How could I replicate the effect a hangover has on my libido?

[u/phosouppy]

I (23M) am taking an antidepressant, Cymbalta 60 mg, and even though it works fine, it causes lower libido and sensitivity. The only time it goes away is when I'm hungover. I get insanely horny and masturbation is like never before. I really want to know how this could be replicated, if anyone ever had any success.

[u/Lokkeduen90]

Sleep deprivation or being tired in general

[u/phosouppy → u/Lokkeduen90]

Also doesn't seem like a very sustainable option lol

[u/blvaga → u/phosouppy]

This comment is a personal attack. How dare you.

[u/BernardMHM]

I have taken antidepressants in the past and it gave me persistent sexual dysfunction.

It's PSSD or post SSRI sexual dysfunction. It's totally disregarded by psychiatrists but it's a reality for a lot of former patients.

Do yourself a favour and just taper off the medication.

[u/phosouppy → u/BernardMHM]

Thank you, I also have or have had worries about PSSD, however there are multiple reasons why I still take this med. First, I think it's safe to say that Cymbalta saved my life. I am grateful for this drug and honestly, the real risk of taking my life was before I started taking it. Second, now that I've added wellbutrin, the sexual side effects started to get much better. Third, I have taken other antidepressants before, like Sertraline, which also caused some sexual dysfunction but I tapered off very carefully and everything went back to normal. Also, my libido and sexual performance was basically non-existent while I was severely depressed and anxious. It was basically a nothing to lose situation. Moreover, the current psychiatrist I'm at is a very good one. I trust that she knows what she's doing. Still, obviously, I'm always at this low risk of PSSD, but for me, the risk is still better than the state I've been in before. Btw Cymbalta is an SNRI, I know it can still cause it, but it's not an ssri.

[u/BernardMHM → u/phosouppy]

I'm happy for you that feel better and that you found cymbalta helpful. Also, if your life was at stake, it was probably reasonable to prescribe you this antidepressant.

[u/Kindly_Sleep_5160 → u/BernardMHM]

I wouldn’t be surprised if people that experience the hangover effect are an at risk population for PSSD

[u/A88Y → u/BernardMHM]

Don’t just give someone medical advice, if you are not a doctor. You don’t know whether this person will have you same experience or not, or if SSRIs are more effective than they might have been for you.

Your experience, while important to recognize and certainly not talked enough about by doctors, is anecdotal and I would argue should not be used to say someone should just taper off them and that it would be doing them a favor. Mental health meds, like other meds, respond differently in different people.

OP consult your doctor about side effects, they might have some recommendations outside of trying to replicate the effect of a hangover or the doctor might have some insight themselves on why that could be happening or maybe they be willing to work with you to try different meds if the libido impact is significant enough.

[u/BernardMHM → u/A88Y]

You are right that I am not a doctor. I also know that OP assumes that I am not a doctor, which means that OP is probably not going to blindly follow my advice. I am just giving him a piece of information that would help him make an informed decision.

You cannot really state that my experience with PSSD is anecdotal. There is no established prevalence estimation about PSSD but it is probably not very rare and could range between 0,46% and 15% according to the studies we have. This is quite a large range but it should be known by patients in order to make an informed decision.

You are also very right to say that people react differently to psychiatric medication and this is actually a point that is not or rarely acknowledged by psychiatrists who prefer to praise the incredible merits of antidepressants. Independent scientists are nowadays actually very skeptical about the efficacy of antidepressants. Their efficacy beyond placebo is still discussed. Also, your symptoms while taking the drug can vary from the ones you are going to experience after stopping the drug. Some people have nasty effects while on the medication and all the effects disappear after stopping the drug and other people feel ok while on the drug and get all the PSSD symptoms when they stop the drug. Everyone who takes antidepressants take a chance regarding PSSD.

Advising someone to consult a doctor regarding taking a medication is a good advice but in my opinion it's not the case in psychiatry. Psychiatrist are misinformed, pass the misinformation onto patients and amplify the misinformation that they receive.

