203 replies to this topic

[Troypants]

I bought some, I'll let yas know if I go crazy or not.

On another note, still holding on 14 beads, getting shitty cortisol in the morning last 2 days, and took a while to settle last night. Bit of anxiety still, its like a reflex arc, I react to things, get paranoid, have negative thoughts, my body reacts without me getting to think about it and it makes me think I'm coming off strangely, my mate told me I'm just acting normal so it's an internal turmoil that I inflict on myself. Its no worse than it has been before, but I have been better.

Still got ear ringing for the second half of the day, similar to others experiences my symptoms tend to increase as the blood levels of duloxetine rise during the day, and fall over night when I sleep.

[fishinghat]

Classic symptoms but still exasperating and wears a person out. It will get better.

[Troypants]

They sure do get exasperating.... Especially after a year +.

I got a salivary cortisol/testosterone test, testosterone was low, cortisol was low/normal low... Any idea why???

Sounds like pituitary issues, I need to get FSH/LH done I think.

[fishinghat]

Also TSH, t3 and t4.

 

Antidepressants are famous for causing low testosterone. Cymbalta caused mine to go from 480 to 62 in just a few months. The thyroid can also cause some of these issues as well.

[Troypants]

Wow that is a hell of a drop... No wonder I have an attraction to testosterone injections.

But why low cortisol? I read a study which found that SSRIs modify density of glucocorticoid receptors in the hippocampus and amygdala in a way which reduces cortisol secretion, and downregulates expression of Corticotropin releasing hormone. I remember my cortisol was sky high when I was frequently dropping in dose. Do you think it could be adrenal fatigue? It would make sense, adrenals not responding, hypothalamus raises crh production in an effort to raise cortisol, crh feeds back onto the hypothalamus and inhibits release of gnrh, causes low testosterone.

[fishinghat]

there is research in both directions concerning cortisol levels in relationship to antidepressants. It is just my opinion but focusing on cortisol levels is typically non-productive. Cortisol levels are affected by dozens of different factors and trying to figure out why these levels are changing in a certain way is problematic. Just my opinion.

 

Adrenal fatigue is a non-existent condition that has been disproven many times. It has been shown that the adrenal gland is very active during antidepressant withdrawal with increases in norepinephrine and adrenaline production as well as high levels of both neurotransmitters in the blood. This is one of the reasons that clonidine is so effective against withdrawal anxiety as it provides negative feedback to the adrenal glands slowing the production of these two neurotransmitters.

[Troypants]

Ahhhh ok, yep makes sense. I can see that because I get vasoconstriction and other adrenaline type effects, I don't think cortisol has those same effects. A lot of withdrawals seem to have similar effects on adrenaline for some reason.

I had 250mg agmatine this morning, not really noticing anything, might bump it up to 500mg tomorrow.

[fishinghat]

thanks for the update on the use of agmatine. interested in seeing how that goes. 

[Troypants]

Well so far it seems to have dulled the ear ringing when I take it, it can be a little dulling on the emotion, and can feel effects of low blood pressure, I'm on an ace inhibitor too though.

When it wears off the ear ringing comes back and adrenaline rises, leading to mild anxiety and peripheral vasoconstriction, but it doesnt feel like a full on withdrawal, just a bit of rebound. Although I noticed the effects lasted shorter and shorter times the longer I've taken it.

I'm going to have a break today and see how I go, maybe start it up again on Thursday.

[Troypants]

Ive had marked increase in vasoconstriction today, quite noticeable increase in adrenaline.

I am interested to know whether continued use causes withdrawal, it doesn't sound like it does, but if it doesn't it could be very useful, as long as the effectiveness stays stable over time.

[Troypants]

I'm stopping the agmatine, it seems like my body was getting used to it and I'm afraid of having withdrawal. It made me really tired and cloudy headed and I felt like my blood pressure had dropped quite a bit.

It may be helpful for others, but I didn't like the effects after consecutive use.

[Troypants]

I'm getting pretty over this shit tbh, I am going to get a script for testosterone hopefully and see if that helps. If it doesn't I am considering low dose prozac with buspar or something I don't know, I want to get through this but it feels like it will never end at the moment. I've come such a long way but I just want to be able to function properly, you know, have fun and socialise and shit.

[invalidusername]

Hi Troy.

 

My apologies for the delay catching up here and to all for my absence in general. I am in such a bad way with the wife's case against the NHS and it has been taking every hour God gave us.

 

Glad you tried the agmatine but I would have said that you shouldn't get too excited about it as all these things rely on getting a very specific balance rather than just "upping" everything. Unfortunately this isn't a game of throwing enough balls to win a fish. It is precise work that we don't fully understand ourselves. But no harm in trying.

 

Regarding your other question, you can read about my entire journey in the two following forums;

 

https://www.cymbalta...ea-where-to-go/

 

https://www.cymbalta...fter-last-dose/

 

Plenty to read through there! And please feel free to ask me anything about any of the content. I have no problem revisiting it as that is all part of the recovery. We don't bury these things and pretend they never happened. With a job done right, there is nothing left to be scared of as you know how to deal with whatever comes your way again...

