Antidepressants for PE (Zoloft/Sertraline)

[venom888 Senior Member Find all posts View Profile Close venom888]

To elaborate on my hesitation with upping dose because of it keeping me content -- I don't know if it's the zoloft entirely or just getting used to isolation since Covid, but I just don't particularly care about going out and doing anything when I do get the opportunity. I think for those who have libido issues it may be because of this, where you just feel content no matter what so you don't need sex. It has affected my libido some.

It's got its plusses and minuses. I feel like I'm a lot more able to entertain myself and be ok when I'm bored. Don't feel sad or nearly as lonely. At peace basically. Would like a bit more help on the anxiety side at times, plus with pre-e of course, but I'm a bit afraid of becoming less interested in everything, sex or otherwise.

It's hard to say. Right now it's definitely a positive, cause I rarely see friends, can't really date, etc, so it's good to be content alone, but I've always been a bit antisocial anyways, so I just wonder if when things are back to normal whether I would be disinterested in socializing still. I had read it typically makes people *more* social, because you don't have as much anxiety (I've always def struggled with social anxiety), but I dunno

Long ramble...

[venom888 Senior Member Find all posts View Profile Close venom888]

I feel like the effect of the medication has diminished further. I'm sure things are better than from before, but not by much now. I don't know if increasing the dosage would help, or if it would help and then diminish again, or what. Might have to talk to my dr about it.

Bummer. Was good while it lasted :/
(no pun intended)

[venom888 Senior Member Find all posts View Profile Close venom888]

Had another appt with my doctor and he suggested I try 100mg and if that doesn't work (and continue to work) then try 150mg. He said he really doesn't know another option aside from seeing a pelvic floor specialist. I feel like there's enough wisdom on these forums when it comes to treating the physical side of things that that might not be too useful.

I mentioned possibly swapping Zoloft for another SSRI (studies show similar results in all of them, but I know different meds affect people differently). He said they all do affect people differently, but he suggested just upping the dose because he said even 100mg is not a strong dose (I've been taking 75). My concern with taking higher doses is just that it would numb my emotions or otherwise be too much in one direction in terms of my mood, etc, but he didn't think that was a concern. (I'm also taking the Zoloft for anxiety and 75 isn't really helping that much, and I've read of people taking as much as 300-400mg for anxiety.)

One thing I did notice is that as the improvement to PE subsided, my sex drive started increasing back (it's still lower). So hopefully I can find a dose that works and a balance between sex drive and lasting PE improvement. I'd rather not go to 150mg, but I said the same about upping past 50mg, so we'll see....

Hopefully 100 will do it

[skyisthelimitpe Senior Member Find all posts View Profile Close skyisthelimitpe]

I'm sure you already know this but I'd be careful going that high to solve PreE. And im saying this because I've been on Zoloft before and it really does change you as a person especially with higher doses. Plus once covid is over you'll be out and about again and Zoloft made me not want to do shit lol.

As for not seeing a pelvic floor specialist, at first I was against it but after hearing some things on the forum it's definitely a good idea so you can get stuff fixed permanently. Or a regular physio

[VirgilD5to6 Senior Member Find all posts View Profile Close VirgilD5to6]

I'm sure you already know this but I'd be careful going that high to solve PreE. And im saying this because I've been on Zoloft before and it really does change you as a person especially with higher doses. Plus once covid is over you'll be out and about again and Zoloft made me not want to do shit lol.

As for not seeing a pelvic floor specialist, at first I was against it but after hearing some things on the forum it's definitely a good idea so you can get stuff fixed permanently. Or a regular physio

I have nothing against physios, but honestly they are worthless for many things. There is tons of information online, and exercises already available online like a whole workout to either relax your PF or strengthen it. Those who are going to physios are just too lazy to find what they need. I tried physio for my scoliosis and honestly didnt help at all, all I was doing on my sessions were some exercises that you can do at home.

