Hypersensitive neural pathways to orgasm causing neuroinflammation (pois attack)

[hosamitaha]

5/3 update: instances of bipolar II patients developing pois like symptoms during the depressive phase of bipolar II disorder and milnacipran anti-epileptic role are added to the post.

A member here told me that a combination of carbamazepine 200 mg and amirtriptyline 25 mg taken every night was 100% effective in preventing symptoms. He said that he still got pois when he tried amitriptyline alone but didn?t report any POIS on carbamazepine alone. This effect has been consistent for over a year of treatment till now given that he masturbates not more than once every three days or else he would get POIS.

So I looked up on POIS centre, subreddit and FB group for any evidence on anti-epileptics which are also mood stabilisers: 1-carbamazepine. 2-valproic acid. and found no data on carbamazepine except for one recommending it because levetiracetam (a novel anti-epileptic drug with very close mode of action but isn't first line for epilepsy and not a strong mood stabiliser like valproic and carbamazepine) worked for them. another on reddit said levetiracetam worked but isn?t clear to what extent. One on POIS centre said that 3 months of valproic acid worked

This article proposes a model mechanism for the etiology of Chronic fatigue syndrome (a condition I believe is very much like POIS but in POIS the trigger is evident and measurable)

https://pmc.ncbi.nlm.nih.gov/articles/PMC3166239/

it postulates that our neuronal pathways are abnormally sensitive to the point orgasm can trigger an electrical ?i.e seizure-like? activity in the brain and we know in medicine that in epilepsy, the patient has a ?hypersensitivity to stimulation mechanism? and that seizures cause neuronal excitotoxicity which the neurons can?t handle ultimately leading to neuroinflammation. Neuroinflammation is what also causes the stopping of brain and body functions we see in POIS symptoms.

Holy fuck if POIS is actually a rare type of seizure-like illness all along leading to neuroinflammation and chronic fatigue attack symptoms. We need to embark that road more. These drugs can increase the threshold for stimulation targeting that very etiology.

Just a clarification for those who don't know, seizure doesn?t always mean the dramatic rhythmic muscular contraction and presents as non-motor forms as well. This is the medical definition of seizure: A seizure is a sudden, brief disruption of brain activity caused by abnormal, excessive, or synchronous neuronal firing. Depending on the regions of the brain involved, seizures can lead to changes in movement, sensation, behavior, awareness, or consciousness. Symptoms vary widely.

Also I believe that those who get symptoms with bare sexual stimulation without orgasm may have the most hypersensitive neural pathways of us all

This may also be part of why many report decreases of symptoms with being in a state ketosis. It is known that ketosis helps epileptic patients too. Also, this might be why a lot report migraines during POIS which are known to have a pathophysiology of abnormal sensitivity and excitotoxicity too.

Milnacipran reported to be effective in preventing pois with many partially because it raises threshold for stimulation

https://pubmed.ncbi.nlm.nih.gov/19841905/

Many people with POIS, experience worsening of symptoms with glutamine supplementation which is also the case with epilepsy and bipolar disorder!

https://pmc.ncbi.nlm.nih.gov/articles/PMC8970572/

https://pubmed.ncbi.nlm.nih.gov/34233236/

https://www.nature.com/articles/npp20092

https://www.reddit.com/r/Nootropics/comments/jx5his/hypomania_from_lglutamine_discontinue_or_just/

https://www.webmd.com/vitamins/ai/ingredientmono-878/glutamine#:~:text=Bipolar%20disorder%3A%20Glutamine%20might%20increase,body%20converts%20glutamine%20to%20glutamate.

