T Nation

SSRI Induced HPTA Damage: Fix???


Can anyone here shed any light on any possible way to treat SSRI induced HPTA/ HP-Thyroid axis function?

I was treated with Zoloft for 3 years (age 17-20) at a dosage of 100-200mg/day for Tourette's (no history of depression), and absolutely no other medical issues to that point. I discontinued Zoloft when the Tourette's was no longer an issue, but by that time I felt bad enough that I didn't have much desire left to live life, to be honest. I was not laboratory tested until age 22, and the results showed that my Hypothalamus-pituitary function had basically been demolished post-SSRI. Testosterone had dropped to around 220, Free T3 and Free T4 were also both below clinical lab range. I responded to Clomid for 2 weeks, and then my hormone levels unexplainedly crashed again and never came back up. I tried again 2 years later and the same phenomenon occured. For 2 years now, I have been on TRT with Test Cyp. and Anastrozole. Total T, Free T, and E2 have been perfected after 2 years of trial and error to optimal/average values for a young man my age. With Levothyroxine 50 mg/day, my Free T4 and Free T3 were 0.85 ng/dL and 2.9 pg/mL, respectively. I started Liothyronine 10 mcg/day 2 weeks ago, and transient improvements in mood occur but they are very short lived.

My biggest question: Is there any known mechanism to reverse the damage to the Serotonin and Dopamine signaling pathways that is caused by chronic high dose SSRI use? All the symptoms that remain for me after hormone replacement are the standard ones given for depletion of these neurotransmitters (loss of joy in life, depressed thoughts, fatigue, low libido, occasional thoughts of suicide, etc) I have scoured many, many resources and can find no solution. For 4 years now I have been up against this terrible thing. Is there any solution? Could a higher dosage of Liothryonine help reverse such damage or in the long term up-regulate the serotonin system again? Does anyone know of any possibilities?

Thanks so much,

KSman is Here

I have been using SSRI Zoloft welbutrin all my adult life - 45 yo - the pros to using them far out weighed any side effects . They have my feeling of happiness back - occasionally I got off to see if needed , and eventually I needed them again . Some recent rx out Abilify proves to boost the effects of regular SSRI RXs . Works on dopamine instead of serotonin . I use this if my regular SSRI need help . TRT can be done along side of these meds . They all effect hormones and the trick is finding the balance . Don’t dismiss SSRIs yet as an option . You have many tools ( RXs ) to use if needed . Good luck and keep reading about options and treatments , education on subject empowers you to find answers .