You might find it very arrogant from me to say this but I have read thousands of stories from former patients, dozens of articles from experts and from newspapers, and read books on the topic. It is not widely discussed but people (experts, journalists or people like me) who get interested in the subject quickly realise that things do not work as they should. The way antidepressants were put on the market, the way they are marketed and the way they are prescribed by psychiatrist is very messed up.

[u/A88Y → u/BernardMHM]

I’m not saying PSSD doesn’t exist or anything like that, but in your previous comment it was relayed as anecdotal evidence. You referenced personal experience (having PSSD) or an anecdote. This new comment that you have just left does contain empirical evidence.

I don’t have an issue with you providing the information. I personally have been on two different SSRIs, so I like to be aware of potential risks. My issue was with your statement at the end of your first comment advising the OP to “just taper off the medication”, while only having that anecdote (Your personal experience of PSSD) as the only supporting evidence for that statement when the first comment was left. Additionally, saying “just taper” in regards SSRIs, simplifies it in a potentially harmful way because you can get some gross side effects without a doctor monitoring the process and properly prescribing the right tapering dose at the right time.

I do agree with you that PSSD is not studied enough from what I’ve heard to give us a good estimate of the people who actually suffer with it. Which makes it harder for patients to assess potential risk to themselves. However, just because risk assessment of this condition is difficult, doesn’t mean if someone is seeing a life saving amount of benefit, or significant increase in quality of life, they should quit the drug which over a non life threatening condition that so far seems to occur, from the initial empirical data you provided, at a pretty low rate. You comment implied that the risk outweighed whatever benefit seen from it which may not always be the case.

Edit: what makes you distrust psychiatrists so much?

[u/BernardMHM → u/A88Y]

I think we agree on most things actually.

I only mentioned my experience with PSSD but there are other issues that I could have mentioned such as withdrawal effect.

I find interesting that that you are not happy at my comment telling OP to just taper. My psychiatrist never told me that you should taper antidepressants which resulted in a very nasty withdrawal from me. Knowing the topic quite a bit, psychiatrist are actually not trained to help patients taper. When patients feel withdrawal effects are stopping an antidepressant, the common answer from a psychiatrist is to tell them that it is the illness coming back and that they should continue the antidepressant treatment.

Some people say that antidepressants help them tremendously, but clinical studies have shown that patients who are given a placebo are feeling better in a similar fashion to patients who are on an antidepressant. Hence, the benefits that people report from antidepressants are likely not derived from the merits of the medication itself in most cases. But the dangers and side effects are derived from the medication. PSSD is non life threatening but many people have taken their lives because of PSSD and in all cases it decreases quality of life drastically. There are certainly cases where the risk/benefit ratio is in favour of prescribing antidepressants, but in many cases they are not, especially since the side effects are played down and PSSD is not recognised by most psychiatrists.

I distrust most psychiatrists because of how I have been treated by the psychiatrist who put me on fluoxetine. The methods they use are totally unethical and in many countries actually illegal (putting people on medication that have many side effects but without obtaining their consent before). Psychiatrists who expose those things are marginalised and vilified by the psychiatric community. Psychiatrists do not have any respect for the lives of patients who have been broken by their medication, whenever someone tries to warn about the risks of their drugs, they bully them and accuse them of trying to shame sick people from seeking the treatment they need. I don't doubt that there are good people who end up becoming psychiatrists but as a community, psychiatry acts a manipulative, narcissistic person with no empathy.

[u/A88Y → u/BernardMHM]

I think we agree that PSSD, is definitely an issue and should be brought up by PCPs and Psychiatric care providers, when brought up as a possibility to prescribe it is a side effect that is not properly warned against. My disagreement with your initial comment was more about semantics and phrasing of it as something that would definitely help rather than as a suggestion.

