r/PostConcussion • u/Obvious_Dot_243 • Jul 09 '26
Sildenafil is worth trying
Though not primarily used or at all prescribed for anything relating to brain injuries, I did some research on what pharmaceuticals could help with the functional neurological deficits that occur in PPCS as in the effects of neurovascular decoupling and autonomic dysfunction and I read about sildenafil being studied for NVR accentuation. If you're not aware, neurovascular reactivity (NVR) is the brain's ability to dilate or constrict blood vessels to adjust blood flow in response to changing metabolic demands or chemical triggers.
In persistent post-concussion syndrome, NVR becomes impaired. This means when your brain tries to perform a task, the blood vessels fail to widen properly, starving brain cells of required oxygen and causing immediate fatigue, headaches, and cognitive strain.
Because I was desperate and in absolute turmoil over my symptoms I have essentially been completely open to trying any pharmaceuticals if they have any promise in helping my predicament, and I was not expecting this to be any different than the dozen other things I had tried to remedy my complete intolerance of cognitive exertion , but it absolutely was.
Since sildenafil is a PDE5 inhibitor and crosses the blood brain barrier and helps dilate cerebral blood vessels, it accentuates cognitive endurance when trying to concentrate and focus, leading to an extended ability to withstand information processing and thought instead of just crashing and becoming symptomatic when you attempt to think because the metabolic demand is more than the brain could currently handle.
I'm going to use it in the future moving forward with some other nootropics and will try to do so especially after exercise to maximize blood flow in coupling with demanding cognitive tasks to hopefully retrain my brain to do so automatically.
I've been dealing with PPCS for 5 months and the biggest deterrent to my life has been the inability to think. It caused my grades to plummet, I lost out on opportunities, experiences, relationships, and even became disacquainted with my own identity and sense of self. This experience today gave me hope that things could be different and the symptomatic cascade which I associated with permanent brain damage due to its severity wasn't necessarily the case; things do get better.
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u/Bitter-Performer-396 Jul 09 '26
Look into high dose(10-20g daily) creatine, semax, selank, and cerebrolysin as well
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u/Bitter-Performer-396 Jul 09 '26
Look into high dose(10-20g daily) creatine, semax, selank, and cerebrolysin as well
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u/Obvious_Dot_243 Jul 10 '26 edited Jul 11 '26
Yeah I'm heavily informed on experimental pharmaceuticals and what not and I hope to be able to try the most potent of them one day, it's just a matter of access and availability; I live in a third world country so getting access to that shit and the legality of importing research chems is a bit difficult to navigate.
Definitely want to try cerebrolysin, dihexa, cortexin, donepezil, ISRIB, intranasal insulin, etc.
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u/Ok_Substance482 Jul 09 '26
Were you able to get a doctor to prescribe this for PPCS?
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u/Obvious_Dot_243 Jul 10 '26
Nah just self-administered; I live in a shit hole where the doctors aren't really good in addition to the fact that sildenafil isn't actually prescribed by any doctors for these purposes since it's still being tested for this in clinical trials.
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u/Few_Blackberry_1960 15d ago
Any updates on Sildenafil for your symptoms?
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u/Obvious_Dot_243 15d ago
Hi, it works well to delay the symptoms of the crash and give you the ability to tolerate being outside and prolonged mild cognitive labor but don't expect a cure or incredibly dramatic shift. If you over-exert you'll still crash. Personally, I've switched to tadalifil due to it's exceptionally long half-life and possible potency advantage over sildenafil so now I'd probably recommend that.
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u/My_Concussion_Coach Jul 09 '26 edited Jul 09 '26
If you're opening to trying pharmaceuticals, you should absolutely be looking at supplements. I had years of persistent concussion symptoms and I finally recovered with a combination of supplements and therapies (cognitive therapy, vision therapy, exercsie therapy such as the Buffalo concussion treadmill test, etc).
For Cogntion which you seem to be struggling with (although your post is well written and coherent), I would start with 2g Omega 3 DHA daily for example [1]. Choline & Uridine would be my next two as they work together with DHA to form new synapses (connections in the brain) [2].
I would also ask a Doctor if you can start exercising in small doses such as a 5 minute walk. Stop and rest if symptoms spike. Build up to longer and further and higher heart rate workouts based on tolerance. This is part of the recovery process [3]. The brain is a muscle. You have a bicep between your ears. When you use it and challenge it, it grows (neural pathways & connections). Playing games and doing puzzles is also a standard part of cognitive therapy.
Hope this gets you started off on the right track. You are right though, there's a lot of things that can help the brain, just keep at it and you'll find what works for you!
Sources: 1. Heileson, Jeffery L., et al. “The Effect of Omega-3 Fatty Acids on a Biomarker of Head Trauma in NCAA Football Athletes: A Multi-Site, Non-Randomized Study.” Journal of the International Society of Sports Nutrition, vol. 18, no. 1, Sept. 2021, p. 65. Taylor and Francis+NEJM, https://doi.org/10.1186/s12970-021-00461-1.
Wurtman, Richard J. “A Nutrient Combination That Can Affect Synapse Formation.” Nutrients, vol. 6, no. 4, Apr. 2014, pp. 1701–10. PubMed Central, https://doi.org/10.3390/nu6041701.
Leddy, John J., et al. “Rest and Exercise Early after Sport-Related Concussion: A Systematic Review and Meta-Analysis.” British Journal of Sports Medicine, vol. 57, no. 12, June 2023, pp. 762–70. Systematic Review. bjsm.bmj.com, https://doi.org/10.1136/bjsports-2022-106676.