Multiple report of pois like symptoms during depression phase of bipolar 2 disorder

https://www.reddit.com/r/bipolar2/s/Y6sooLk8AA

https://www.reddit.com/r/bipolar2/s/DAvQHgHWta

https://www.reddit.com/r/bipolar2/s/9Tx2LfgihT

https://www.reddit.com/r/bipolar2/s/NVw4B1SlsK

report of depression phase of bipolar 2 resolving by getting a flu which also happens in pois

https://www.reddit.com/r/bipolar/s/AVB9gjs3XM

Finally, I want to add that I feel very good on prolonged abstinence with exercise and healthy lifestyle like some sort of hypomania but when pois ensues during that it becomes a living hell of melancholy and suicidality worse than normal pois attacks (text book major depression maybe?). Like all my good progress was multiplied by -1. This extremely big difference doesn?t happen when I regularly masturbate and don?t care for my life that much.

POIS may be an undocumented form of a mood lability ending in cfs-attack due to hypersensitive neural pathways

[Quantum]

Thanks for sharing your hypothesis, Hosamitaha.
I see POIS as a group of related ailments having the same triggers and causing similar symptoms, and it is clear that many POIS types have a strong neurological component.

I, too, think that many POIS symptoms are similar to what we see in CFS/ME, and in long COVID, and it has been discussed here, on the forum.  I also think the exotoxicity has a central role, that is why I use TDO and IDO inhibitors in order to control my POIS symptoms, among other things.
Somw years ago, I also created a thread here about the similarities between a POIS attack, and encephalitis.  Inflammation in the brain sure seems to be an important aspect of POIS. 

Carbamazepine had been mentioned before on the forum, There is even a thread from a member who eliminated his POIS with carbamazepine and/or levetiracetam, while taking those for temporal epilepsy ( see https://poiscenter.com/forums/index.php?topic=4583.msg49301#msg49301).  But, as usual with POIS, this solution will work only for a certain proportion of POIS sufferers, and not for the others.
Some POIS types seem to be more systemic than just affecting the brain, like those who have strong allergy symptoms, joint aches, intense flu-like symptoms, dermatologic problems, and so on.  But extreme fatigue, mood swings, difficulty concentrating, etc, are very often present, and point to neuroinflammation in the brain, just like you discuss in your hypothesis.
I am not surprised to read that this member has to limit his sexual activity in order for his control method to stay effective.  I experiment quite the same with my own pre-pack method.  If too many repetitions in a short time period, it will not contain my POIS symptoms anymore.

[hosamitaha]

I appreciate yours sharing this knowledge with us, Quantum.

Encephalitis usually refers to life-threatening inflammation of brain that doctors undergraduate curriculum covers up well.

What doctors curriculum doesn?t teach is the concept of functional diseases (i.e. neuroinflammation) or non life-threatening inflammation of central nervous system (brain and spinal cord). Doctors are unexposed to those kind of diseases and are most of times resistant to education on this part too.

The systemic symptoms as allergy, aside from neuroinflammation, are interesting because we don?t know if they occur (1) downstream from nervous pathology or if (2) they share a common origin with neuroinflammation or (3) totally have another distinct origin. Three possibilities. Yet I believe fixing the neurological component is of utmost importance.

In epilepsy, we know that valproic acid is more broad-spectrum for all kinds of brain hypersensitivity problems, more stronger on the neuroinflammation part and can induce long term changes. Carbamazepine is golden too in some other kinds of epilepsy and has some neuroinflammatory modulating properties but has the advantage of being more tolerable. However, despite both being safe, they require some follow-up investigations every while to make sure the few unlucky who get side effects are detected early.

I believe I read that someone here said depakene (valproic acid) taken for three months completely resolved their pois but this was recent. Let?s ask them if the effect persisted!

Thanks for sharing your hypothesis, Hosamitaha.
I see POIS as a group of related ailments having the same triggers and causing similar symptoms, and it is clear that many POIS types have a strong neurological component.

I, too, think that many POIS symptoms are similar to what we see in CFS/ME, and in long COVID, and it has been discussed here, on the forum.  I also think the exotoxicity has a central role, that is why I use TDO and IDO inhibitors in order to control my POIS symptoms, among other things.
Somw years ago, I also created a thread here about the similarities between a POIS attack, and encephalitis.  Inflammation in the brain sure seems to be an important aspect of POIS. 