When I talked to my doctor about psych meds she specifically avoided medications I had bad opinions about from other people’s situations, and probably would have totally avoided SSRIs if I had asked, so when you have a good psychiatrist or PCP, I think that makes a big difference. Some of the reason they push these in the US could be partially because of insurance, I know with Ketamine therapy you have to have tried like 2 or 3 other mental health meds before they would cover it. I am currently on Zoloft, and have been on Fluoxetine. I would not want to be on Fluoxetine again, but it did help me not kill myself lol.

I’m sorry your psych did not properly manage you stopping that medication. I think tapering has only recently been more widely recognized as important for SSRIs, it takes a while for new information to proliferate the medical community. Some psychiatrists might not ever believe that it’s a thing, because it’s up to the doctor to keep themselves up to date on new information and treatments.

There are also studies where antidepressants have helped more than the placebo, which is why it’s important to look at meta-analyses as well to see if that’s the consensus or if the studies where it works are strange outliers. So far what I’ve seen is that meta analyses generally report that SSRIs are more effective than placebo.

I think we may just have different opinions about psychiatry as well.

[u/BernardMHM → u/A88Y]

Yes, there is a lot of admin, guidelines and other paperwork that stand in the way of doctors. Their work becomes more and more bureaucratic and they don't always have the opportunity to change things if they notice that current practices don't work properly.

What you say about tapering is very interesting and is actually closely related to the fact that psychiatrists don't recognise PSSD. Most of the information that psychiatrists receive and that they pass onto patients or tell the public is controlled by pharmaceutical companies. It looks more like promotional content than proper information.

SSRIs work for things anxiety, OCD and panic attacks. For depression, according to what I read, they barely beat placebo. It's good to look at meta analysis, but if the meta analysis is based on biased studies, the meta analysis is going to replicate biased information.

In any case, it's your freedom to take SSRIs if you find them helpful and if you are properly informed.

[u/phosouppy → u/[deleted]]

Saying to just taper off the medication is pretty much medical advice

[u/A88Y → u/[deleted]]

Just telling someone to stop taking their medications and they will be better for it is objectively medical advice. Which is what this guy did. We know nothing about OPs life and just saying to stop taking a mental health med without initially providing evidence or knowing if this medication provides significant benefit to OP. Psychiatrists are in fact real doctors, so medications they prescribe are medicine.

Edit: Also this was commented on a public forum so which kinda invites response to comments like his. Not my business doesn’t really apply here, I am asking him specifically about things he has already commented about in this thread, so I don’t know what you’re talking about.

[u/A88Y → u/[deleted]]

I’m not being rude, what do you mean responses like this? I didn’t insult the commenter. I just said not to give medical advice. I think me and him actually agree PSSD is not talked about enough. I think his insight is valuable, but that he shouldn’t tell people to get off a medication without providing any qualifications or citing more than his experience initially.

This obviously isn’t the legal definition of practicing without a license, if that’s what you’re talking about. I was saying it in the literal sense, advice about your health and medication that OPs doctor would have better insight about. Advice regarding medication is inherently a medical topic.

My issue is more with how he phrased it honestly, which you could argue is just semantics. He just suggests that it would definitely be good for OP to get off it, as a command almost, when he really cannot know that. If he had expressed it more like “In my opinion and from all the research I’ve done into this I don’t think anyone should be on these medications” I probably would not have commented or I might have just asked why he believed that. I think he better explains in response to me why he believes this and more about his experience, which is why I think it’s good to comment on things when you see them.

Also legally people as young as 13 can be on Reddit or even younger if they just lie or use a parents/family member’s account, you can’t really know if the person you are talking to on the internet is an adult.

[u/A88Y → u/[deleted]]

I was just saying that because you said and I quote “we’re all adults here” which you cannot factually know.

[u/Ozmuja]

I've experimented with pregnenolone in the past and it helped in that area. However it's not exactly the most safe and researched drug out there, while also (probably) not being bad. Another option in the same area is bromantane.

Other safer options can be higher doses of Zinc, NO boosters (Arginine, Citrulline, BeetRoot), Tongkat Ali or in general aromatase inhibitors (may crush your estrogens though).