[PYT Member Find all posts View Profile Close PYT]

I’m up to 125mg for anxiety reasons but will report how it effects me. Still not having sex with my gf though she’s pregnant and sex hurts for her at the moment. We probably won’t be having sex for atleast 9 weeks as few more weeks of pregnancy then also you can’t have sex after giving birth. I just edged though and lasted around 15 mins and I hadnt ejaculated for 3 days and normally I would reach PONR quite quickly I think pre-Zoloft if not ejaculating for a few days.

[venom888 Senior Member Find all posts View Profile Close venom888]

I'm sure you already know this but I'd be careful going that high to solve PreE. And im saying this because I've been on Zoloft before and it really does change you as a person especially with higher doses. Plus once covid is over you'll be out and about again and Zoloft made me not want to do shit lol.

haha, yeah it kinda makes me not want to do shit already. Since it makes me content just sitting home. But some of that may also just be getting used to sitting home, due to Covid. Also I feel like being content sitting at home isn't a good excuse for not doing shit, I just need to recalculate my motivation for doing things. So doing things just to live a full life vs doing things to try and not be depressed haha. In some ways it may get be to do more, once restrictions are lifted, because I' could be less anxious. It's hard to judge things right now because of covid and lack of normal social life.

[venom888 Senior Member Find all posts View Profile Close venom888]

btw my Dr said he prefers Lexapro (another SSRI) for anxiety but he didn't know how effective it is for PE. I looked it up and one study said it wasn't as effective for PE as other SSRIs plus had more side effects. That study said Paxil was most effective, with Zoloft second. Another study also said Paxil was more effective, claiming a 9-fold improvement for Paxil and 4-fold for Zoloft as second best. But that was just in the summary, the full text and raw data of the study wasn't available unless you buy it (ridiculous). Other studies that I've read tho have all said that any of the common SSRIs give about the same results, including studies I read that showed the actual numbers. So I dunno. But it's worth considering a switch to Paxil if Zoloft doesn't do it for ya. Tho they're all SSRIs they affect different people differently and I've read that people often try more than one SSRI before finding the best one for them (in general, not specific to PE).

My DR also suggested that it could have been a mental thing as to why it worked and then stopped working, ie a placebo effect). That thought crossed my mind but I don't think so, as I expected it to work sooner than it did, and it didn't kick in til two weeks later. Also the studies I've read do show improvement with placebo but small compared to the effect of an SSRI.

[venom888 Senior Member Find all posts View Profile Close venom888]

I’m up to 125mg for anxiety reasons but will report how it effects me. Still not having sex with my gf though she’s pregnant and sex hurts for her at the moment. We probably won’t be having sex for atleast 9 weeks as few more weeks of pregnancy then also you can’t have sex after giving birth. I just edged though and lasted around 15 mins and I hadnt ejaculated for 3 days and normally I would reach PONR quite quickly I think pre-Zoloft if not ejaculating for a few days.

Is this the first time you've seen results til now?

[esco555 Senior Member Find all posts View Profile Close esco555]

From the studies online and reading forum posts etc, paxil/paroxetine at 10/20mg dosage is the most effective for PE. Unless you have personal reason not to, I'd maybe look into that

[sameel Senior Member Find all posts View Profile Close sameel]

I wasted more than 2 years on reading those studies and trying different SSRI's including Zoloft, Paxil, and another tricyclic antidepressant. Those did nothing to me except giving me insomnia, nightmares, heavy sweating, body pains (serotonin syndrome) and ED. And it took me 2 months to wean off the last SSRI.
Here are some important lessons learned.
1. All those studies talk about just adding seconds to your timing if they work for you.
2. If one type of SSRI does not work, most probably others will also not work for pre-e. It is kind of established fact.
3. And remember serotonin is not the (only) cause of premature ejaculation. GABA works better than serotonin. But keep in mind, all those brain altering drugs lose their efficacy because body quickly adjusts all other chemicals through a feedback mechanism that is not completely understood yet. That is why they keep on trying different drugs one after another. It is just a trial and error process.
4. And even if you have depression or anxiety, your doctor must check your vitamin d levels first. It is a major risk factor.
When I started taking vitamin d3, my depression went away and now I am sure it also works for pre-e. Why? primarily calcium/magnesium or other electrolytes balance depends on vitamin d levels. If you are vitamin d deficient, your body will be unable to store calcium in the bones and it would keep on depositing in the tissues, creating a lot of problems for hormones and neurochemistry etc. There is also a study that says about 1/3rd of lifelong premature ejaculators are vitamin d deficient.
5. After doing a lot of exercises like squats, glute brides, frog pose, pigeon pose, and deep breathing, things started to improve gradually.
6. Ultimate breakthrough came through clamped edging. Within a couple of weeks, I was able to edge like a machine even watching hardcore stimulus and doing kegals and reverse kegels etc., at the same time. Somehow the clamp keeps the BC muscle from flexing and makes kegals and rks more effective. Additionally I can press the pelvic floor with hand when it swells due to high arousal. It is kind of advance form of "squeeze technique". You can mimic the same wearing a kind of tight ring at the base of your member during actual sex. First time lasted 40 minutes and had to cum on demand.
Now a days, sex is not that often. But I usually wear it for the first couple of minutes and then remove it and continue for 10 or 15 minutes and cum on demand.
I don't think that could have been possible through any SSRI.
I hope this helps.

