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Monday, April 29, 2013

An American Psychiatrist in New Zealand

"Beware the moon" - An American Werewolf In London [PolyGram Pictures 1981]

I wish this were parody. It's not.

A reader from NZ sent me the following audio . His GP was unable to explain the sexual dysfunction after exiting from 10 years of ssri use, given to him to cure repetitive strain injury from keyboard overuse, so he was referred to a psychiatrist to get some answers . He asked the psychiatrist what was the future prognosis. The psychiatrist, having just claimed he'd never heard of pssd (post ssri sexual dysfunftion), then went on to explain the reasons for the sexual dysfunction.

The audio is now available on youtube [video below] - For those who, like me, find some of the audio difficult to listen to, there's a transcript for you perusal.

The patient, Mark Carter, will be writing a series of guest posts for my blog soon. In the meantime, please listen to this remarkable audio.

Before you listen it may be useful to know what PSSD is.

I won't go into the mechanics of it all, in a nutshell PSSD is a sexual dysfunction believed to be caused by SSRi use, an SSRi being the group of drugs we more commonly know as, Celexa, Lexapro, Prozac, Paxil, Zoloft and the SSRNi, Effexor. These are all US brand names and may be called something else depending on what part of the world you live in.

Pharmaceutical companies know there is a problem but, as usual, play it down. They claim that "psychiatric disorders" can cause sexual dysfunction thus enabling them to say that untreated depression can be dangerous. They say the same about suicide - whilst acknowledging that SSRi's can induce suicide they claim that depression causes suicide.

Ironically, another SSRi, GlaxoSmithKline's Wellbutrin, has been deemed as a treatment for PSSD. Treatment with Wellbutrin comes on the back of studies that show it's one of the SSRi's that doesn't cause PSSD. Amazing huh, if a pill doesn't cause an adverse event then it must be able to treat it!

The psychiatrist featured in the audio recording explains PSSD as something completely different than an SSRi induced problem, in fact, after listening I'm not sure the psychiatrist exactly knows what causes PSSD.


Mark - “Is it going to improve because it seems to me like it's been two years and it seems to be diminishing you know… I just want to know if it’s coming back or its going to be permanent?”

Psychiatrist - “Well I think the other factor that has to be considered here is age, now I  have the advantage or disadvantage of being older than you are and I know desires tend to diminish with age, so there’s that, and then there is also … circumstances. 

"I have to tell you that one thing I appreciate about New Zealand culture and on the other hand I have to say is quite different from the States. There is very little sexual provocation around here, women tend not to dress sexually whereas in the States, if you are on the sidewalks of New York, probably every 10th woman you would be looking at because she is dressed provocatively and have…. so the demure in which you are has a lot to do with it and one of the ways we know this is that er... stories about Catholic priests and sexual abuse aside, when people dedicate themselves to the monastic their  testosterone levels go down measured in this more accurate way as I've described um… so…. so  the prognosis here in part  depends  on whether or not you are reacting to age whether or not you are getting sexual stimulation apart from manual and um… and then there’s the whole question of what role sex plays  for you and... um... to what degree  is that bound up in intimacy and that gets to be very complicated.

"There are some people who don’t have sex unless they are  feeling really close to another person, and there are other people for whom being close to another person is in fact somewhat of a turn off that’s why there are all these people who are married and have mistresses, so it can get very complicated and I can’t give you a prognosis."

---- thanks for clearing that up doc. Only thing I learned after listening to this explanation of PSSD is that more women in New York dress provocatively than they do here in New Zealand. I don't know if that's a compliment to New York women or a compliment to women of New Zealand.

Coming Soon: A trilogy of guest posts from Mark Carter in which you will learn how Paxil and Effexor were prescribed for repetitive strain syndrome and how this started a series of chain reactions.

Bob Fiddaman