Sorry for the misleading title guys. This is not a "cure" but more like my own experience of what worked for me and might help some of you.

Heyy guys. I hope you all are doing everything you can to get the most out life with this debilitating condition. I have been suffering from PSSD from long term Ashwagandha abuse AND about 7 doses of Pristiq (Desvenlafaxin). I had the all the classic symptoms hard-flaccid (genital shrinkage), numbness, ZERO libido, Complete dark black hole anhedonia (resistant to even stimulant drugs). Complete loss of all emotions both positive and negative - you name it.

I was hell bent on finding any cure for this disaster of a disease and researched for months.

Eventually I figured out a sort of protocol that has relieved some (almost all) of my symptoms. The sexual side is still a bit meh. But most of my emotions are back, I feel happy - heck even a little better than used to before all this.

This maybe a long post but would I request you to try to go through all of this. I want to help as many of us as I can.

So many here maybe familiar with the 5HT1a autoreceptor theory of PSSD. Simply put - SSRIs increase serotonin leading to autoreceptor downregulation which eventually leads to post synaptic receptor downregulation. The brain reaches this new homeostasis and once people get off the meds, the myriad of 5HT receptors remain understimulated leading to all sorts of symptoms including sexual ones.

I'll cut the rest of the science (will make another post if you guys want ) for now and get straight to the protocol :

There are three main bases of the stack

MAIN STACK

1) Roflumilast (PDE4 inhibitor) + forskolin (for INFLAMMATION)

2) Syrian Rue (Harmala Alkaloids)

3) St John's Wort

BONUS / OPTIONAL / YMMV

Bonus 1 - Bupropion

Bonus 2 - Mucuna Pruriens

Bonus 3 - Buspirone

Now I know many of you have already tried Buspirone or SJW, but there's a catch.

1)Roflumilast is extremely powerful stuff GODSEND for inflammation. This reduces inflammation on a cellular level - PDE4 inhibitors increase cAMP levels in target site cells which increases the release of Kinase protiens that lead to reduction inflammatory cytokins etc. Couple this with forskolin helps to increase cAMP even further. Seriously this combination works to reduce inflammation like CRAZY.

2)Syrian Rue is at the base of this stack : Harmala alkaloids are very potent MAO-A inhibhitors. MAO enzyme breaks down monoamines (including serotonin and dopamine) You must take about 10-15 grams of raw (semi roasted) seeds every day. This stuff is super cheap and easily available if you look a bit. You might feel a little nausea for the first few days but it works! I was amazed how powerful this is.

3) SJW is a very crucial part of this stack. I know you've heard and probably tried this without luck - but hear me out the trick is in the dosage and duration. You need to take VERY large doses (3000-4000 mg) for atleast 2-3 months. SJW would be close to a miracle drug if such a thing existed. I would recommend you buy this stuff in powder form instead of pills (would be cheaper). Long term SJW treatment at the right doses potentially unregulate 5HT1a/2a receptors. This also does a LOT of other stuff to balance out neurotransmitter systems

4) Even with the above two, the 5HT1a will take some time to upregulate and is understimulated. Buspirone is a weak-ish 5HT1a agonist. You need to take very small doses of this (10-15 mg spread across the day). This helps stimulate 5HT1a without downregulating it.

On the Bonus - you can take Mucuna Pruriens for boosting your dopamine levels, and ofcourse there is Wellbutrin for saves if you need an extra kick.

There is A LOT more to share but this post has gotten too long! Will come back with more information and the science behind all this.

PS: Guys I know that people have tried these before. But the thing is this stack is supposed to work SYNERGISTICALLY. Also for instance SJW is usually taken for a few days in small doses. That probably wouldn't work anyway. Please look at the doses and duration before saying "everything has been tried before" And I recovered from serious PSSD from THIS VERY STACK. It probably has atleast something going for it. Please don't simply ignore/discard this without going through the whole thing.

PPS: Guys SJW is not SSRI. At best it is DNRI with VERY mild SRI. Many people confuse it for "a natural SSRI" which is simply not true. Please look it up before making this claim. If it were an SSRI I would probably have died of serotonin syndrome by now (I take a strong MAOI like Harmala along with SJW). If maois are combined with SSRIs serious serotonin syndrome happens. Not only am I not dead, I never had anything even close to serotonin syndrome.

EDIT: Maybe I shouldn't claim this is a cure because that implies it would work for everyone. Maybe I should correct it and say this is what worked for me, here are the reasons why it worked and to those looking for a solution - you can take any valuable POVs from my experience and consider it if you find it useful.