Wow, what a description. Could i ask permission to use this for teaching? This is the best description of EB i have read, but it describes the importance of emotions in all of us. SSRIs reduce amygdala firing, which is a core component of PTSD pathophysiology. However, the same pathway mediates arousal, and threat response mediates reward. A delicate balance. Thank you for such a poignant description. I hope you feel better with the switch. Please let me know if you would like me to attribute the quote to your name if i have permission to use it.

@@PsychiatrySimplified Yes no problem, I'm obviously relieved to be heard and understood, after so long being ignorant of the actual mechanisms involved. It's just a shame that I couldn't actually feel the immense elation, at the discovery of the sheer extent of knowledge, on the subject of SSRIs, irony!

I’m curious - how do you see the SSRIs as affecting your PTSD? Did they help? This trade off - how do you weigh it? Thanks again for engaging.

@@PsychiatrySimplified Sry I didn't like my previous reply, it was partly based on my current knowledge and not my consciousness at the time. The PTSD triggered a 'shutting out' of everything as I became vulnerable and unable to cope, I became a zombie essentially. The Sertraline took a while to 'kick in' and have a notable effect on my moods and emotions. I started feeling less negative and less reactive to my environment, this was very calming and I gradually realised that I could actually function on a basic level much better, albeit with lethargy, disinterest, disassociation, and absolutely no emotional/sexual reaction to anything!. I was also not cognitively impaired at all, in fact I could fully understand my state of mind, think more clearly and communicate in a calm manner, 'untroubled' by emotions. Life was much better and I honestly didn't see it at the time as a trade off, ie: Losing all negative emotions, vulnerability, lack of confidence, depression, anxiety, fear, etc etc in exchange for losing all emotions was not a conscious consideration at the time. Coming from a deep and dark pit into the light (however dull) was In essence such an improvement that it subconsciously far outweighed the loss of something I didn't really miss (at the time). I had become totally seduced by the numbing effects of the drug and although I wasn't happy I was pretty satisfied with my lot.

Hi, can I ask which medication you are on? ❤️

You won't know any different for 18 years then! try two years off them and connect!

I am in that zone and it is hard to even feel motivation in any sence. I try to, at least, go to work but I am losing that too. I just don't care about much of anything. I have even dodged my grandkids. My biggest fight is fighting the urge to despise myself. It's hard at times but at least I know it's not my fault and I am not the only one experiencing it.

​@@cynaptyc please gradually taper the meds if you're stable. These side effects can endure for years, or even permanent without treatment. Look into a therapy called behavioral Activation to help rewire the brain.

@@cynaptycare you currently taking meds? If so try to wean off them .. the emotional blunting and avolition are horrible though.

Bupropion can be prescribed as an adjunct to SSRIs and it can reverse all sexual dysfunctional symptoms, or it can be taken instead of SSRIs as it also works as an anti depressant.

@@brianmeen2158 i am currently on Suboxone, now down to 4mg twice a day and also Buspirone 15mg a day. In process of weaning of both. Albeit i know the Suboxone is going to take a lot more time. I do feel a bit moody but it is still way manageable. Also been off of Duloxetine, after wean off, for 2 months after about 5 years. No manic depression this time! In fact i am feeling more emotional lately but it's not as hard as before to deal with it!

Have you tried alternatives? Diet, exercise, supplements, support group, therapy? I find that when I eat right and supplement, even if I isolate and I am sad about it, I feel better connected to nature which helps me to appreciate actual sunrises and sunsets. I experienced the same thing on SSRI. Bouts of rage, for which psychiatrist gave me mood stabilizers and neuroleptics. Very dangerous combination. I am happy that I am free of drugs. But that is only becouse I kept digging and looking for information about these drugs and psychiatry as a whole. Today I know that they are nothing more than poisons that accidentally keep anxiety and depression at bay - just as alcohol enhances your mood and relaxes you. And that comes with long term consequences, as with any substance. They are not medications, they are just drugs and psychiatry have very little and sometimes conflicting basis in science. Wishing you the best.

@@michasosnowski5918 Thank you for that answer. I am quite careful with diet and exercise and am aware that most serotonin is produced in the gut and so diet is the key. I have been smoking weed for the past few years and that works fine at keeping the rage at bay but have recently been diagnosed with CHS, so in my case, I think it made things worse over time. I have tried from time to time to stop taking the Venlafaxine but find the withdrawals are too much to cope with. I feel that I gave up on wanting to be free of the drugs a long time ago and that is more of a submission than being happy to be on that hook.

@@michasosnowski5918- Hi, Thank you for your comment… are there any particular supplements that you know of that help with Anxiety & Depression ?? Would appreciate your feedback?

