A PSSD story from 2013 describes the effects of many reinstatements of SSRIs

I translate into English a story originally written in Italian here.

It'is a reply to the first topic on pssd ever opened in Italian. The story is very interesting in terms of the possible effects of reinstatement.

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Hello everyone, my name is Nicola, I'm 28 in a few months, I'm also researching possible permanent damage and I want to tell my story with psychotropic drugs focusing on the sexual side effects about which I fear I have had damage.

At the age of 18 I was diagnosed with major depression (recently the diagnosis changed to bipolar disorder). I used to (and still do) play a lot of sport, live a healthy life, don't drink, have never taken a cigarette in my life and never used drugs. Apart from depression my health is perfect, the last time I had a blood test I didn't have a single value out of range. Until I was 18 years old my libido was very high and my erections were so fast and frequent that I found it difficult to control them and I was often ashamed of them, fearing that people might notice if they happened at inappropriate times. A small parenthesis on my general state of health, I think, is necessary before talking about the disease, the medicines and the side effects. So now back to us.

So after the diagnosis I was prescribed fluoxetine. I took it for a month and in a month it brought me back to the top. Sexual side effects ZERO! The only effect I experienced was night tremors in the lower limbs. After a month I decided to stop taking it thinking I was cured and fell back into depression.

A few months later I went back to the psychiatrist feeling worse than the first time and I took it for a long time (I don't remember well but I think it was a year and a half), the only side effect was a slight delay in orgasm. A perfect erection. After a year and a half (or maybe more...I don't remember well) suddenly impotence. I stopped the treatment and after just a couple of days I recovered 100% of my sexual function. The fear of remaining impotent was great and I swore to myself that I would not take any more (the beneficial effects were much lower than the first intake and I decided that the balance was negative).

In 2010 after a good period I relapsed into depression, I went back to the psychiatrist and he prescribed cipralex reassuring me that the side effects were temporary as I had seen. Very frightened, I started to take cipralex in low doses expecting impotence in the near future. But ... surprise of all surprises, when I increased the dosage from 3 to 6 drops the next morning I woke up with my heart beating in my chest and with an erection that was, to say the least, exceptional, much, much stronger than the natural ones, it almost hurt me how hard it was!... The abnormal erection lasted for hours during the morning, although I had no sexual desire my penis did not want to go down. I can say with absolute certainty and without a shadow of a doubt that that was the strongest and longest lasting erection of my entire life. The psychiatrist was astonished and could not give me an explanation. Over the next 4-5 days I had a strong increase in libido with frequent erections during the day....mystery! After 4-5 days the frequent erections stopped and everything went back to normal! The orgasm began to delay more and more until I reached anorgasmia in 2 weeks, after which the delay began to regress until it was almost completely extinguished. Once it had regressed (by then I was on a full dose of cipralex) I began to gradually lose my erection until I became totally impotent. In spite of the excellent results, frustrated and frightened I decide to take off the cipralex and start by halving the dose from 15 to 8 drops. Switching to 8 drops the erections came back easy and frequent. At the suspension everything returned to normal. Then I change drug, I pass to efexor, the sexual effects are milder but the headaches and the insomnia are unbearable, therefore I take off the efexor and I put again the fluoxetine. With fluoxetine another strange effect: the first three days of taking it I woke up for three days in a row with an erection... but this time it was a normal erection, not like that of cipralex. After a couple of months the impotence returned and I took the fluoxetine off. This time, however, it was a nasty surprise...the erection did not return! At the beginning of 2012, after stopping fluoxetine, the problems remained, no erection! After a few months, however, I began to feel really bad...suicidal...and so I said to myself who cares about the erection! I have to take them, I have no choice. The psychiatrist (changed) prescribed citalopram. I took it resigned to the idea of worsening the already devastated situation...and instead MIRACLE! After taking citalopram suddenly the erection comes back!!!! IT DIDN'T SEEM TRUE!!! What the hell do doctors say???? An antidepressant gave me back my erection when I was impotent...incredible...!!! Although it was totally free of sexual side-effects, the citalopram did not work, so after two months I went back to fluoxetine... and I thought to myself that I would soon get my erection back. No way! This time fluoxetine doesn't give me any sexual side effects either!!! But alas...the results are poor. I decided with my doctor to go back to cipralex...I took it for a few months and this time cipralex also had no effect on my erection! The results are discreet ... I am satisfied, but after 3 months of cipralex + lamictal therapy, my mood suddenly collapses. The psychiatrist decided to change my medication. This time he prescribed Thymanax which, according to him, did not affect the sexual sphere at all. I take the Thymanax...and my erection starts to lose steam!!!!! How is this possible???? What the hell do psychiatrists say? I've asked my psychiatrist several times for confirmation, but for some strange reason, when I switched from cipralex to thymanax, the situation got worse. The mystery deepens!!! Because of other side effects the psychiatrist decided to do a wash out and remove everything and clean me up for at least 45 days. I will be without medication for at least the whole month of February. After the suspension of the thymanax the situation remained unchanged! There is an erection, but it is slow, it takes longer (it arrives at 80% of the golden years) and it arrives with difficulty with longer times, weak and not very pleasant ejaculation, decreased libido! This is the current situation. Taking stock, I can say that I have lost 50% of my sexuality. I would like your opinion and also that of the doctors. I hope very much that the situation will improve. The idea of taking antidepressants again in a month's time makes my blood run cold. I have sent 3 e-mails to three different andrologists, one, Dr. Pozza, has already replied telling me that antidepressants can cause permanent sexual damage, confirming my fears.

I hope I am wrong, but I am also of the opinion that the side effects of these drugs are not always completely reversible, while the first times the recovery was clear and complete, now it is not. Fortunately for me I am not impotent, but I think that prolonged use has in the long run weakened me and taken away a piece of my sexuality.

A sincere hug to all those who suffer as I do from illnesses and the side effects of drugs.