 

Again, sincere apologies for my absence. I would explain, but I would be here all evening!

 

IUN

[Troypants]

Hey IUN, I found one of your threads, I left you a message on there and I don't think you recognised me haha.

Its all good mate, we all have life to navigate, and you can explain it all you want if you need to, I'll listen.

Can I ask how you guys feel now after a couple + years of recovery, and what medications you are on now?

I just want to get back to life to be honest, I'm on 2.5mg duloxetine, I have low testosterone, and I am almost always at some level of hypervigilance and it just makes it extremely difficult to socialise and generate good feelings for myself. Its been 1.5 years since I had my last big drop, a couple of months since I dropped from 3mg to 2.5mg. I'm much much better than I was but I just feel like I'm missing out and its wearing thin. I can't even apply for a scholarship because I don't want to have to goto the awards ceremony. I push myself to get out a couple of times a week, and its got a lot easier, but its still not easy or enjoyable.

I'm going to try testosterone injections if I can get the endo to prescribe it, and if that doesn't help me out, I am considering remediation but I really don't want to go on cymbalta again cause its a shit go to come off.

[fishinghat]

You should feel a noticeable improvement in your emotional status after going on the testosterone.  Low T is famous for causing depressoin. And problems in that area?

[Troypants]

Yeah hat, I've had low testosterone every time I check it, checked it at least 4 times in the last year.

I was on injections a couple of years ago, self prescribed, and I felt good, but I was also on duloxetine so I'm not sure which was the biggest contributor. But that was the reason I was coming off the duloxetine, I felt good, and the high blood pressure from duloxetine was annoying me so I figured id come off.

Since then, I've lost a lot of muscle that I had, and my bones are becoming thinner, and anxiety is shit because I don't have confidence in myself and I over think everything negatively, and I'm missing that control over my thoughts.

So hopefully I can get on the test, and I can get my mind and body back.

[Troypants]

Hey IUN and hat, can you guys tell me if you are still on SSRIs, what dose, and how long it took you to feel socially capable and look forward to going out with people rather than wanting to avoid it?

I'm 1.25 years along and still at 2.5mg duloxetine. Things are getting better and I don't immediately hyperstartle at triggers, sometimes I do but it is far less. Still quite hypervigilant and socialising is still a task, although I do get some reward out of it though.

[fishinghat]

Troy, i was put on 150 mg Zoloft because of my Cymbalta withdrawal. I have recently began weaning off and am down to 134 mg (Still a long way to go). 

 

As far as "how long it took you to feel socially capable and look forward to going out with people rather than wanting to avoid it" i am not sure I would be a good example as I am not a social person and a definite introvert. I never really felt socially limited as I do not feel the need for routine social contact. I felt less stressed by going out in public (eg. shopping) about 4 or 5 weeks after starting the 150 mg Zoloft.

 

As far as the "I'm 1.25 years along and still at 2.5mg duloxetine.", that is a little fast. I always tell people that if I had it to do over (God forbid) I would do a 3 year wean instead of 3 months so be patient. As long as you are showing signs of improvement try to hang in there.

[invalidusername]

Hi Troy - 

 

I am still on 30mg Citalopram and much like Hat, I could say that I am a good example. Everyone's circumstances are different. 

 

I was first put on Citalopram following a car accident at 70mph and narrowly escaping a coma. It took me 18 months to come around from that, and then I had 10 years with no problems at all. Then 5 years ago I had a relapse courtesy of my wife being screwed over by the Home Office and the health service over here in the UK. 

 

Wouldn't say I am completely stable, but this is 100% due to ongoing circumstances. 

 

"As long as you are showing signs of improvement try to hang in there."

 

Just as Hat said - I agree...

 

IUN

[Troypants]

Thanks guys, so you had no issue going back on?

I went to psychiatrist today and her diagnosis is OCD, which I guess I've always had some of but it's very noticeable now. Past drug abuse didn't help.

She wants me to go back on, either 60-90mg duloxetine or 40mg prozac, plus quetiapine(seroquel) as needed.

I would like to try testosterone replacement and see if that helps before I think about going back on SSRIs.

I didn't come off the duloxetine over 1.2 years, I meant I had only dropped dosage once over the last 1.2 years by 2 beads, stabilising for 1.2 years. I've been tapering for at least 2 years.

I felt good on physiological testosterone replacement + 60mg duloxetine. But as my hematocrit came up I started getting withdrawal effects from the duloxetine which was relieved when I gave blood, I assume its because of blood volume change with the red blood cell increase. I come off the duloxetine because I thought it may be the cause of the high hematocrit, due to its vasoconstrictive effects, and I liked how I felt on testosterone. I didn't realise the high hematocrit wasn't actually the cause of the shitty feelings, it was more likely from changes in duloxetine plasma concentration, as these effects were identical to the withdrawal effects I recognised later.

Now I wonder if the testosterone by itself would work, or whether I would feel better on 60mg duloxetine with the testosterone.

[Troypants]

Or maybe on another SSRI + testosterone...

[fishinghat]

A simple blood test can determine if you need more testosterone.

