Hello.
Thanks for using DoctorSpring for posting your query.
I have gone through your query in detail and I can understand what you are going through.
The kind of symptoms that you have stated range across various symptoms and the diagnosis which can explain them is either a 1) Chronic Fatigue Syndrome or 2) Somatoform disorder.
I understand that almost all of your blood reports have come normal and hence organic causes are not suspected.
You have mentioned that you have been started on antidepressants but you have not stated that since how long are you taking them. Actually antidepressant medications like amitryptyline will be a good drug for such problems. Many patients in my clinic have responded well to Amitryptyline 25 mg dose and probably you can discuss this issue with your psychiatrist. For you to be having somatoform disorder or getting well with anti-depressants, you need not be depressed.
Hope that helps,
If you have any further queries I would be more than happy to help you.
Regards
Dr. Srikanth Reddy MD
Psychiatrist & Sexologist
Patient replied :
Thank you for your answer. I have been thinking about it this week and would like to add to what I said before.
I am not sure what blood tests I have had but apparently they haven't shown anything unusual. I have read about Chronic Fatigue Syndrome and Somatoform Disorder and can see I have some of those symptoms but am still not sure why they seem to be affected so much by when I masturbate? I have recently masturbated about 5 times within a week and strangely it has helped my symptoms a little. Previously it always made it worse so I am wondering if the Fuoxetine 20mg capsules I am taking have changed anything? I have been taking them about 3 months but have been trying not to masturbate during that time. Is Amitryptyline very different to Fluxetine? I am just wondering what is best to do as I have started reducing my dose of Fluoxetine a week ago as I felt it wasn't making any difference.
I have also looked into what chemicals are released after ejaculation and wonder if too much or not enough of any of these could be causing my symptoms: Dopamine, Norepinephrine, Testosterone, Oxytocin and Serotonin? Thanks again.
Hello,
I will try to answer all the questions that you have put up.
Along with the neurotransmitters that you have stated, any pleasurable activity like masturbation will also cause release of endorphins (endogenous opiods) and this causes improvement in your symptoms. It causes relaxation and reduces anxiety.
Anitryptiline is different from fluoxetine and you should give it a try as you are already reducing the dosage of fluoxetine.
Its OK to masturbate 5 times a week and you need not restrict yourself or feel guilty otherwise.
Hope that helps
Wish you good health,
Regards
Dr. Srikanth Reddy