The sexual side effects by SSRI's are caused by a restriction of blood vessels in the brain, what about this?

Question

SSRIs help relieve the symptoms of anxiety and depression by increasing the available supply of serotonin in the brain.

Seratonin is a brain chemical that helps to regulate your mood.

There is more.

Serotonin is also a potent constrictor of the blood vessels and is thought to be involved in the mechanism of migraine and stroke.

And sexual problems?

Is this the whole reason behind why SSRI's cause sexual side effects, because they restrict blood flow and blood vessels in the brain?

Those people out there saying it has caused them permanent sexual dysfuction have suddenly caused me to give them merit, as those blood vessels in the brain that have been restricted for so long, especially for those who took the SSRI's while growing up, will definitely effect the time, if any, that it will completely reverse.

It does also appear to indeed increase the chance of stroke and one person claimed it caused them an impairment of vision, which also makes sense. SSRI's are constricting the blood vessels in the brain, I can't believe it. I wish this had to be explained to people, as I wouldn't have taken an SSRI pill this morning, which I now plan to quit.

Would taking an appropriate dose of a brain blood vessel relaxing medication (?), stop the side effects of SSRI's, while reaping the benefits of the added serotonin?

Perhaps, but that is beginning to sound like chemistry to me.

Incidentally, is there anything else that can help my OCD? And how long will that 50mg dosage of sertraline hydrochloride that I took this morning take to completely leave my body? Thankfully, it is unlikely that it could have caused any permanent damage with one pill, I mean, thats liking thinking of it has a poison pill. Anyway, I have taken a few Effexors precribed to me when I was 17 and I stopped after a few times when I noticed my sexual ability stopped.

What the h**l is wrong with those eggheads, can't they see something wrong with this?

Answer 1

Exactly as the above author proffered, it seems like there a bit of confusion about the MOA of SSRIs versus the MOA of serotonergic agonists used in the treatment of Migraine headache.  If we accept the theory that Migraine is the product of intracranial vasodilitation, then a serotonergic agonist would only be sensible in it's treatment (and they do appear to work rather well for many).

SSRIs function in a very different manner (at the level of the synapse), so it's really rather complex pharmacology that we're talking about and rather than complicate the matter, your best bet is to adhere to your physician's recommendations.  Generally, the advice physicians offer is highly well-thought out, so you'd be well advised to trust your Psychiatrist's judgement, but again, like most things in life, it's entirely up to you.

Answer 2

You're in a very very iffy realm. The relationship between SSRIs and blood pressure is pretty weak. The effect they have seems to be very, very mild, and in fact they seem to constrict the larger arteries to the brain and dilate the smaller capillaries in the brain tissue. The idea that vasoconstriction is responsible for sexual side effects really has no merit for several reasons. The sort of blood deprivation that you're describing would result in tissue death, which would be clearly visible on the imaging studies done on the twelve odd cases of PSSD - there was none present. Second is that sexual arousal is clearly monitored by the serotonin system itself.

PSSD has been getting a lot of unwarranted attention on Answers lately. This is very rare, there have been twelve confirmed cases in a few billion patient-years, and none of the people claiming to 'have' it on the internet have had the few hundred other causes of sexual dysfunction, most of which are comorbid with depression, ruled out. If you read those studies, they clearly went through every possible cause known to medical science before assigning blame. This is by all accounts, astronomically.

Imaging of the blood flow in the brains of people taking SSRIs shows no significant alteration in blood flow or pressure. This is probably due to the fact that the Serotonin Transport Protein targeted by SSRIs is not shared by the serotonin system involved in blood pressure regulation (I'm not good with cardiovascular drugs, so I don't know the specifics of how this system works.)

OCD lives in the anxiety domain. And if anyone wants to know why anxiety disorders are difficult to treat, just read the question again. You may also consider the drug Amitriptyline.

As for the specific questions

Sexual side effects due to vasoconstriction? No. Sexual side effects are due to an increase in serotonin activity in the areas responsible for regulating sexual drive and arousal. More serotonin slows down this system.

Would a vasodilator help? No, because the effects on blood pressure and blood vessel tone are negligible. Near none existant as far as we can tell.

So you've got a choice here. You can have a little faith in your doctor's experience and education and work with the process, or you can wait until you can't tolerate the psychiatric symptoms you're having anymore.