[invalidusername]

I am waiting for some testosterone results to come back as we speak. 

 

I have no problem in making it public that I have these problems. 

 

Without making it too graphic, there is nothing expect a "real life "situation that might satisfy my urges. I have no interest in the smut that can be found online. My wife, as most on this form know, suffers severe mental health and has no sex drive at all, so whether it is something that has been driven into me, or a result of the pills I do not know.

 

So I don't have a definitive answer for you, but all I can tell you is that I have no sexual desire most of the time, and when it does, it quickly dissipates. I have no outlet, so it is not so much of a problem for me.

 

I hope that isn't a little too much information for some, but we believe in honesty in the forum and if it helps some, then all the better. Just FYI, I am 44/M, so not exactly outside of my prime!

 

IUN

[Troypants]

Hey guys, yeah I'm no prude, we're here to help each other.

I have sexual desire, I'm just not in the right frame of mind or socially calm enough to go and approach women. I can't really get it up fully either.

I'm more worried about other things at the moment, I know testosterone makes me feel driven and motivated, it gives me more energy, better bone density, I can actually gain muscle in the gym which makes me feel 100% better. I feel like half a man when its low, its important for a mans health and wellbeing to have correct hormones.

Its the mental aspect that I'm thinking about, I'm not going out and picking up until I get that sorted.

I know its low because I've had saliva tests every month for the last 6 months. I just hope that I can get a prescription, and that it helps my mind.

The pdoc says I have OCD, the obsessive thinking, intrusive thoughts etc, 100% from the post acute withdrawal syndrome imo. Dunno if the testosterone will help with that, but we'll see.

If it comes down to it, I will go back on an SSRI if this is just how my mind is because I'd rather live than be socially aversive. I still need to find a good woman and start a family, I'm 35/M and I actually want to do this sometime I'm the near future, and I can't do that if I'm too scared to go out and meet people.

[fishinghat]

I might as well join in. I went into testosterone failure when on Cymbalta which led to my Cymbalta withdrawal. Usually when this happens from taking a ssri/snri things return to previous levels but that was not the case with me. This condition is called PSSD (Post Ssri Sexual Dysfunction). I had to go on hormone replacement therapy (HRT) but while that cured the side effects of lack of testosterone it did nothing for my sexual function. I have absolutely no ability to have intercourse and not had sex in nearly 10 years. The really bad part is that I still have a tremendous libido which is unusual in these situations. This libido creates a great "distraction" in my life. I have seen 3 different drs about my PSSD and they said there is no known treatment for it and there has been little research done on it. Some of the online recommendations seem a little risky and are unproven and many use supplements with little side effect information. My wife has had many back surgeries and has nearly constant pain, so her libido is long gone.

 

By the way I am not 44 (lol). If you double that you would be a lot closer to my age. 

[Troypants]

Hey hat, have you though about getting your prolactin levels checked? Cabrergoline might be an option

I used to use cialis for the erectile problems which worked pretty well.

[invalidusername]

Hey Guys,

 

This is something that can be very close to us guys and Troy, I totally get where you are at. Being on the forum for as long as I have, Hat has kept me up to date with his situation... and my (older!) brother, you know I feel so much for you having gone through everything to date, the research, the trials of so many supplements. 

 

I think the issue for me is that my wife just does not have any interest at all. Again, this is clearly put down to her mental health. It will have been 5 years in December that we last had sex. And as I said, over time, this has depleted my own levels of sexual desire. It is barely there. The only thing that now interests me is sex, as I said. I haven't engaged in self pleasure for months. Prior to the issues that set my wife off, we had a good sexual relationship, but I cannot blame her for what happened, nor her reaction to it as I know full well what it is like. It is akin to asking someone to eat a meal just after you have eaten. Doesn't matter what it is, you just don't want it.

 

Please keep us posted on how things get on for you Troy. So now you have my circumstantial version of how these things can happen as well as Hat's version which was bought about initially by his medication. 

 

IUN

[fishinghat]

Prolaction and all hormone levels have been normal since starting HRT in 2013. 

 

I have not tried Cabergoline but will check it out (Thank you for the suggestion) but have tried Cialis and Viagra with no effect whatsoever. There is some research on other possible medications/supplements but tests show they didn't work either.

 

Thanks for the suggestion.

[Troypants]

Thanks IUN, maybe your wife could try cabergoline too . Its a dopamine agonist and can cause hypersexuality.

I suggested it because dopamine acts in the pituitary to lower prolactin, prolactin acts on the hypothalamus to block gnrh, gnrh acts in the pituitary to release FSH/lh, lh acts on the testes to release testosterone, or in the ovaries to trigger ovulation.

So prolation causes low levels of sex hormones, and is well know to cause erectile dysfunction.

Plus dopamine is essential for sexual desire.

SSRIs tend to block dopamine signalling in key areas including the pituitary, so they can lower sexual desire, and sex hormone production.

Food for thought, I know from past drug use that dopaminergic drugs can cure hyposexuality no problems when used in the correct amount.

[fishinghat]

Impressive Troy. Well done.