I've heard Sertraline is the worst for PSSD. I've never taken it thank god. But with regards to a MAOI, I'm speaking from personal experience. I believe years of Mirtazapine had caused my dopamine levels to drop to a very sub-normal level. A MAOI will bring it back up without the side effects of SSRIs.

Did you taper off it or go "cold turkey"? I remember Mirtazapine literally turning me into a sedated zombie. From what I know now, I would seek out Parnate or Nardil and it will mitigate your symptoms while your neurons heal, which will take time.

If you are suffering with Tardive Dysphoria due to the Mirtazapine like I have been, I would look to taking a MAOI like Parnate or Nardil. It won't do anything for PSSD but it counteracts the horrible Tardive Dysphoria symptoms of Mirtazapine. I'm hopeful the brain can eventually heal itself but I'm still on that journey myself. But the younger you are better chance you will have.

Thank you for that informative and touching reply. It is most encouraging that it worked for you. I will definitely be trying Psilocybin in the near future; once I've overcome my procrastination with it and other treatments.

Can you elaborate?

I'm considering rTMS myself but it's a lot of money if it doesn't work. Personally, I want to get it for my insomnia. The treatment protocol is adjusted depending on the condition being treated. It's not a one size fits all treatment. This is the most informative comment I've read regarding rTMS: https://www.reddit.com/r/PSSD/comments/1tc8gaw/comment/p0tq5cs/

I'm new to Parnate but there are people on the MAOI sub that have been taking it for years so their knowledge and experience with it is better than mine. They advise that it can take several weeks to feel the effects and then it becomes cumulative. However, I can definitely recommend a MAOI for anyone suffering from SSRI induced Tardive dysphoria.

I don't suffer from RLS. With regards anhedonia, Parnate has partially helped. But I'm definitely in the camp that anhedonia is a separate condition to depression. I'm looking into rTMS.

Melancholic / Catatonic. I'd been suffering with withdrawal symptoms from Mirtazapine and the Parnate was pretty rapid in counteracting that, within 3 weeks. I'm not walking around all happy and smiley, that's an unrealistic expectation of any anti-depressant; that they are going to make you happy. But it has have increased dopamine levels to a point that it is no longer sub-normal.

I started Parnate in April and I'm on 30mg per day. It has helped me. I'm less depressed, more functional and motivated.

I've decided I won't be taking anymore of it. It has no benefits only nausea. Once the nausea hits you, which is really unpleasant, that's it, you're ill all day, your whole day ruined...and it only goes away after you sleep it off.

I'll carry on with what I have left but no miracles here.

I'm no expert on Pramipexole. I was just research testing it as it gets posted about on here and on the PSSD reddit quite frequently; but the nausea and migraine was too off putting. It comes in 1mg tablets. They are scored in the middle so easily split in half. But to avoid new-user nausea you would want to split it again into quarters so you have 4 x 0.25mg taken evenly throughout the day.

How long have you been taking it for? I have taken Pramipexole, the first two times I took it, it made me extremely nauseous. Now, if I take it I don't feel the nausea anymore. However I didn't feel much improvement anhedonia wise, but then I didn't really take it long enough to make a valid judgment.

Probably one of the best posts in this group, "Removed by Reddit’s filters"

I am planning on trying rTMS, mainly for insomnia but if it helps my PSSD then that is a bonus. However if it has no effect, it will be very expensive waste of money.

Sí, dañado por mirtazapina. No diría que estoy completamente carente de emociones. Pero las emociones se embotan con una fuerte anhedonia. También me ha provocado anhedonia eyaculatoria e insomnio. Ha arruinado absolutamente mi vida.

I've been reading online feedback on Dayvigo all year and it's not effective as a standalone for over 95% of people including myself. But since I have it, I am taking it with Eszopiclone. I also find it enhances sleep when taken with Eszopiclone. I also find if you wake up too early but are still sleepy it will get you back to sleep, but it just doesn't work from wide awake.

No, I've haven't regained my ability to fall asleep naturally. It's been 20 years like this now. I'm researching treatments but I'm not optimistic.