angels to wrap their wings around you and protect you during your surgery and recovery.

If you are anything like me, the recovery and recuperation and time off from training will be harder on you than the surgery itself. I am so OCD that taking any extended time off from training drives me crazy, even after injury.

When I tore the left distal bicep tendon off the bone and had it surgically repaired, I was back in the gym the next day, with my arm in a cast and a sling (and later a Bledsoe Brace), doing planks and one-armed presses and leg presses/extensions/curls, anything to keep training. It drove me crazy to just sit at home and feel myself atrophy. Body dysmorphia and orthorexia and OCD all seem to go together to one degree or another in this wonderful activity and state-of-mind we call bodybuilding LOL.

Lifting weights and other training is the best medication for OCD that I've ever found, and I always feel better after a good workout. I missed that terribly after my surgery, and I'm sure that you will as well. Just try to give your body time to physically recover, stay safe, and then you can tackle the mental issues when your body and mind are ready.

Prayers for your successful recovery, mind and body and heart and soul.

I haven’t been in the gym since the 26th of January, and I was at my biggest/strongest since staring trt after my tumor rupture almost 3 years ago!
I needed emergency hernia surgery in January and that’s were they saw I needed my whole abdominal wall reconstructed, which I will be doing in few weeks. Probably won’t see the gym until June/ July so it sucks big time.
And yes absolutely the gym has been the biggest help in my life with dealing with it.

Thanks again for the kind words my friend, God Bless.
 

ripriot

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I understand. Perhaps you misinterpreted what I said or I did not express it clearly enough. It is true that dosages of a drug are commonly adjusted if side effects are immediately experienced. In fact, very common. But in practice, the specialist is usually hesitant to switch medications outright inside 6-12 months unless serious side effects occur. Specialist appointments of 90 days apart are not uncommon. A specialist does not normally take recommendations from the patient in regards to "trying different medications".

This is not a matter of a retired psychologist "who thinks trying different medications is impractical". It is a matter of what happens in reality. My point was that it can take years to determine the right medication in the right dosage even for chronic disorders.

I have very often heard complaints from patients who would like to switch medications instead of working with and adjusting dosages of a drug they feel is not right for them. I have heard that complaint in different forms for many years and have placed many a phone call to a patient's specialist to relay that information.


Please keep in mind that while I have dealt closely with a patient's specialist, ultimately it is up to the specialist to assess those complaints/reports and make changes if he or she deems it appropriate; not on the advice of a patient's therapist nor the patient's determinations. We may not like that reality but it is nonetheless true.

My appolgies for misinterpretating you. Yes, we are on the same page now. OCD is rarely never managed with medication and it can take years to find a combination of medication with therapy to see significant improvments in behavior.
 

OuchThatHurts

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SSRI's are certainly the standard treatment of care, but like you I fear the negative effects on libido and sexual function. I wish there were better answers, but every option has the potential for things to get worse instead of better. Of course, there is always the hope that things will get better instead of worse.
Both of you need to make your doctors aware of your fear of this particular side effect. There are certain SSRIs/SDRIs that have a low incidence of reported sexual side effects (e.g. Viibrid and Trintellix). But those meds may have other side effects that are undesirable for you (e.g. insomnia, nausea, somnolence, etc). If you're more likely to be successful in your treatment without a particular side effect, your doctor will most assuredly take that into consideration. As I said, tell your doctor everything you've said here. You do have options.
 

gungalunga

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Both of you need to make your doctors aware of your fear of this particular side effect. There are certain SSRIs/SDRIs that have a low incidence of reported sexual side effects (e.g. Viibrid and Trintellix). But those meds may have other side effects that are undesirable for you (e.g. insomnia, nausea, somnolence, etc). If you're more likely to be successful in your treatment without a particular side effect, your doctor will most assuredly take that into consideration. As I said, tell your doctor everything you've said here. You do have optiOO
On a side note, it's good to see you back and posting OTH. You always have good info and insight.
 

OuchThatHurts

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On a side note, it's good to see you back and posting OTH. You always have good info and insight.
Thank you. It's great to see all my bros here. Life trips you up, you blink, and 5 years have gone by. I just saw an an article I wrote after buying 200 Sustanon ampules from must be 15 years ago and it's still bouncing around the boards to this day. Someone even claimed it by the name of "The Steroid Guru". Once you get out there on the internet, all the receipts just seem to hang there. But thanks again. I'm ready to get back to slinging some big steel.
 

j2048b

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anyone use abilify or lithium for depression/ anxiety ? if so did u see an uptick in motivation, better moods etc...?
 

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