@@intermilan6202 Its good, but tricky question. I think when it comes to depression, the best one for me is vitamin D. I find that I enjoy nature and weather more. I look at the clouds like I was on some kind of drugs, they mesmerize me :P It certainly enhance my mood, but it doesnt change the painfull emotions you might be feeling - you still will feel them, just with a little pink cloud over them. I dont think there are supplements that will cure depression or anxiety, becouse they are part of life and responses to relationships and the past - that needs to be dealt with seperately(like yournaling, support etc). But junk food and poor sleep can certainly worsen depression. So be sure to eat plenty of fresh and cooked vegetables and some fruits and nuts/avocados/olives. When it comes to anxiety, I find that the more healthy I eat, the more I feel the anxiety(at least initially). Healthy food connect me with deep part of my soul, and that might be scary at start. Mostly when it comes to sleep at night - I get scary dreams. But that might not be your experience. I heard that GABA enhancing foods are good(coconut oil, butter - but you dont want to overdoe them also). Also be sure to eat lots of food containing magnesium and zinc, and cut some diary(diary for me can worsen anxiety, while magnesium containing foods like bananas or whole grains calm me down). Studies show that exercise are as effective or better as drugs for anxiety and depression. 30min of vigorous exercise 3 times a week should be a good start. Wish you good luck, strenght but also plenty of kindness with yourself(that also helps with A&D :).

Same, helps me tremendously due to being highly emotional, my medicine keeps my emotions in check.

​​​@OsakaSyndrome​ I m also feeling sexual numbness during forplay... There is no hot feeling when touch a girl ! I get erection pleasure and orgasm also...when I think about sex and do sexy talk with girls on call and do masturbation ! But dont feel hotness When touch a girl body in real ! I feel like I m touching a boy body or a child body... When do forplay with girl 😢😢😢😢 I took 5 mg of Escitalopram and 0.25 mg clonazepam for 4 month.. Then I left it within next 2 month by tappering slowly slowly ! But after 6 month of tappering completely I m facing this issue What should I do 😢😢😢

so what can you do about this

Idk I kind of enjoy not having rage all the time. But I agree with some of the rest.

@@Scarlettbankergirldo u not get angry anymore?

⁠@@Scarlettbankergirloh did u have rage before and now its permanently gone???

Thank you for your feedback

Sorry to hear. Hope you can get the appropriate treatment. Wish you well

@@PsychiatrySimplified Thanks. I think it is naive to suggest there is an 'appropriate treatment'. From my reading of the area and from what David Healy says, there is no cure. Its the new (invisible) tardive dyskinesia. And just like when TD began to happen, most psychiatrists pretend it doesn't exist.

@@PsychiatrySimplified have you researched any treatment or ideas to healing/repairing the cognitive function of the brain after SSRI or AP exposure?

​​@@jaredmreaganThere are new drugs. As well and non-drug treatments like magnetic stimulation. And an old one electric shock treatments. Neither is painful.despite the term 'electric shock' ,may sound terrifying.

@@PsychiatrySimplified I like that you reply to people that are truly suffering.

Yes will certainly add that to the list. We have done a video on sexual dysfunction where pssd is covered briefly but recognise that it needs a separate video. kzfaq.info/get/bejne/mJ1hgt2B2tC1dJs.html

@@PsychiatrySimplified Thank you so much, you probably cant even imagine how much of a help this might would be for all the sufferers of that condition, mostly nobody believes you.... and the doctors who prescribed you the medication start to gaslight you.... i talked to so many people who made exactly the same experience.... also its hard 2 talk with others about that

Yes, a separate video on PSSD would be greatly appreciated by me & many of your followers! I would also be curious if you want any full stories i can write mine up and share it with the channel.

There is also a Sub on Reddit dedicated to the condition with 4 thousand members.

@@js7018 sure - with consent I can use it in the video as appropriate.

Thank you for your feedback. appreciate it.

​​@@PsychiatrySimplified​​​ I m also feeling sexual numbness during forplay... There is no hot feeling when touch a girl ! I get erection pleasure and orgasm also...when I think about sex and do sexy talk with girls on call and do masturbation ! But dont feel hotness When touch a girl body in real ! I feel like I m touching a boy body or a child body... When do forplay with girl 😢😢😢😢 I took 5 mg of Escitalopram and 0.25 mg clonazepam for 4 month.. Then I left it within next 2 month by tappering slowly slowly ! But after 6 month of tappering completely I m facing this issue What should I do 😢😢😢

Thank you for your feedback 🙏🏻

That's really good to hear. They are helpful. Re sleep there are options that can be considered to counteract this sleep dysfunction. A sleep evaluation, ruling out sleep apnea and synergy with medication to counteract the SE can be done. We have a video on insomnia kzfaq.info/get/bejne/iNiUq5Ri16rFaaM.html