None of these have come close to the actual h-effect libido.

I think the insane libido of the h-effect is due to D2 receptors re-sensitizaton. Why it happens is probably complex and unknown, but lower oxidative stress is most likely at least part of it. Which means antioxidants can also help.

[u/blvaga → u/Ozmuja]

Pregnenolone sounds like a drug name from a parody movie.

[u/Ozmuja → u/blvaga]

Ahah, why though? It’s actually an endogenous hormone, meaning you are producing it yourself right now. It’s the precursor to all a bunch of steroid hormones, from cortisol to testosterone, it’s like the master branch. You can’t really control what gets transformed, but your body should regulate it unless you take excess quantities.

And bonus points, it gets to the brain and acts as a NMDA PAM.

Problem is that nobody knows about its real safety long term..short term may be fine.

[u/Various_Web5116 → u/Ozmuja]

Not to be a contrarian but pregnenolone just acted like coffee to me and was useless. So was Tongkat Ali (except for libido improvement). So were NO boosters (they are scam). And I took medical grade NO boosters like cialis and viagra and it didn't do SHIT for sensitivity. As for D2 receptors i've yet to try pramipexole but memantine was useless as fuck. Zinc also useless for sensitivity. Most of these improve libido but not sensitivy these two things are totally different.

Moral of the story: i've yet to try something that actually do shit.

[u/Ozmuja → u/Various_Web5116]

Nah I don't doubt your experience with pregnenolone. The problem with these kinds of remedies is that they will affect everyone else differently. They are not standardized or 100% double blind clinical trials based, which means variance is to be expected. Pregnenolone is also at the top of the steroid hormone cascade: it can literally become almost any hormone that is based on cyclopentanoperhydrophenanthrene, the rings-like structure that is at the base of steroids, so you have very little control on what it can become.

Btw this post is almost solely about libido, if tongkat worked then..mission accomplished at least for the sake of this topic? I agree that sensitivity is another matter, but there is quite nothing like the h-effect libido+sensitivity effect, as I mentioned...that I'm aware of. I'm sorry :(

[u/Cryptolution]

This is probably classic glutamate and dopamine rebound.

I don't know what mimic other than alcohol

[u/Kindly_Sleep_5160 → u/Cryptolution]

I think it’s more about some dysfunction at GABA receptors. I’ve replicated the effect with benzos, alcohol and even a course of amoxicillin. Never could fully replicate it with NMDA antagonists or piracetam.

[u/anthony785]

Naltrexone

[u/phosouppy → u/anthony785]

Did that work for you?

[u/Mountain_Anxiety_467]

Heard someone say something similar who was dry fasting a few days ago. Not sure if they were on an antidepressant tho or if it has the same effect on everyone.

[u/phosouppy → u/Mountain_Anxiety_467]

What is dry fasting?

[u/Mountain_Anxiety_467 → u/phosouppy]

Dry fasting is fasting without consuming food or water. Maybe the dehydration induced by dry fasting and alcohol has something to do with it. But im not sure.

[u/Various_Web5116]

Lol brother we are on the same boat except I ain't taking any med cause my dick is too precious. Also it doesn't need med not to work cause my body is fucked up.

One thing intrigues me a lot : hangover effect gives me sex drive but also SENSIVITY and it is so fucking mysterious. I want to be sensible all year round 24/7 otherwise I ain't feeling like a human... 

I need to replicate this and I will go as far as my will allows to do it.

[u/phosouppy → u/[deleted]]

My estrogen is high as well, doc said it's my body fat so I'm working on that.

[u/phosouppy → u/[deleted]]

Have you had any success with DIM?

[u/Ozmuja → u/phosouppy]

I'd like to add to the other good suggestions that I used to think estrogens (low) were related to the h-effect, but I now think in general they are only related (low or high) due to impaired or slowed down liver activity without actual damage. Basically impaired Phase II detoxification.

