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SWIM has been suffering from Post SSRI Sexual Dysfunction (PSSD), which for those of you who don't know are permanent sexual side effects related to SSRI use, even after stopping the medication. You can wikipedia it.
SWIM is a 28 year old male who was put on Paxil for social
anxiety disorder (SAD). After a few months, he found it really hard to orgasm. He was having marathon sex sessions with his wife. He went off the Paxil in March of 2009 (after a total of 8 months on it) and since then he has noticed that it takes him forever to get aroused. He has also been hit with extreme premature ejaculation, loss of libido and interest in sex.
It is hypothesized that it is due to a permanent desensitization of the presynaptic 5-HT1A receptors. Being a PharmD, SWIM has been looking at substances that resensitize 5-HT receptors in an effort to revese this horrible state. He fortunately stumbled across inositol (namely myo-inositol), a naturally occuring carbohydrate in the body which is widely sold in health food stores, and that has been found in studies to resensitize 5-HT receptors.
SWIM has been taking 18 grams of myo-inositol once daily at bedtime for 7 weeks and has experienced drastic improvements in his symptoms. SWIM has also found inositol to be an effective agent in treating his social anxiety disorder (SAD) (if only he had discovered it before Paxil damaged his body ).
What SWIM has been doing is dissolving the powder in a water bottle, adding some Crystal Light and chugging it down (the powder itself has a sweet taste, but its much more palatable with Crystal Light). Side effects are diarrhea and gas, but they seem to get better with continued use.
SWIM has much less anxiety, is more sociable and sleeps much better.
Inositol has also been found to treat depression and OCD with comparable efficacy to SSRIs with a MUCH better side effect profile, so keep this in mind if you suffer from PSSD, dropped the SSRIs, and are still looking for a viable alternative to treat your depression, OCD, anxiety etc. Dose is in the 6 gram - 18 gram range daily (can be in divided doses as well).
At about the 6 week mark into SWIM's inositol experiment, SWIM's craving for carbs has EXPLODED. He has literally eaten a whole pot of pasta in one sitting, a large pizza by myself, 4 chocolate bars in one sitting, a whole box of cookies in one sitting, 2 bags of sour patch kids in one sitting, and the list goes on.... (These are all actual events taken from SWIM's experiment diary with inositol, I know I shouldn't be reading his personal stuff, but oh well). This is a new phenomenon for him.
SWIM's memory has turned to crap. He can barely remember something he did 5 minutes ago. He has to check if he has turned off the iron 5 times before he leaves the house. Just stupid little things that he NEVER ever used to think twice about. Hopefully SWIM's memory will get better with time (it has only been 4 days since stopping the inositol).
My theory: I think that the inositol has successfully resensitized a subset of SWIM's 5-HT receptors (5-HT2A or 5-HT2C receptors, not sure).
1. Antagonists at 5-HT2A receptors suppresses appetite. Up regulation would do the opposite.
2. Increased availability of the 5-HT2A receptor in hippocampus is associated with poorer memory function.
3. SWIM's body could be telling him that he is low on serotonin now that the receptors are resensitized. The most immediate way to raise neural serotonin levels is to eat a high carbohydrate meal. (The insulin released lets more tryptophan cross the blood-brain barrier)
In any case, I thought I would share SWIMs inositol experience.
I would appreciate any feedback, partiularly on SWIMs memory loss which I hope is not permanent as SWIM needs to make a living using his brain.
My jackalope is in a remarkably similar situation (minus the inositol) and will definitely look into inositol. Funny how all but one of the inositol trials I found were 4 weeks in length. A little ironic that it has been investigated as a treatment for OCD, and someone is having a problem constantly checking if they left something on before they leave. Did it seem like the side effects built up over time, or happened all of a sudden? Perhaps a change in formulation occurred, or was it always the same product? Did SWIY do weigh-ins before starting to see if the carb-craving may have started earlier? Perhaps worth trying a maintenance dose? Since most of the inositol research (rat and human) is coming out of one lab in Israel, try emailing the group and seeing what they think?
I don't think SWIM's new found problem is OCD related, but it is more memory loss and inability to concentrate. Forgetting simple things like where he put the keys, what did his manager just tell him to do, getting home and realizing he forgot the milk his wife asked him to get twice before leaving. Interestingly, inositol is contraindicated in ADHD and ADD as it can aggrevate these disease states. I hope this does not mean that SWIM has one of these conditions.
Looking back at SWIM's log book, he first mentions memory issues on day 13 of his log in his words as "feeling fuzzy" and "forgetting things". This gradually builds up to "WORST MEMORY DAY OF MY LIFE" on day 42 of his experiment. So it definately seems like a gradual occurance.
SWIM has also been using the exact same inositol product throughout his experiment and from what I see, he still has about half a kilogram of powder left.
SWIM's carbohydrate cravings are a gradual occurance as well. He lifts weights regularly and checks his weight on a regular basis. He has gained about 6 lbs. of weight since the beginning of his experiment and almost has 16" arms. But carb binging has never been something of his nature as he tends to eat very healthy to build lean muscle.
SWIM has considered a maintinance dose of 2 or 3 grams a day for keeping his anxiety in remission, but is more concerned about his declining cognitive function and inability to be organized, as physicians and nurses depend on him for many issues at his work place. SWIM recalls reading that the researchers chose 12-18 grams as a treatment dose because it raised CSF levels of inositol, where lower doses did not, however this does not mean that lower doses of inositol are not effective in treating anxiety.
I will definately email the group and see what they have to say to SWIMs findings.
Swim has used Inositol 18g daily divided into two doses because mirtazapine started to lose its effectiveness for Swims anxiety and depression. Swim noticed that his mood seemed to stabilize and would have less intense anxiety or low moods. Things never bothered or agitated Swim that much. Swims libido decreased quite a bit on Inositol similar to SSRI's although not to the extent of anorgasmia. Swims memory is very foggy, very hard to remember things, cant focus and feel spaced out. Swim is thinking of lowering to maybe 12g and is starting Cymbalta to combat anxiety and depression. hopefully this will fix Swims brain fog.
Joerpg added 2 Minutes and 27 Seconds later...
Does the maintinance dose of 2-3g help swims anxiety without affecting memory?
Last edited by Joerpg; 12-01-2012 at 15:31.
Reason: Automerged Doublepost
Update: No feedback from any of the three research members I sent emails to.
But on a good note, SWIMs memory has returned to normal and his carb binging has stopped, so I am happy to say that it was totally reversible.
I have yet to find reports of anyone having these two problems with inositol.
Thanks for sharing your experiences.
Of particular interest to the subject of the thread itself, has your PSSD remained non-symptomatic since dose reduction of inositol? IE, would a 6-8 week treatment of 18g inositol/d be a way to resensitize the 5HT-2 receptors as a reversal of the SSRI-induced changes permanently?
Interesting experience, I'm not sure what would cause the memory issues but Inositol is involved in a lot of signalling pathways.
I personally take it for health, but I found that it complemented SAMe (S-adenosyl-methionine) very nicely for my winter depression (SAD). Inositol seems to work well at improving the effects of drugs such as antidepressents, there are a few studies supporting this, but on its own there isn't a lot of evidence.