My testimony

[Guest guest]

Hi

I became aware of this site many months ago and have been periodically tracking

developments here for some time but today I felt compelled to share some of my

observations. Some of the opinions I express are not simply regarding the issue

of SSRI induced sexual dysfunction

I have been on SSRI medication since January 2002. For 4 of those years I have

taken escitalopram. The cynical marketeers at Lundbeck tried to differentiate

escitalopram from the remainder of the SSRI family by categorizing it as an

allosteric serotonin inhibitor. I have discontinued the medication on at least

three occasions. Here are my experiences;

The main symptom upon complete withdrawal is sexual dysfunction (predominantly

genital anesthesia), overwhelming depressions, drug cravings and diminution of

memory / cognitive functioning that persist for the duration of withdrawal. No

indication that these improve over time. Max withdrawal period I have managed

is 4 months.

When I restart SSRI medication, sexual functioning slowly starts to recover,

albeit the recovery is unpredictable

I have a tendency to tinker with my dose often - this is an attempt to minimize

weight gain and other side effects, a reaction to a severe depressive episode or

a vain attempt to wean myself off the meds. Recently I have found that I cannot

tolerate higher doses (10mg and 20mg) like I used to. This I find paradoxical

since I always assumed that chronic SSRI use is more likely to result in

tachyphylaxis as the 5-HT receptors become habituated to the medication.

I definitely however find the meds less efficacious than in the past -

curiously, they were most effective when they used to cause my face to bloat. A

physician once explained that the bloating is due to its affect on electrolytes.

I no longer experience such bloating, especially at lower doses.

I am currently on 5mg escitalopram (a " sub-therapeutic " dose). At this dose, my

libido is very high and I am slowly regaining sensation. The curious thing is

during stimulation, I get periods of intense sensation followed by a loss of

sensation as I approach climax. This is another idiosyncracy of SSRIs. I feel

that my memory is still impoverished at this dose.

ANOTHER THING I experience is obsessiveness. Can anyone relate? I ruminate

about things daily and cannot let things go. I obsess about a specific thing

and microanalyse

Regardless, since I discontinued last time I find that I frequently get

depressed at all doses of SSRI and when off the SSRI. This is very debilitating

and means that I am currently unable to work. Ironically, I normally work as an

analyst in the pharmaceutical industry, where I get to speak with Opinion

Leaders.

The oddest thing is that re-initiating an SSRI after withdrawal does not return

the body / mind to the state prior to discontinuing the meds. I cannot work out

this discrepancy but I suspect that during the period in absentia, the 5-HT

receptor undergo further complex adaptive changes.

Oh and these are random initial observations - I will add to them but one more

thing. The provision of mental health care and particularly SSRI therapy in the

UK is appalling. The knowledge levels of GPs and even specialists is

frightening!!! One psychiatrist suggested that my chronic compensation upon

withdrawal of SSRIs had nothing to do with the meds. 80% of serotonin is

expressed in the GI tract and is intimately involved in peristaltic function

that is critical to egestion of feces - how can it not be linked??!!!

Thanks

T