@PsychiatrySimplified thank you. I'm sorting things out one thing at a time. First things I did was sort out my personal hygiene and start eating more than once a day. I didn't have an ED, just depression things lol. Now I'm working on making healthier choices with food. I think physical fitness is next, and then I might tackle sleep after that. Baby steps, CBT, and all that jazz I'll check out your video though :) thank you for the recommendation

I am off SSRIs now but spent about 10 years on paroxetine. I have used strong medicines to help me sleep but the quality of sleep was not good on them, but then I tried melatonin and this was fantastic for me, it gave me natural refreshing sleep with normal dreams. I recommend taking it, but you have to inform your healthcare provider first to ensure it is safe for you to take this. Other than that it is very cheap and does not require a prescription. Marijuana can help also but again you need to discuss this with your doctor or psychiatrist first ! These two drugs I mentioned are not perfect for everyone. Good Luck with your sleep and your ongoing recovery. I hope you have a great day today. If today is over already, then I wish you that for tomorrow.

amazing. you cant sleep anymore. thats really good yeah

@@GuilhermeGomesmmm suicidal thoughts Vs being tired, I know which I'd pick. Lifestyle changes can help with tiredness, like diet for example. I often sleep for 4 hours, do some housework, errands, whatever I can, relax for a bit, then sleep a bit more. It's far from ideal, don't get me wrong, but before I was just sleeping for 11 hours and not doing anything with my life.

I just read your comment and I can relate to what you have said. I have been on Effexor for 23 years and to be honest I've also self medicated with other things to try and feel something but now I've decided to stop all other self medications and lower my meds to get off them. What's the worst that can happen right ! Truly cannot be worse than the withdrawal from alcohol or the discontinuation of the Effexor. 🫤

Bro I feel the same way you explained exactly how I feel wow bro I wish I never started this

Sorry to hear. There have been a lot of requests for PSSD so it's definitely on the list.

Thank you for your feedback. 🙏🏻

Thanks for your feedback 🙏🏼

Thanks for your feedback 🙏🏼

Yes it has been requested a lot so will do this one for sure

good point - yes via glutamate modulation it can improve cognition and perhaps other symptoms. - it's not used for this purpose though. I;ve covered memantine and indications in this article - psychscenehub.com/psychinsights/memantine-psychopharmacology/

Thank you for your feedback 🙏🏼

Anything worked for you? I've found cialis to help and other artery expanding supplements such as arginine, citralline and some chinese herbs. The psych meds are usually vasoconstrictors which exacerbates these issues, if it isn't the very root cause. THere's been a study confirming the relationship between ssri's and cerebral vasoconstriction, as well as peripheral vasoconstriction. This and heavy exercise has been my best strategy. All to get the circulation and vascular tone back to normal.

Sorry to hear. Have you discussed this with your prescriber? Emotional bluntimg can be treated and there are other antidepressant options as well. Please speak to your doctor. Wish you well

​@@PsychiatrySimplified which are the other antidepressants for it?Does brintellix give you an emotional bluntness?

Try Wellbutrin as add on with Lexapro ...

Moclobemide is a RIMA and can be broad spectrum just as Vortioxetine. Main issue is twice or thrice daily administration. It has a good side effect profile. Vortioxetine has multiple mechanisms of action - SSRI action is minimal ( 50 percent less SERT inhibition) ; here is an article psychscenehub.com/psychinsights/vortioxetine-mechanism-of-action-2/

@@PsychiatrySimplified Thank you so much!!! I will read the attached info on vortioxetine. Interesting that it doesn't reuptake serotonin; I had no idea!

@@PsychiatrySimplified What combination is known to be used for those that need the full SSRI effect but need a boost in emotion, reduce apathy, motivation as some people are emotionless, have no drive, apathy etc to begin with prior any treatment yet SSRI helps with anxiety

Sorry to hear. Yes many have requested a video on PSSD. Are you saying the blunting has been persistent or secual dysfunction or both?

How are you now ?

​@@PsychiatrySimplified​​​@OsakaSyndrome​ I m also feeling sexual numbness during forplay... There is no hot feeling when touch a girl ! I get erection pleasure and orgasm also...when I think about sex and do sexy talk with girls on call and do masturbation ! But dont feel hotness When touch a girl body in real ! I feel like I m touching a boy body or a child body... When do forplay with girl 😢😢😢😢 I took 5 mg of Escitalopram and 0.25 mg clonazepam for 4 month.. Then I left it within next 2 month by tappering slowly slowly ! But after 6 month of tappering completely I m facing this issue What should I do 😢😢😢

​@@PsychiatrySimplified the blunting can definitely persist after meds are stopped. It's happened to me and many others. It's extremely disabling because you lose normal motivation and reward response. I can function with numbed emotion, but not with avolition, fatigue and lack of normal capacity to care about anything. Can't even shower. It's horrendous.