Carbamazepine had been mentioned before on the forum, There is even a thread from a member who eliminated his POIS with carbamazepine and/or levetiracetam, while taking those for temporal epilepsy ( see https://poiscenter.com/forums/index.php?topic=4583.msg49301#msg49301).  But, as usual with POIS, this solution will work only for a certain proportion of POIS sufferers, and not for the others.
Some POIS types seem to be more systemic than just affecting the brain, like those who have strong allergy symptoms, joint aches, intense flu-like symptoms, dermatologic problems, and so on.  But extreme fatigue, mood swings, difficulty concentrating, etc, are very often present, and point to neuroinflammation in the brain, just like you discuss in your hypothesis.
I am not surprised to read that this member has to limit his sexual activity in order for his control method to stay effective.  I experiment quite the same with my own pre-pack method.  If too many repetitions in a short time period, it will not contain my POIS symptoms anymore.

[Quantum]

I appreciate yours sharing this knowledge with us, Quantum.

Encephalitis usually refers to life-threatening inflammation of brain that doctors undergraduate curriculum covers up well.

What doctors curriculum doesn?t teach is the concept of functional diseases (i.e. neuroinflammation) or non life-threatening inflammation of central nervous system (brain and spinal cord). Doctors are unexposed to those kind of diseases and are most of times resistant to education on this part too.

The systemic symptoms as allergy, aside from neuroinflammation, are interesting because we don?t know if they occur (1) downstream from nervous pathology or if (2) they share a common origin with neuroinflammation or (3) totally have another distinct origin. Three possibilities. Yet I believe fixing the neurological component is of utmost importance.

In epilepsy, we know that valproic acid is more broad-spectrum for all kinds of brain hypersensitivity problems, more stronger on the neuroinflammation part and can induce long term changes. Carbamazepine is golden too in some other kinds of epilepsy and has some neuroinflammatory modulating properties but has the advantage of being more tolerable. However, despite both being safe, they require some follow-up investigations every while to make sure the few unlucky who get side effects are detected early.

I believe I read that someone here said depakene (valproic acid) taken for three months completely resolved their pois but this was recent. Let?s ask them if the effect persisted!

Thanks for sharing your hypothesis, Hosamitaha.
I see POIS as a group of related ailments having the same triggers and causing similar symptoms, and it is clear that many POIS types have a strong neurological component.

I, too, think that many POIS symptoms are similar to what we see in CFS/ME, and in long COVID, and it has been discussed here, on the forum.  I also think the exotoxicity has a central role, that is why I use TDO and IDO inhibitors in order to control my POIS symptoms, among other things.
Somw years ago, I also created a thread here about the similarities between a POIS attack, and encephalitis.  Inflammation in the brain sure seems to be an important aspect of POIS. 

Carbamazepine had been mentioned before on the forum, There is even a thread from a member who eliminated his POIS with carbamazepine and/or levetiracetam, while taking those for temporal epilepsy ( see https://poiscenter.com/forums/index.php?topic=4583.msg49301#msg49301).  But, as usual with POIS, this solution will work only for a certain proportion of POIS sufferers, and not for the others.
Some POIS types seem to be more systemic than just affecting the brain, like those who have strong allergy symptoms, joint aches, intense flu-like symptoms, dermatologic problems, and so on.  But extreme fatigue, mood swings, difficulty concentrating, etc, are very often present, and point to neuroinflammation in the brain, just like you discuss in your hypothesis.
I am not surprised to read that this member has to limit his sexual activity in order for his control method to stay effective.  I experiment quite the same with my own pre-pack method.  If too many repetitions in a short time period, it will not contain my POIS symptoms anymore.

Let us know of the resutls if you try carbamazepine.