[Pegasus AdministratorPE Gym EditorPEGym Hero ☺ Admin of the Month Mar 2015 Find all posts View Profile Close Pegasus]

I wasted more than 2 years on reading those studies and trying different SSRI's including Zoloft, Paxil, and another tricyclic antidepressant. Those did nothing to me except giving me insomnia, nightmares, heavy sweating, body pains (serotonin syndrome) and ED. And it took me 2 months to wean off the last SSRI.
Here are some important lessons learned.
1. All those studies talk about just adding seconds to your timing if they work for you.
2. If one type of SSRI does not work, most probably others will also not work for pre-e. It is kind of established fact.
3. And remember serotonin is not the (only) cause of premature ejaculation. GABA works better than serotonin. But keep in mind, all those brain altering drugs lose their efficacy because body quickly adjusts all other chemicals through a feedback mechanism that is not completely understood yet. That is why they keep on trying different drugs one after another. It is just a trial and error process.
4. And even if you have depression or anxiety, your doctor must check your vitamin d levels first. It is a major risk factor.
When I started taking vitamin d3, my depression went away and now I am sure it also works for pre-e. Why? primarily calcium/magnesium or other electrolytes balance depends on vitamin d levels. If you are vitamin d deficient, your body will be unable to store calcium in the bones and it would keep on depositing in the tissues, creating a lot of problems for hormones and neurochemistry etc. There is also a study that says about 1/3rd of lifelong premature ejaculators are vitamin d deficient.
5. After doing a lot of exercises like squats, glute brides, frog pose, pigeon pose, and deep breathing, things started to improve gradually.
6. Ultimate breakthrough came through clamped edging. Within a couple of weeks, I was able to edge like a machine even watching hardcore stimulus and doing kegals and reverse kegels etc., at the same time. Somehow the clamp keeps the BC muscle from flexing and makes kegals and rks more effective. Additionally I can press the pelvic floor with hand when it swells due to high arousal. It is kind of advance form of "squeeze technique". You can mimic the same wearing a kind of tight ring at the base of your member during actual sex. First time lasted 40 minutes and had to cum on demand.
Now a days, sex is not that often. But I usually wear it for the first couple of minutes and then remove it and continue for 10 or 15 minutes and cum on demand.
I don't think that could have been possible through any SSRI.
I hope this helps.

Wow.
This not only suggests that ssri's will rarely be effective long term but that vit d should be looked at by guys with pre e as a general thing.

[venom888 Senior Member Find all posts View Profile Close venom888]