@@mcb00 “you lose normal motivation and reward response” I’m suffering from these right now and have for quite awhile. I exercise daily and that helps but beyond that I just do not feel anticipation for much of anything. I wouldn’t even walk across the street for sex . Yet doctors just want to prescribe more meds

Thank you for your feedback. Appreciate it 🙏🏻

Was just commenting on the other video we did on agomelatine where a viewer commented on this swap. How is Agomelatine different from other Antidepressants? | A Psychiatrist Explains | Dr Rege kzfaq.info/get/bejne/mK-egZOf2Zq3Yo0.html

@@PsychiatrySimplified haha that was the first video i watched when i was prescribed Agomalatine from my gp.. keep up the great content

Thank you for sharing your personal experience. It is a distressing side effect no doubt.

The only emotion that I want blunted is sadness and depression, irritability and agitation.

​​​@@PsychiatrySimplified​ I m also feeling sexual numbness during forplay... There is no hot feeling when touch a girl ! I get erection pleasure n hotness in penis and orgasm also...when I think about sex and do sexy talk with girls on call and do masturbation ! But dont feeling hotness When touch a girl body in real ! I feel like I m touching a boy body or a child body... When do forplay with girl 😢😢😢😢 I took 5 mg of Escitalopram and 0.25 mg clonazepam for 4 month.. Then I left it within next 2 month by tappering slowly slowly ! But after 6 month of tappering completely I m facing this issue What should I do 😢😢😢

@@cindyrobertson3780 so so true Cindy. Me too. Sending 💖

@@cindyrobertson3780it doesn’t work like that though. Ssris will definitely blunt the negative emotions but also things like enthusiasm and sex drive . I wish they didn’t but they do

Unfortunately for some the side effects outweigh the benefits.

Good question. In general in the presence of an antagonist ( blocker) - receptors will upregulate ( more receptors ) as you said and more sensitivity sometimes. In presence of an agonist - downregulation. Could do a short video in future linking to side effect such as tardive dyskinesia. Thanks for the suggestion.

@@PsychiatrySimplified Thanks that makes sense, I'm guessing withdrawal is attributed to this mechanism which goes hand in hand with tolerance? An imbalance in receptors results in an overactive or underactive part of the nervous system in a withdrawal. What doesn't make sense to me is why tolerance builds up quickly, but after cessation in many cases takes far longer for receptors to regain equilibrium absent of the drug? I ask because I have a mirtazapine withdrawal which I did comment on your mirtazapine video. I thought of the Idea of using a H1 agonist to counteract Remeron's H1 antagonism but I don't even know if it's possible to obtain anything like that or even if that would work.

They're probably being narcissistic to you. Gaslighting you to get their own way. Ypu don't owe them setting yourself on fire to keep them warm ❤

Ssri and snri augmentation is an established augmentation strategy with minimal risk of serotonin syndrome as mirtazapine has minimal serotonin increase and has serotonin antagonist properties. STAR- D trial had venlafaxine and mirtazapine combination as 4 th line in TRD. I've covered this in the video on melancholic depression and also done a separate video on mirtazapine where I cover properties in more detail. Mirtazapine - Mechanism of Action and Psychopharmacology By Dr. Sanil Rege kzfaq.info/get/bejne/kMdzn8uI2Jy2qoU.html Bupropion is a good choice for augmentation. Thank you for your feedback.

We can't specifically provide advice here but in general agents that promote NA and or DA have a lower incidence of Sexual side effects. Here we cover some additional aspects of AD induced sexual dysfunction in general. kzfaq.info/get/bejne/mJ1hgt2B2tC1dJs.html

Glad you found it useful.

Do you mean after stopping medication or while on it

@@PsychiatrySimplified i meant while on it but I’d be interested to know how long it would take on both cases

@@webw3b346 while on medication SSRIs are usually most associated with it. In general if present after dose is stabilised for > 2 weeks and not reduced then it could indicate dose adjustment needed or switch to other AD: some patient find the blunting helpful as it keeps the anxiety at bay, reduces the hypersensitivity to distresing stimuli. If however one finds the blunting problematic - discuss this with doctor: usually after stopping it goes away in 1-2 weeks ( may will find rush of emotions or emotionality). There are other options which include dose reduction or divide reduction plus another AD which is not associated with blunting e.g agomelatine, vorrtiixetine, bupropion etc: your doctor would be able to discuss these options. With you well. Emotional blunting persisting after cessation or switch to other nedication ( one that is not associated with EB) long term is every rare. Ps not medical advice

@@PsychiatrySimplified thank you so much for the valuable information. Greatly appreciated!