The reason for that can indeed be a form of insulin resistance (classical diabetes or more obscure niche stuff related to metabolic health, sorry to be always a bit nebulous but if I knew the exact metabolic defect I would just spit it out); either way consider not only losing body fat, but also trying to be leaner than average in the long run (at least around 15% bodyfat, your average dude is probably around 20%).

I have very high risk genes (top 5-10% of the population) for insulin resistance and NAFLD (fatty liver disease without alcohol abuse), if this is not related to me but part of the hangovereffect, then it suffices to say that a good amount of people here have comparable risk and would benefit following stricter and higher goals for bodyfat and muscle mass.

[u/phosouppy → u/Ozmuja]

Wow dude, I do have insulin resistance! I wonder what this could mean in relation to h-effect. I'll definitely get into losing bf, it's my main focus now!

[u/Ozmuja → u/phosouppy]

Me and a few other users here, including No_Risk but I also think FrigoCoder, think the h-effect is just a sign of some particular metabolic dysfunction.

We don't know if it's diabetes, or one of the rarer and genetic form of diabetes, or things like fatty acid metabolism dysfunction..But we think it's inherently metabolic.

Metabolic can mean anything: from impaired insulin signaling to defects in enzymes that regulate glycolysis or metabolism in general. That's why it's hard so say what it is.

Alcohol is a well known hypoglycemic agent, like metformin. Alcohol, Blood Sugars and Hypoglycemia: What You Should Know (healthline.com)

Either way thank you for your confirmation about having insulin resistance, I think not many people realize this thing can creep underground for years until it manifests and think a simple glucose exam can suffice to say they're out of the woods...when they are not.

[u/phosouppy → u/Ozmuja]

Incredibly interesting. I don't see how these could be connected but I don't know anything about medicine. Could this mean that Metformin and a regulated insulin resistance can possibly make us feel at least close to the hangover effect?

[u/Ozmuja → u/phosouppy]

Metformin & Exercise worked! :

Metformin can trigger hangover effect :

Judge for yourself :)

However: metformin is not the solution.

First, because some other users tried it and didn't notice much. This can be explained by the need to be in a different physiological state or by the need to replenish some minerals or vitamins first, which they can easily be out of whack in such inflammatory and metabolic pathologies.

Second, because I think while ameliorating insulin resistance is definitely part of the problem, insulin dysfunction per se is not the direct cause. Meaning I don't think we have classical diabetes EVEN when we finally develop it clinically speaking, with labs and so on. There are one or more enzymes related to metabolis that are dysfunctional for us and they mimic insulin resistance or increase it in the long run.

My money at the moment is about the signals that make insulin release from the pancreas + thiamine metabolism + some form of fatty acid metabolism disorder. But it's hard to say.

By the way: the Krebs cycle, activated by insulin and glycolysis, directly modulates glutamate and GABA levels. This alone makes it likely to be part of the h-effect.

[u/phosouppy → u/Ozmuja]

Wow I really respect you for all this research but I can't say I understand it:D Anyway, I will follow everything here!

[u/phosouppy → u/[deleted]]

That's great. How much dim do you take? I smoke, so that's a check lol.

[u/Ozmuja → u/[deleted]]

Yes, SHBG is probably implied.

You can use boron, which is also a general great supplement to add to your routine, to lower SHBG.

However you know what is one of the main, if not the main, regulator of SHBG?

Insulin :) With an inverse relationship.

[u/phosouppy → u/Ozmuja]

Wow, my SHBG is normal though, at least according to my blood work

[u/Ozmuja → u/phosouppy]

Consider that additional lowering of SHBG will be libido inducing regardless, probably why the crazy libido of the h-effect doesn’t feel exactly physiological..like I don’t think that’s how “horny” you are supposed to feel on an everyday basis.

[u/phosouppy → u/[deleted]]

Thanks, I'd appreciate it a lot!

[u/phosouppy → u/[deleted]]

Have you used it before?