Do I have erectile dysfunction from citalopram?

Thanks for your reply.

I've always been on 5mg cialis a day.

I've spoken to my GP and he's not aware of PSSD from citalopram.

He's also said it's unlikely considering I was on taking it for 7 days and also on the lowest 10mg dose. I could also get full erections whilst taking citalopram.

He also thinks that spontaneous nocturnal elections and whilst watching porn are good signs and that it's probably more to do with the anxiety attacks and psychological issues considering I've had issues for years. The erectile dysfunction did return with the anxiety attacks and before I started taking citalopram.

The doctor seems to think I need to sort the stress out before my erections fully return.

He's also said that 4 weeks to 3 months is an acceptable timeframe for withdrawal symptoms to last.

Is this right?

If the cialis stopped working its magic before you started taking the citalopram, then that makes PSSD less likely.  My guess is that you'll be back to normal at some point soon, and the doctor's advice makes sense to me.  Good luck!

The cialis stopped working because of my own fault. I stopped taking it all together thinking I was ok. The erectile dysfunction came back leading to the increased anxiety then finally 2 weeks of severe panic attacks.

That's when I took the citalopram for a week.

I've been taking the cialis again now for 2 weeks ànd starting to see some improvements with the night erections, whilst watching porn and even waking up with about a 75% erection for the last week.

I think because I haven't got back to normal I've done some reading online and come across PSSD which is worrying.

But the doctor thinks it's unlikely and purely down to anxiety now.

He also says the night erections, although not every night are proof everything is working fine and it's psychological.

I'd assumed that you were taking cialis the whole time.  If you stopped taking it, and getting ED back may have caused the panic attacks, then I wouldn't worry about PSSD.  I'd expect being back on cialis would probably fix the ED, and indirectly the anxiety,

No, I stopped taking the cialis for 3 weeks whilst my partner was on holiday with her children. I then had a few personal issues which resulted in the anxiety attacks, then no erections at all, then further anxiety about ED and my partner. All in all a bad few weeks. This was about a month ago which is when I tried citalopram for a week.

Been back on cialis for 14 days. It's usually only taken 7 days to work which is why o started to worry about PSSD.

Although starting to get some erections back is making think again about PSSD and maybe the doctor is correct and it's just stress about the whole situation and the cialis will work in time if I manage the stress?

Do you mean that PSSD is less likely with citalopram than any of the other SSRI's?

Also the fact that I was on the lowest 10mg dose for only 7 days should also mean this is less likely?

My doctor seems to think this is the case and the issue is stress related.

Any comments would be gratefully appreciated.

Thanks

Yes - that's exactly what I mean. Citalopram may cause PSSD as it belongs to the SSRI class, but the probability is not that high, especially taking into account that you took a low dose (5 mg of active S-citalopram in 10 mg tablet) for a short period of time (7 days). PSSD is typically observed in people who take paroxetine, sertraline or venlafaxine (SNRI) for many months - you're unlikely to develop this condition in one week. Within this timeframe citalopram wouldn’t even reach a stable level in your plasma, so... it's a long shoot.

I think that the problem is related to the stress / anxiety. Have you tried any relaxation technique? You wrote that you can manage full erection when you watch porn - this suggests that when you feel safe (unless you watch it with someone else ;p), the problem does not occur. However, in the presence of another person, when you experience anxiety, you encounter problems...

I hadn't realised that. Everything I have read on PSSD related to SSRI use and and it was anywhere between 35%-75% which made me worry more. I think this also grouped all the SSRI's together and wasn't just for citalopram.

I hadn't realised the active ingredient was only 5mg either making PSSD even less likely.

At the moment I can only get an erection on my own whilst watching porn. I don't get any movement at all during the day although I can sometimes wake up with an about 75% erection which does make sex possible. Also I wake up some nights with a full erection too. Does this mean PSSD is even less likely??

With regards to the stress levels, I've been seeing a therapist for cbt which has helped massively although still have flare ups. I'm also on a waiting list for erectile dysfunction cbt too.

What do you think?

Well, I think that cbt can be helpful. You should stop worrying about PSSD and manage the cause of your problems (anxiety) rather than the symptoms (erectile dysfunction).

As I mentioned before, there is a medication called bupropion (original tradename Wellbutrin) - it's a noradrenaline and dopamine reuptake inhibitor, a unique antidepressant in its class. Some psychiatrists prescribe it off-label to ease the sexual side-effects of SSRIs, I think you could benefit from it as well providing that you start cbt (it may make the anxiety worse during the first weeks of treatement). And finally - give yourself some time. Men have been struggling with erectile dysfunction for centuries and everyone can have a bad day. It's not your fault.

Anyway, I hope you get better soon!

Thanks for your comments. I've looked bupropion but it's not available in the UK.

And I'm not sure if I want more medication after this scare.

I really don't think it's PSSD, more anxiety. It's made worse with the cialis not working at the moment.

But I am seeing signs of improvement by having erections during the night.

Hopefully I just need the time to sort out the anxiety issues and that'll be it.

Bupropion is also marketed as Wellbutrin and Zyban.  It's licensed in the UK as Zyban, but only to stop smoking.  I've used it to try to stop smoking, and had to stop because it had fairly fierce side effects.  Even after dropping to half the normal dosage, I was still never quite fully awake or fully asleep, and I had the most vivid dreams I've ever had in my life, where it would take me 20 seconds after waking up, often drenched in sweat, to finally accept it was all only just a dream.  I didn't complete the course as the cure seemed worse than the condition, though I should maybe have persevered.  Your mileage may vary...

I did stop smoking, but started again not long after. :-(

Thanks for the info. Not sure I want to take anymore medication just yet. It's only been 3 weeks since I stopped the citalopram and even though I was only taking it for a week on the lowest dosage, maybe I need to stop worrying that this is going to be permanent as it's probably making the issue worse.

Maybe the 4 weeks to 3 months timeframe that I've read is a more accurate recovery time?

Thanks for your comments.

I think my relationship is fine and our sex life was also fine before I started with the panic attacks.

Although I can get some satisfaction on my own it's not all the time which is another reason I was wondering if it was PSSD from the one week of 10mg citalopram which I stopped 3 weeks ago.

I've also read that rapid onset of PSSD following this short dose is unlikely but could take 4weeks to 3months to recover fully.

I guess my worry is that it's permanent but that's probably making the issue worse too and the anxiety attacks worse