@@webw3b346 his lying to you the emotional blunting stays their forever I still feel it till this day and its been a yeat

Thank you for your comments . What Depression and Anxiety Look Like in the Brain kzfaq.info/get/bejne/rN9patqLtt-pomw.html Recovery - The Neurobiology of Recovery in Mental Health - Understanding Motivation and Reward kzfaq.info/get/bejne/ip2Embd9nMqdfIk.html

Please seek a medical opinion again. We wish you well.

Thanks for the feedback. Can't give advice but in general. 1. Reduction of doze fo evaluate is reasonable 2. Reduce dose plus combine with agent that combats emotional bkunting and doesn't worse. / treats anxiety - agomelatine : vortioxetine ( not as good for primary anxiety) . 3. Switch ( greater time to implement, risk of withdrawal. Ps not advice.

Sexual dysfunction and Anhedonia frequently coexist as similar mechanisms. It is highly unlikely though after one tablet. But I’ve learnt never to dismiss anything but probability is low. Usually the most common reason is an underlying anhedonia related to depression. This is only identified through history and examination. Anhedonia consists of 3 types . Anticipatory ( no point doing it because I won’t like it anyways) , Consummatory ( I want to but I don’t get any enjoyment ) ; motivational ( I don’t want to ) . In depression begins with second then moves to first and then in severe cases third. Anhedonia as you can see with depression depending on duration can be all 3. If all 3 or even two are present this is more likely depression as a single dose is unlikely to lead to anticipatory as that takes time to affect reward learning. SSRI blunting initially affects the Consummatory.

@@PsychiatrySimplified Thank you so much Dr. Sanil. I’ve been spiralling into an anxious mess trying to work out what has been going on the last two days, but your reply is very well explained and has helped me a lot. All the best, so good to hear some helpful info on this topic from a fellow Aussie! 👍

I just took 25 mg for just 4 days of sertraline, and I feel like EMOTIONAL NUMBNESS without feelings Can you tell me how did you recovered your physical feelings please?

Dopaminergic agents - agomelatine ( video on this channel), mirtazapine ( video), bupropion, psychostimulants ( video on this channel) ( require specialist input), tricyclic antidepressants and MAOIs ( specialist input. SNRIs. However maoi, tca and snri contain the S component so can still lead to side effects associated with serotonergic activity. ps not advice

Those are HIGHLY illegal.

@@justinedse8435 MDMA and Psilocybin are illegal, but the degree to which varies greatly. Psilocybin is being decriminalized in several places and some are even pushing for full legalization. Ketamine is completely legal with a prescription, though its hard to be approved for in most places it is certainly an option

Advising over a forum would be in appropriate. Lexapro is evidence based and effective for anxiety and dose can be increased - this will depend on tolerability. Buspirone is also evidence based for anxiety - this is a discussion best had with the treating doctor as they will know the plan and your specific circumstances. Thank you for your feedback and wish you well.

@@PsychiatrySimplified Thanks, always look forward to your videos: You help make research actionable, because when we understand the evidence we're better able to discuss with our providers.

@@PsychiatrySimplified Yep out of all tablets i tried and it was many, Lexapro was the best for anti-anxiety.

This is a really broad topic. Have you discussed this with a doctor or a psychologist?

We have just done a video on PSSD - we cover treatments. However the management can be challenging. kzfaq.info/get/bejne/aZplmqh835zPfIU.html

Sorry to hear. There are ways to address this as discussed towards the end of the video. Agomelatine, vortioxetine, bupropion are agents that do not lead to emotional blunting and may reverse it. Ps not medical advice. Please discuss medications with your doctor. Wish you well.

Vyvanse is dexamphetamine which is dopaminergic - the mechanism of ssri indices blunting is reduction of dopamine in ventral striatum - which vyvanse will counteract. This is an appropriate strategy if indicated and monitored.

Try rhodiola rosea, its very safe, fights stress makes my mood more vibrant and colourful. Its slighly stimilating (dopaminergic) but also it helps anxity

Stimulants tend to stop working and in some cases cayseta rebound effect, so you're left more apathetic and numb thsn before. Please be careful.

Sorry to hear. It's a difficult question to answer. A discussion with a medical professional or psychiatrist is recommended as there are a number of aspects to be ruled out.

Maybe they need to start earning their pay cheques. This would be received on how many patients they actually helped accurately .

