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Originally Posted by DoctorTan
Completely agree that over-prescription and polypharmacy are a big problem in today's practice of medicine
Also completely agree that many medicines especially medicines to treat mental health have ED and low libido as a side effect
For patients who really need pharmacotherapy I tend to favor Agomelatine which has fewer sexual function side effects
That said, from your description of your symptoms "Hear ringing noise, irrational fear that everybody wanna harm me" it sounds to me that you may not have just straight forward anxiety. It sounds to me like you may be suffering from early psychosis. So I think it is very important that you continue to see your mental health professional. Have a frank discussion with him/her about your sexual health concerns and try to find a way to improve this without adversely affecting the management of your mental health.
Because uncontrolled psychosis is a very slippery slope and can have rather unthinkable consequences
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The biggest elephant in the room that nobody talks about and that some doctors are unaware of is the fact that sexual dysfunction can continue even after medication is withdrawn. No doctor should prescribe an SSRI/SNRI without first warning a patient of the potential disastrous long term side effects for which there is no known treatment at present.
PSSD
https://www.pssdnetwork.org/
What is Post-SSRI Sexual Dysfunction?
Post-SSRI Sexual Dysfunction is a condition that can arise following the use of antidepressants in which sexual function, cognitive and/or emotional function does not return to normal, or worsens after stopping the medication.
The strict definition of PSSD refers to the persistence of sexual dysfunction after stopping SSRI or SNRI medication, however, significant sexual dysfunction can happen while on treatment and after stopping any serotonin reuptake inhibiting (SRI) drug. Furthermore, there are anecdotal reports of the condition arising after the use of tricyclic antidepressants, atypical antidepressants and antipsychotics.
The medical term, 'PSSD', does not accurately highlight the debilitating cognitive and emotional impairment that many people with this condition also suffer from.
It is common to develop side effects while taking antidepressants, however, it is not currently known what proportion of people recover fully when they stop taking them. For some people, symptoms only start appearing when they stop taking the medication or begin to reduce the dose.
PSSD affects both men and women. It can happen after only a few days of exposure to the medication and can persist for months, years, or indefinitely. There currently is no known cure.
PSSD can be detrimental to the lives of the people it affects. It has caused marriages to fail, unemployment, and in the worst case suicide.
Persistent sexual dysfunction from SSRI/SNRI medications (lasting long after quitting) was acknowledged by EMA (European Medicines Agency) in 2019.