I wasted more than 2 years on reading those studies and trying different SSRI's including Zoloft, Paxil, and another tricyclic antidepressant. Those did nothing to me except giving me insomnia, nightmares, heavy sweating, body pains (serotonin syndrome) and ED. And it took me 2 months to wean off the last SSRI.
Here are some important lessons learned.
1. All those studies talk about just adding seconds to your timing if they work for you.
2. If one type of SSRI does not work, most probably others will also not work for pre-e. It is kind of established fact.
3. And remember serotonin is not the (only) cause of premature ejaculation. GABA works better than serotonin. But keep in mind, all those brain altering drugs lose their efficacy because body quickly adjusts all other chemicals through a feedback mechanism that is not completely understood yet. That is why they keep on trying different drugs one after another. It is just a trial and error process.
4. And even if you have depression or anxiety, your doctor must check your vitamin d levels first. It is a major risk factor.
When I started taking vitamin d3, my depression went away and now I am sure it also works for pre-e. Why? primarily calcium/magnesium or other electrolytes balance depends on vitamin d levels. If you are vitamin d deficient, your body will be unable to store calcium in the bones and it would keep on depositing in the tissues, creating a lot of problems for hormones and neurochemistry etc. There is also a study that says about 1/3rd of lifelong premature ejaculators are vitamin d deficient.
5. After doing a lot of exercises like squats, glute brides, frog pose, pigeon pose, and deep breathing, things started to improve gradually.
6. Ultimate breakthrough came through clamped edging. Within a couple of weeks, I was able to edge like a machine even watching hardcore stimulus and doing kegals and reverse kegels etc., at the same time. Somehow the clamp keeps the BC muscle from flexing and makes kegals and rks more effective. Additionally I can press the pelvic floor with hand when it swells due to high arousal. It is kind of advance form of "squeeze technique". You can mimic the same wearing a kind of tight ring at the base of your member during actual sex. First time lasted 40 minutes and had to cum on demand.
Now a days, sex is not that often. But I usually wear it for the first couple of minutes and then remove it and continue for 10 or 15 minutes and cum on demand.
I don't think that could have been possible through any SSRI.
I hope this helps.

Thanks for your response and sharing your experience.

The studies don't show adding mere seconds to your time. It's typically an increase from seconds to minutes

My Vitamin D has been checked a couple times and is always on the high end of normal.

People do respond to different SSRIs differently. One may give you one side effect and another not. From your personal experience though, yeah definitely not working for you.

I do have doubts on how long an SSRI fix will last, yeah. If you go to reddit and read the Zoloft forum, some people say they've found it hard to orgasm for years, some say it went away after several months, and of course some never have the problem (for them) at all. It does seem the body will generally acclimate, in terms of negative side effects going away (nausea, tirednes, etc go away for most people within a couple of weeks), and none of the studies I looked at tested SSRIs long-term, but for that reason I can't say it's a given that your body will acclimate the benefits away. Afterall, your body doesn't acclimate to the SSRI in the sense of it no longer treating depression. (I believe it does actually, but not dramatically)

Have done all of the strengthening and stretching every other day for 2+ years without results. Not a fix for me. I don't believe the problem is entirely physical for everyone (which is generally accepted here, as people suggest vitamins, quitting porn, etc etc)

It's interesting to me that some people (not you specifically) are very anti-SSRI as a treatment, when vitamins and various other things are accepted, when serotonin has been proven to be connected to the ejaculation process. If it's just for fear of "taking drugs that affect your brain" the same could be said about many common drugs. SSRIs have been studied for decades without any serious concerns.

I don't view a cock ring as a fix. Nor do I want to put a clamp on my dick

[esco555 Senior Member Find all posts View Profile Close esco555]

Do you plan on trying paxil at some point if your not happy with zoloft, venom?

[venom888 Senior Member Find all posts View Profile Close venom888]

It's definitely an option. I don't see a downside to it. Afterall I'm still finding an SSRI helpful for my anxiety and cycles of depression.

btw, I just re-visited the reddit and saw some people definitely having delayed orgasm even after 2+ years. but, also decreased sex drive as well. So I'm not suggesting an SSRI is the ideal, perfect fix.

My sex drive continues to be lower than normal. I vaguely think about sex consciously, and the thought of masturbation, but I don't get horny unless I think about sex in more specific terms, use my imagination etc. Or decide to watch porn. I don't really have an urge to masturbate, just the thought of it. But I do think it'd be better if I were around a pretty girl

Yesterday was day 9 at 100mg and I used my fleshlight to test things out. I'd say it was an improvement over a couple weeks ago, but not as good as the peak effect I had after the first couple of weeks at 50. I'm sure it'll fluctuate over the next week so we'll see...