Yes it is such an unfortunate side effect of SSRIs

Same for me, I was only on sertraline for 2 weeks 6 years ago, life has been ruined by anhedonia, you can't make any life decisions and it's a pretty pointless existence

These are recommended agents to counteract blunting. Dopaminergic and nor adrenergic agents can treat emotional blunting

Generally emotional blunting post SSRI is due to residual non medication effects than a post SSRI effect. So the things you mentioned will help if mild. Exercise, activity, regular routines, goal directed activity are things that help with Reward enhancement through dopamine. Otherwise medications that are dopaminergic are considered Rx.

vasodilators can help. Psych meds are vasoconstrictors and also affect venous tone, which can even further issues. Exercise, arginine, citrulline, creatine, protein powder, cialis (tadalafil) has helped me. Oh and saffron too. Make sure you have your overall vitamin and mineral needs met.

Sorry to hear. Hope things are better

Emotional blunting is a very specific symptom. This can be confused with brain fog, or slowed cognition arising from other causes. Emotional blunting is usually described in the context of medication related blunting.

please look into # PSSD ( post SSRI sexual dysfunction)

It is on the list. Will do one hopefully soon.

@@PsychiatrySimplified Thank you!!

Just got back from the fourth doctor that gaslit me about it. Even after I referenced the reported side effects of vasoconstriction (a huge part in pssd). The response he had to that was: "well you haven't been diagnosed with that have you?" I'm like, yeah not yet, I'm trying but so far nobody believes me. Next time I'm gonna write an entire thesis about my diagnosis; but that will probably only serve to make me seem even more crazy and conspiratory. Hopefully the neurologist will believe me. There really needs to be a revolution on this subject.

SSRI can be associated with this yes but of course other aspects need to be ruled out. Over time for some dose modulation is needed. In clinical practice in the context of such side effects a gradual reduction often can reduce or disinhinit the blunting ( like lifting the leg of the brake a bit - not completely ) .

@@PsychiatrySimplified Yes I should have had a 'maintenance dose' at some point apparently and yes the effects of the original problem (depression/MDD) will have contributed towards my mental state as well my personal circumstances. I realise the many cases of SSRI side effects can be diverse and people can be affected to different degrees, I'm sorry if I seemed a bit 'full on' but I haven't been able to share this with anyone who understands before and express myself to this extent. I see two paths ahead, either gradual reduction of dose or change to Vortioxetine to better moderate the control of Norepinephrine, Dopamine etc as perfectly illustrated in your video. Thanks again.

Will do

Get viagra, phizer gor u covered💪

Hello Jack. I just took 25 mg of sertraline for 4 days. I feel emotional bunting now

@@josefdez8258how are you doing now? Are your emotions back?

Sorry to hear . It is an important topic and unfortunately under recognised. We just released a video on this kzfaq.info/get/bejne/aZplmqh835zPfIU.html

How are u right now? I was taking right now that med it feel like im a robot and zombi i will stop this medicine it makes me crazy

@hardesttruth0116 I totally agree with you about the immense harm caused by psychiatric drugs and my heart goes out to you as well! In fact, my life has been destroyed by family members and others who've been on one or more drugs for many years, or even decades, including my late mother. I won't go into the details because you have more than enough to deal with, unless you've improved by now, which I hope is the case. ❤

Like someone else has said, There is constant blank mind. It feels almost like a brain injury. If you can address or comment I'd appreciate it. Thanks

@@portside228 Good question. The exact mechanism is not known. It is a similar mechanism to persistent sexual dysfunction, which again is not clear. Downregulation and desensitisation of 5HT1A are involved in regulating sexual motivation, and steady desensitisation may be one mechanism. Other aspects such as hormonal changes/changes in prefrontal dopamine may be additional mechanisms.

I think it's due to cerebral vasoconstriction that has been linked with ssri's. This can cause your nervous system to not get the blood supply it needs and or the genitalia. Look up reversible cerebral vasoconstriction syndrome

@@TheDavveponken Thank you for sharing this! I've never heard of this condition before but will look into it.

I just took 25 mg for just 4 days, and I feel like EMOTIONAL NUMBNESS Vous avez envoyé Can you tell me how did you recovered your physical feelings please?

It's definitely on the list. Will plan to shoot soon. Thanks for your patience.

I have same problem can't cry or feel joy.Lost pleasure and creativity.I can't handle a job.😢

No this does not as they are all dopaminergic. Dopaminergic potentiation improves drive.

Venlafaxine can lead to emotional blunting as it's sert affinity is significant and continues to increase with higher doses without at higher doses NA and some DA comes in. Agents with lower sert affinity snris are desvenlafaxine, milnacipran, duloxetine, levomilnacipran. Other agents that are mainly dopaminergic and noradrenergic are bupropion, psychostimulants, agomelatine ( milder), mirtazapine at higher doses etc. Ps not medical advice. You can view the video on antidepressants mechanisms we did

@@PsychiatrySimplified Thank you :) Can Venlafaxin be combined with Buproprion?

