BenyaMarubo: PSSD after psychodrugs (risperiodne, mianserin)

[BenyaMarubo]

Hi everybody!

 

Will try to sum up shortly the nature of my problem:

- Jun'17. Big family tragedy. Got nervous, could barely sleep at night (3-4 hours daily max.), lost appetite. Used simple herbs-based anti-axiety pills to calm myself. No big impact.

- Jul'17. Nervousness continues, sleepless nights, poor appetite. Added other more potent natural pills (as I live in Germany - Neurexam). Took Stillnox (aka Zolpidem) as sleeping aid. To no avail. To calm down took 1 single pill of Laif 900 (Saint John's Wort, SJW). My anxiety paradoxically increased even further. maybe because I drank juices (which is not advisable with SJW).

As my nervousness continued went to doctor, who prescribed escitalopram 10 mg per day (in the morning). To be on the safe side, took half of the pill (i.e. 5 mg), immediately felt unwell (sweating, heart palpitations, giddiness). Took char coal to wash the pill out.  As I did not know what an antidepressant is (thought it to be a sort of anti-anxiety / sleeping pill), took 2.5 mg before sleep for the next 2-3 days. My agitation got worse. In retrospect I think that I provoked a mild serotonin syndrome, given that I took escitalopram soon after taking SJW. My body was shaking, trembling, I was not able to control my hands. Neede even to call sick from work. Got strange suicidal thought which I had never had in my life. Did not know this state was provoked by pills. I somehow foolishly decided that because of my insomnia and malnutrition, my brain started to die off.

Dropped escitalopram. Got electric splashes in my head. Panicked. Did not know it was a side effect of escitalopram withdrawal. Was afraid that my brain was harmed beyond repair and decided to commit suicide by jumping from the balcony. My relative held me tight, but I somehow managed to drop him on the floor and get loose. Panicked that I harmed my relative. I called ambulance but they came not alone but with ... police (apparently neighbors called them as I shouted a lot). Was not able to understan what was going on, tried to jump off the balcony in the presence of doctors / cops. Was hospitalized in the ward involuntarily.

- Aug'17. Spent 14 days in the ward on 4 mg risperidone (aka risperdal) daily in pill form + tranquilizer (lorazepam).

 

After this "treatment" did not feel well. No thoughts, no emotions, personality erased. Dropped risperidone cold turkey.

Was not able to sleep for a week. Went to private psychiatrist. He reinstated risperidone at 1 mg ( I went from 1 mg daily to 0 within 1 month) + gave lerivone (mianserin) 15 mg as antidepressant for sleep.

 

Have been on various doses of mianserin (from 15 mg up to 45 mg and then progressively down to 0) from September to December (i.e. 3 months). Dropped the last 5 mg cold turkey.

 

Since Dec'17 - drug free. Though my initially poor thinking / no thoughts etc has dramatically improved (thanks God), I still suffer from a symptom which first appeared somewhere in mid November: genital numbness, loss of sexual interest, decrease in libido. I found out it is PSSD.

 

My questions are as follows, to which I would kindly ask to help me:

 

1. Why is this impotence? What is the more likely culprit: risperidone or mianserin. I ask as I have read that SSRI / SNRI are the most likely culprits of PSSD, whereas mianserin is actually used to treat it (with varying success though).

2. How can it be cured?

3. Has anyone experienced reduced eyesight (increased myopia) on antipsychotics / antidepressants and will the issue resolve itself?

 

Thank you very much in advance for your kind help !!!!

[Altostrata]

Welcome, Benya.

 

Some people are very sensitive to antidepressants and have immediate severe adverse reactions within a few doses. That sounds like what happened to you.

 

PSSD can follow psychiatric drug use. The drugs are hormonal disruptors, taking them can cause sexual dysfunction or it can occur after quitting, particularly if significant withdrawal symptoms followed. It's impossible to tell which drug might be responsible for your PSSD; it could be the combination.

 

We see that people very, very gradually recover from psychiatric drug damage. Recovery can be slow and frustrating. As you've already seen some progress, that's a good sign.

 

This is also true of the vision symptoms.

 

You need to take care of yourself, keep your body healthy, eat well, sleep well, to support your natural healing process. Above all, stay calm -- worrying will make symptoms worse.

 

Many people do better with fish oil and magnesium supplements, see
http://survivingantidepressants.org/index.php?/topic/36-king-of-supplements-omega-3-fatty-acids-fish-oil/

http://survivingantidepressants.org/topic/15483-magnesium-natures-calcium-channel-blocker/

 

A lot of people find them helpful. Try a little bit of one at a time to see how it affects you.

 

 

 

[Gridley]

Hello, Benya, and welcome from me too.

 

To give members the best information, we ask them to summarize their medication history in a signature -- drugs, doses, dates, and discontinuations & reinstatements, in the last 12-24 months particularly.

• Any drugs prior to 24 months ago can just be listed with start and stop years. 
• Please use actual dates or approximate dates (mid-June, Late October) rather than relative time frames (last week, 3 months ago) 
• Spell out months, e.g. "October" or "Oct."; 9/1/2016 can be interpreted as Jan. 9, 2016 or Sept. 1, 2016. 
• Please leave out symptoms and diagnoses. 
• A list is easier to understand than one or multiple paragraphs. 
• Link to Account Settings – Create or Edit a signature.

