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masturbatorsanctum:Anonymous wrote :I used to take SSRI drugs for depression. Most guys on SSRI’s...

masturbatorsanctum:

Anonymous wrote :

I used to take SSRI drugs for Depression. Most guys on SSRI’s won’t cum. Me, I tried for hours ! And tried all sorts of stimulation too. Everything. Six months ago I stopped the medication cold turkey. Docs say never do that, as you have to “ween” yourself off, over time. SSRI’s aren’t addictive. However withdrawal-like symptoms happen when stopping abruptly : this is sometimes called “discontinuation syndrome”. I managed this. I’m 63 years old, and I’m angry. Why is nobody advocating for new antidepressants that don’t affect orgasm and sexual functioning. Can you address this issue in your column ?

You are right that amongst the side effects of SSRIs[1] and SNRIs[2], one may have delayed orgasm, complete anorgasmia, retrograde ejaculation, as well as decreased libido[3]. Like all side effects, though, not everyone will be affected — far fewer than the “most guys” you say that do — but a fair number do indeed have sexual side effects.

An important problem when discussing the potential side effects of any psychiatric drugs is that they are used on a dysfunctional brain to begin with. The very fact of being depressed is enough to put a damper on sex drive. And if and when a depressive guy does have some libido, the lack of energy that characterizes depression means that he often won’t have the drive to work on it until the end anyway. No jokes. Non-depressed people taking antidepressants do not have as much sexual side effects as depressed people do because their brain is not ill in the first place (I’m not saying that they have none, though).

So, yes : even though antidepressants generally help to shorten a depression, they do also tend to temporarily (but reversibly) worsen some symptoms. In a way, that’s the price to pay to get better. Drugs without side effects do not exist.

Yet, this is not done on purpose. In fact, this annoys everyone — including therapists — because sex is a positive event. Depriving someone of a positive, when the depressed only perceives negativity around him, is not a therapeutic goal.

Right now, our understanding of depression involves two important neurotransmitters : Serotonin and norepinephrine. We know that acting on those we can — and we indeed do — improve the outcome of men and women experiencing the emotional distress of depression. And so, nowadays, this is what we do.

Unfortunately for us, saying that serotonin and noradrenaline plays an important role in the pathology of depression is like saying that oxygen plays an important role in fires. There’s no denying that it is true, but the problem is that they are not specific at all ! Serotonin and noradrenaline are used almost everywhere, both in and out of the brain, in multiple neurological pathways. As a result, acting on them is, of course, going to have other effects than simply “treating depression”. In other words, if there is a serotonin or a norepinephrine receptor somewhere in the body that’s similar to the one we attempt to target with an antidepressant then, of course, the drug is going to attach to this receptor too, causing undesired effects we cannot avoid to this day. Sexually speaking, it is almost unavoidable that the current meds will also cause sexual dysfunction because serotonin and noradrenaline are somehow involved there too.

One day, research may (will) discover new ways to act on the depressed person’s brain without all the side effects SSRIs and SNRIs currently have. But right now, we’re rather limited to those.[4] [5]

This being said, antidepressants are not the only way to treat a depression, and in fact are not efficient on their own. Think of antidepressants as a cast on a broken leg : it’s not the cast that makes the bone heal (the bone will heal itself anyway), it simply helps in making sure it will heal with the right shape. Antidepressants are just the same : they provide chemical support, but the healing has to come from within[6]. Psychotherapy remains central to the treatment of depression although, unfortunately, not every depressed person is granted access to a professional therapist.


[1] Selective Serotonin Reuptake Inhibitors
[2] Selective Norepinephrine Reuptake Inhibitors
[3] Not to mention headaches, tummy aches, constipation, diarrhoea and nausea…
[4] There is one brand of antidepressant that’s not exactly in the same category and that is marketed as having fewer sexual side effects (bupropion), but it is not as efficient as the others, so it is not going to be used as a first choice. New drugs have come to market in the recent years (vortioxetine comes to mind), but they have not yet proven to be effective in real life.
[5] And be thankful you have those. Before SSRIs, the drugs we had were even worse : tricyclic antidepressants, not to speak of the great-grandfather of them all, IMAOs… they surely helped but the price to pay in terms of side effects were steep (and for IMAOs, you even have to avoid complete food categories).
[6] Granted, there are people who suffer from endogenous depression. Those people have a physiological lack of serotonin or noradrenaline, and to them antidepressants are the only solution.

P.S. : You are right to say that antidepressants do not cause addiction. They cannot simply because they act so slowly that the brain does not perceive a causation between any functional improvement and the fact of having begun some medication 6 weeks earlier. SSRIs and SNRIs do act on the brain chemistry, however, and when one stops them cold turkey, the resulting chemical imbalance does cause weird feelings as a result. Yet, there’s no danger in doing so : the only price to pay is to feel really weird for a few days. And sometimes, it can be really, really agonizing. That’s the only reason why “docs say never do that”. Anyway, once all this is over, one never wakes up with SSRI cravings, ever… as ex-smokers do with tobacco for instance. Proof that no one becomes addicted.



This post first appeared on Wank Worthy #NSFW, please read the originial post: here

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masturbatorsanctum:Anonymous wrote :I used to take SSRI drugs for depression. Most guys on SSRI’s...

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