@@Augustin712 Bupropion inhibits CYP2D6, which can increase venlafaxine levels - hence caution is advised. Also, the combination creates a very activating AD, but it depends on what Sx need to be treated. There are other safer ways to get the combined effect which you can discuss with your doctor. Pharmacologically if combined, one would need to be mindful of the interaction as if the dose of venlafaxine is high already, this can be concerning. so it depends on the doses of venlafaxine used. this is a question for the doctor as the dose of venlafaxine is variable. PS not medical advice.

@@PsychiatrySimplified What do you mean by 'activating AD' and 'Sx' in your Answer? Sorry i am not familiar with medical Jargon

@@Augustin712 activating antidepressant. Sx - symptoms.

Please discuss this with your doctor. This can be addressed. Dose reduction with or without augmentation with agents that treat emotional blunting is an option. See videos on Vortioxetine , Agomelatine . Most importantly venlafaxine should not be stopped after taking it for a long period. Dose reduction and augmentation is usually an option for patients. Ps not medical advice

Usually 1-2 weeks the effect of any changes is noticeable . Ps not advice

Some people never get better. Please do not stay in meds that cause blunting. It can become permanent. For many of us this is not a temporary side effect, but a neurotoxic brain injury.

Please discuss this with your doctor as genital numbness if present and loss of libido can also be initial signs of PSSD ( see the other video) - isotretinoin is associated with it.

There are treatments for emotional blunting - switch / agents such as Agomelatine / Vortioxetine / bupropion. Ps not advice

Sorry to hear. Not all antidepressants are associated with this side effect. Also clinically in many patients treating the negative emotions outweighs the blunting effects - th benefits outweigh the risks.

@@PsychiatrySimplified well, I didn't have depression or any mental illness but have disabling ME/CFS. There is no drug and no treatment for this disease still today. But some ignorant doctors back in 2008 thought CFS was just some mild depression when we all know now(and then) it's an immune disease triggered by a virus-flu, ebv/mono, Lyme, enterovirus, covid...

@@larryc1616 CFS is a heterogenous condition. Addressing the various components becomes important - mood, fatigue, pem, pots, sleep and circadian rhythm dysfunction, autonomic disturbances, immune dysfunction and Hpa axis dysfunction. We covered this in another video on CFS. Treatments include targeting symptoms - you are correct that there is no one single treatment or cure because it is a heterogenous condition.

Very good question. Anhedonia is linked to Dopaminergic activity. SSRIs can reduce DA in the reward pathways in some individuals more than others hence the blunting and sexual dysfunction . Agents such as Vortioxetine, Agomelatine , bupropion , Mirtazapine are agents that treat depression without this issue. SNRI’s such as duloxetine and Desvenlafaxine are others that have lower SERT blockade compared to venlafaxine hence address anhedonia well due to NA and DA activity. Your doctor will be able to advice the best option . Ps not medical advice

Yes blunting of emotions is blunting the reward pathway and is not a good thing. SSRIs work at low doses in reducing amygdala sensitivity but it’s the higher doses where the blunting becomes the issue

How long did it take to resolve the emotional blunting? How long did you suffer from emotional blunting? Were you completely numb to all emotions? And whya medications did you take in homeopathy?

Did you get emotional blunting from ssri ? And homeopathy helped you completely from recovering emotional blunting . Please comment as I have hemopathy tonic but I am not using it.

@@SM-by8mg help me in start little but still no recovery hope you will fine.

Depression can be associated with emotional numbing or blunting. It is important to rule out depressive illness or apathy and treat this. A psychiatric assessment would be beneficial. ps not advice

@@PsychiatrySimplified never had depression, never had emotional blunting before ssris. i has been ruled out long time ago

@@Protracted-Withdrawal thanks for sharing. What were the ssri’s prescribed for in your case if you don't mind sharing.

@@PsychiatrySimplified I had mild social phobia, now thats gone too. My personality has been completly removed. How can I bring it back? My sexuallity, cognition, emotions?

@@Protracted-Withdrawal sorry to hear. Have any other medications been tried to treat the symptoms you are experiencing

We don't know exactly how they work in terms of the specific effects on mood/anxiety but there are a number of hypotheses and we can test these in practice

According to the mechanism of action. It does not have a blunting effect.

Yes in the majority the emotional blunting ceases.

@@PsychiatrySimplifiedso i will be able to feel again🥹🥹

Lexapro can lead to emotional blunting but also in the treatment of depression and anxiety - the SSRI initially treats the anxiety so the low motivation and cognitive domains become unmasked after anxiety reduces - it’s difficult to say this on an individual basis but any symptoms that are unusual should be discussed with the doctor. Wish you well

Yep 2 pills of prozac for me. Can’t feel fear for 2 years already. And head pressure during moments when I _should_ feel emotions.

