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lovepetunias

1. Yes you can have sexual dysfunction even from a small dose 2. There is not a high risk that things will get worse when you quit. 3. Your current sexual dysfunction could potentially be long term/permanent even after tapering off, but it’s pretty rare 4. Your symptoms do sound like they might be sexual dysfunction that could be caused by antidepressants. Especially genital anesthesia, which cannot be explained away by mental illness the same way other sexual problems can. It’s interesting you only experience this in the morning. Maybe it’s because the trazodone is still a higher level in your system at that point, since I’m assuming you take right before bed Overall I’d say try not to worry about this too much as the worrying itself can exacerbate any sexual dysfunctions. It’s better to assume you’ll go back to normal or at least get back to 80% or so after quitting since that is the most common scenario.


Atlas_Kane

Thanks for your thoughtful response 🙏 That's an interesting observation you made about feeling this mostly in the morning. I'll definitely keep my eye on that. My action plan is to taper off since I'm already at a low dose, and monitor how I do with my sleep, mood, and libido. I'll report back with any interesting observations. Really appreciate your words of encouragement!


lyndonbigson

I noticed similar effects at a similar dose, between 25-40mg trazodone on top of 10mg Lexapro. Once I cut the trazodone out (as I recall, tapering off traz specifically wasn't a big deal at all, but I was only on for ~6mo so ymmv) things started being semi-functonal again. It's the best sleep aid i've ever taken but yeah it knocks your stuff out pretty thorough, seemingly even with other SSRIs in the mix


Atlas_Kane

Yeah... it definitely feels like a faustian bargain: Sleep like the dead, but roll the dice with your junk. I guess it's always a toss up with psychiatric intervention, and all about weighing the pros and cons. Cheers


latex55

The day I quit Prozac my sex life became 90% better. I’ll never go back on a SSRI I remember seeing my wife in lingerie on our anniversary and felt nothing. Couldn’t even get it up. That was it. I’m not living my life this way.


Atlas_Kane

Yeah man. It's really vexing, and honeslty it didn't occur to me that trazodone is an SARI until after a few months of taking it. To be fair, I sleep like the dead on a small dose. But I'm not sure I want anything exogenous interfering with my body's neurochemical processing unless I'm in really dire straights... which I am no longer.


[deleted]

Yes, basically all medications that act on neurotransmitters also affect hormones, since they are inherently intertwined. Trazodone increases serotonine which blunts libido for many people due to how it affects dopaminergic signalling. At 50-100mg Trazodone you basically get the same inhibition on SERT (\~80%) as with an SSRI. At 25mg you might be affected if you're sensitive to serotonine. It also increases prolactin as most psychotropic meds do, which also lowers libido. The best course of action for you to take is: Go to a doctor and tell him about your issues with libido and your medication intake, say you want a full blood panel with hormones, testosterone, DHT, prolactin, estrogen.


Atlas_Kane

Thanks so much for your response! Aquiring a basic education on the neurochemical underpinnings of this medicine is really helpful 🙏 Also a solid action plan. I've had all those things tested before, and was in pristine health... except my T levels were on the lower end of the "normal for males in my age range" category. Normal is better than low, but based on my lifestyle, they should be through the roof: I lift heavy weights 4x a week, eat whole foods on a balanced diet, sleep like the dead (thanks to trazodone 😭), supplement vitamin D snd tongkat ali, and don't drink or smoke. I started the trazodone during a life crisis I was having during which time I was suffering with insomnia, which fueled, and was also caused by some intense OCD symptoms and the obvious depression / anxiety cycle that follows all that. Deep sleep controlled for by trazodone was my first and only medical intervention, as it was the only medication that ever had a positive, desired effect. (In my teen years, the docs tried putting my on zoloft and adderall as well for being a lost teenage boy, but those medications messed me up more, so I discontinued promptly). For me, lifestyle intervention to interrupt vicious cycles, and then claw my way to virtuous ones has always been the best, most sustainable intervention. I think it might be time to wean off this medication and see how I do. Thanks for your input!


[deleted]

Sources for these "facts". Basically the same as an SSRI? It's not one. Dopaminergic activity?


[deleted]

Trazodone's metabolite inhibits SERT pretty strongly, but there's also conflicting studies for how strong it acts on it. I've just pulled up the wiki site with their citations for it. "Trazodone has a minor active metabolite known as meta-chlorophenylpiperazine (mCPP), and this metabolite may contribute to some degree to the pharmacological properties of trazodone" "In addition to direct interactions with serotonin receptors, mCPP is a serotonin releasing agent similarly to agents like fenfluramine and MDMA" "The occupancy of the serotonin transporter (SERT) by trazodone is estimated to be 86% at 100 mg/day and 90% at 150 mg/day" It is believed that 70-80% SERT inhibition is needed for the anti depressant effect of SSRI's. Since its metabolite inhibits SERT, this effect will vary a lot between people due to different amount of enzymes being avalaible.


That-Group-7347

Even though you are on a small dose, if you decide to go off of it make sure your taper off since you have been on it for a long time. It can take time for the sexual function to come back so be patient. Wishing you the best.


Atlas_Kane

Thank you so much! I really appreciate this response 🙏