 

[BenyaMarubo]

Thank you very much for support and guidance! The signature is there.

 

Indeed, the first 5 months after quitting risperidone, I experienced a very pronounced decrease in intelligence and suffered from terrible insomnia. I literally was able to sleep only 1-3 hours per night, interruptibly.  My sleep cycle was destroyed. Mianserin, which I took basically as a sleeping aid, did not help much (pdoc also prescribed it for my "reactive depression"). The sleep problems appeared immediately after I cold-turkeyed on risperidone. I have never dealt with antipsychotics before and did not know anything about withdrawal symptoms. I was told not to do it at the ward, but I turned a deaf ear to their advice, I was just anxious to get rid of this debilitating stuff. After 5 months, sleep seemed to come back, as I started supplementing with magnesium + took 2-3 L-tryptophane pills (500 mg). Intelligence and speed of thought seem to have been recovering too.

 

In November 2017, soon after I upped my mianserin to 45 mg, I suddenly experienced numbness in genitalia and twitching sensations in my testicles. First, I tried to ignore it, but then I noticed a severe decrease in libido. Which was strange as my pdoc assured me that mianserin was sometimes used to increase potence. Since then I seem to experience reduced interest in sex, less sperm production, unstable erections. Indeed this seems much like PSSD. My question is, could mianserin have caused it, if it is even not a typical SSRI / SNRI, but more of a tetracyclic antidepressant.

 

At first I thought this was mainly the consequence of risperiodne. In September I measured prolactin and it was 3-4x above the norm, while testosterone was below the lowest acceptable level.

In November, i.e. c. 2 months after cessation of risperiodone, prolactin came back to norm, while testosterone recovered as well (albeit only slightly above the minimum acceptable norm). I experience sizeable ******** and penile shrinkage. But from time to time testicles seem to recover, but penis is generally smaller than the norm in its non-erect state. I keep thinking that mianserin might have actually been the culprit. has anyone experienced this on mianserin???

 

I read on testicular atrophy, but wonder if prolcatin and testosterone are back to norm whithin 2 months, could that lead to such drastic consequences? Anyway, will go to the doctor to get testicles go through ultrasound examinantion.

 

[Altostrata]

Very often, people find their nervous systems have been sensitized by withdrawal. They will react in odd ways to drugs, supplements, and even foods. It sounds like the increase in mianserin on top of risperidone withdrawal syndrome might have thrown your sexual functioning off.

 

No one has been able to pin this down on a physiological or endocrinological disturbance. Sexual functioning is a complex symphony conducted by the autonomic nervous system, which is affected by going on and off psychiatric drugs.

 

We have seen PSSD very gradually go away. Please do not obsess about how this happened, focus on helping your body and nervous system return to normal.

[BenyaMarubo]

1 hour ago, Altostrata said:

We have seen PSSD very gradually go away.

Do you have some estimates how quickly can things return to normal on average? At least a timeframe: several months? several years?

 

1 hour ago, Altostrata said:

No one has been able to pin this down on a physiological or endocrinological disturbance

Does it mean that a visit to a specialist will yield no results?

I mean at least to make sure there is no tangible physical damage i.e. testicular atrophy. Given that the organs are not damaged, is there a chance things will get back to normal???

 

Quote

It sounds like the increase in mianserin on top of risperidone withdrawal syndrome might have thrown your sexual functioning off.

 

Based on what you observed on this forum, has mianserin ever caused such effects given that it is not even a SSRI / SNRI strictly speaking?

 

Thank you.

[Altostrata]

It will be some months, I cannot say how many. It might be years of very gradual improvement.

 

You might want to see a specialist to rule out any other problems. It is unlikely any will recognize withdrawal problems or know what to do about them.

 

Going on and off any psychiatric drug of any type might cause these symptoms, mianserin is not excluded. If it acts on a "neurohormone," it is a disruptor of all hormone systems.

[BenyaMarubo]

12 hours ago, Altostrata said:

You might want to see a specialist to rule out any other problems.

 

Just to reiterate, please advise should I go through some tests to make sure that:

• My testosterone and prolactin levels are normal. Last time I checked prolactin was within the norm, testosterone was just close to the lowest limit.
• Go through penis / testicles examination to make sure there is no atrophy?

At least I want to make sure that I am functionally OK. And just play the waiting game.

[ChessieCat]

7 minutes ago, BenyaMarubo said:

should I go through some tests

 

12 hours ago, Altostrata said:

You might want to see a specialist to rule out any other problems.

 

[BenyaMarubo]

Quote

You might want to see a specialist to rule out any other problems.

 

Ok, now I see the point! Will go now to check prolactin and testosteron. Assumingly, if prolactin and testosterone are OK, it is simply the neurotransmitter stuff.

[BenyaMarubo]

After some reading, I am increasingly convinced mianserin (lerivon) is the culprit behind impotence. Though it is not a SSRI, it can still cause persistent effects.

[frasier23]

On 4/11/2018 at 8:05 AM, BenyaMarubo said:

After some reading, I am increasingly convinced mianserin (lerivon) is the culprit behind impotence. Though it is not a SSRI, it can still cause persistent effects.

How is it today?