It physically hurts to cry and by cry I mean shed 1 singular tear 🤣

This must have an individual/genetic component because I’ve been on three different drugs (albeit nos was mirtazapine). I’ve never experienced any permanent effects. Once I’m off, I’ll be just as much of an emotional dumpster fire as I’ve always been.

​​​@OsakaSyndrome​ I m also feeling sexual numbness during forplay... There is no hot feeling when touch a girl ! I get erection pleasure and orgasm also...when I think about sex and do sexy talk with girls on call and do masturbation ! But dont feel hotness When touch a girl body in real ! I feel like I m touching a boy body or a child body... When do forplay with girl 😢😢😢😢 I took 5 mg of Escitalopram and 0.25 mg clonazepam for 4 month.. Then I left it within next 2 month by tappering slowly slowly ! But after 6 month of tappering completely I m facing this issue What should I do 😢😢😢

Is it still the same? I've been this way for over a year now after taking methylphenidate for 8 days. On good days I can focus my energi on overcoming the blockage in my head and instead focus on other parts than the frontal lobe and then feel very intensely, to the point of just sobbing. I've found sobbing really works, if you can manage it. My hypothesis is that the sympathetic nervous system is overactive to the point of being paralyzed, which also would mean there'd be little to no room for the parasympathetic nervous system. Acupuncture between your eyebrows really helped as well for me, it took away a lot of the tense headache stemming from there.

some individuals experience the blunting as positive. When emotional heightening is significant this may come as a positive for some. for others it can be distressing.

i badly and desperately need advice and help rn. i dont understand myself anymore. my studies is my top most priority in life and I cant fail because of this stupid pill and this stupud ocd i have. I wont ever forgive myself if ever. that is how i feel for the past couple of weeks. cant i cure my ocd without gaving to go through such big emotional changes?

Sorry to hear . But this is something to discuss with your doctor openly. All treatment in psychiatry is a risk benefit analysis. There are options in treatment that your psychiatrist can discuss.

For emotional blunting? No ECT is not indicated.

@@PsychiatrySimplified what is other way please doc my condition is critical.

@@shortreviewmedia7409 you will have to speak to a medical professional. It's I appropriate for us to provide advice here

www.ncbi.nlm.nih.gov/pmc/articles/PMC2828549/

Sorry to hear. This is an educational channel only and we cannot give medical advice. Please see a doctor / psychiatrist / General physician / endocrinologist for opinions. We wish you well.

Emotional blunting is reversible in the majority of cases on cessation. In some treatment is needed to reverse it.

If I have been blunted for 3 weeks now should I continue waiting or consider treatment now?

This is 3 weeks post discontinuation

What treatment is available?

Ruling out other conditions , throrough assessment for other coexisting symptoms, alternate treatments for identified symptoms

SSRIs indirectly can reduce frontal dopamine but this may not be clinically evident in all individuals. SSRIs by acting on 5HT1A receptor ( agonist) and 5 HT2C ( antagonism) can increase Dopamine . So the relationship isn’t so clear cut. Salt in excess can be harmful. Please discuss this with a medical professional who can explain this taking your individual needs into account.

@@PsychiatrySimplified thanks, currently 20mg escitalopram, just trying < 1/4 teaspoon of sea salt for a while to see if it helps with motivation, presuming the reward connection with dopamine is valid.

It is difficult to comment on a forum like this. A full assessment is required. Both depression and anxiety can lead to somatic symptoms (distressing bodily sensations). This is more common in certain non-western cultures.

@UCI-PG8VOy5AO0Q79gA_YIIg unfortunately Being an educational channel we don't offer clinical services. Furthermore due ro medicolegal reasons overseas consults are not provided. Wish you well in your treatment

@@PsychiatrySimplified as i mentioned above symptoms except blunting was show good result after taking mirtizipine by just taking second dose 15 mg on second day.but leave this medicine because of seroius side effects of vomiting and uncontrollable diarrhea. Why mirtizipine give me relief and give motivation able to work after lefting dose since two days ago my side effects from ssri come back. Can you able to explain why this is happening?

@@mieero Can't understand your question clearly.

@@PsychiatrySimplified i feel some kind of sensation in brain or whatever you say to it, I cannot able to explain it clearly. This is the second side effect of taking fluoxetine and the first side effect was emotional blunting. it appeared at 3 month of medication of fluxotine.It get more worsen with taking each ssri . This symptom increase by taking ssri or even with virtioxitine I feel like sometimes that the nerves of my brain are burning or have a pressure on my brain nerves affect my thinking, concentration and reasoning. By taking Mirtizipine 15mg one time a day . All type of this symptom started disappearing on 2 days. I feel energy, focus and concentration are improve. Why this medicine improve my specific this symptom scienticly.can you explain it ? Unfortunately i stopped medicine because of serious side effects of vomiting and diarrhea.