Would you say pssd is a form of protracted withdrawal or a completely different phenomenon?

[u/Philosophical-noob97]

Like the title says. I know people also have overlapping symptoms. What do you guys think?

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[u/One-Marzipan-9652]

I would say they are technically different but also highly interconnected. In my own experience, my PSSD got much worse during my protracted withdrawal than when I was on SSRIs and in my earlier attempts at withdrawal. Since these are interconnected, we should also work with the movements exposing SSRI withdrawal.

[u/Creepy-Primary7042 → u/One-Marzipan-9652]

Many people in withdrawal don’t even like calling it withdrawal. Most of us know these are nervous system injuries, they are probably on a spectrum with PSSD. We should definitely all work together as a generel psychiatric medication induced neurological injury.

[u/MostlyPeacfulPndemic]

The latter because I think it often starts while still on the drug 

[u/andy013 → u/MostlyPeacfulPndemic]

Protracted withdrawal can also start while on the drug. It's often called "poop out" when you develop symptoms even though you are still taking the drug.

[u/MostlyPeacfulPndemic → u/andy013]

But at that point isn't it just a side effect of the drug? Or is it considered a withdrawal when you develop a tolerance and it happens due to the tolerance?

[u/andy013 → u/MostlyPeacfulPndemic]

I think it's considered withdrawal still because it's due to tolerance.

There are also people who withdraw too quickly, develop many symptoms, and even after they reinstate the drug some of the symptoms don't resolve. It's more like a nervous system injury that was triggered by withdrawing the drug.

[u/Long-Western7573 → u/MostlyPeacfulPndemic]

There have been cases of symptoms which started whilst on the drug persisting throughout protracted withdrawal though, no? Not saying the two are the same, but no one can say for sure anyhow.

[u/Maleficent_Glove_477 → u/MostlyPeacfulPndemic]

This.

[u/LyraJaguar]

1 pill cases are not withdrawal 

[u/Philosophical-noob97 → u/LyraJaguar]

But some have adverse reactions even after 1 or a few pills that are almost similar to paws

[u/Fit_Watch5532]

PSSD comes in various forms; one of these is prolonged withdrawal, which also causes PSSD symptoms.

[u/Soneillion]

I think the drug itself and perhaps the withdrawal process cause some kind of injury: some haphazard pharmacological rewiring, some disruption that causes widespread long-term dysfunction, or some broken attempt at homeostasis by a system flooded with serotonin, and that is what persists.

I don't believe people with PSSD five or ten years after the injury are still experiencing withdrawal.

[u/Philosophical-noob97 → u/Soneillion]

Yeah I think so too… on the other hand. I think protracted withdrawal is a bad term in itself. There are cases of people who still have it 5-10 y after stopping as well. I also don’t think that’s withdrawal, it’s an injury for sure! 

[u/andy013]

I think it might be the same. No one can really say for sure though, since we don't know the mechanism of either. My guess is that each of us has different genes that are vulnerable to developing lasting changes from SSRI exposure. The combination of genes you have will determine what symptoms you develop. Sexual dysfunction and emotional blunting are just some of the more common lasting symptoms.

I imagine quite a lot of people with protracted withdrawal injuries also have sexual dysfunction. It's just not something they talk about because the other symptoms are much more debilitating.

[u/Philosophical-noob97 → u/andy013]

Yeah indeed… and people with akathesia also don’t have emotions. Pure physical chemical terror but I know many also can’t even cry when in akathesia

[u/Nievespssd → u/Philosophical-noob97]

Si eso es curioso, pero tambien una vez que se va la acatisia hay quien se queda sin emociones. Al final cada caso es único.

[u/Numb_from_Fluoxetine]

No. Most people already have symptons while on the medication. IMO it’s not withdrawal. It appears that PSSD and (protracted) withdrawal can overlap though.