Treatment & Recovery Database
HCG
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Human Chorionic Gonadotropin, known as HCG, is clinically to stimulate testicular function in hypogonadism and fertility treatments.
HCG’s effect on men and women vary widely. There is little, if any, anecdotal evidence of women with post-exposure syndromes (PES) trialing HCG.
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Binds directly to LH receptors on Leydig cells in the testes which stimulates intratesticular testosterone production and steroidogenesis (including neurosteroid precursors like pregnenolone and progesterone)
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In post-exposure syndromes, the HPG axis may be suppressed or dysregulated. HCG may help override the suppression
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Apart from some proposed theories (add link here) by physicians and other PES researchers, evidence is largely anecdotal.
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A collection of 151 entries of self-reported experiences with HCG below depict the outcome of trials across three diagnoses– PSSD, PFS, PAS.
130 with PFS
14 with PSSD
5 with PAS
2 Dual Diagnosis
Overall, 90% had some sort of improvement, with 70% having a substantial improvement or recovery. This figure is similar when isolating PFS patients (n=130).
The figure for PSSD (n=14) patients stand at 13 of 14 improvement, with 11 of them having a substantial improvement or recovery.
The figure for PAS (n=6) patient stand at a 100% rate of improvement, with 4 of them being substantial or recovery.
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HCG is generally well tolerated, but as with any substance, adverse effects can occur.
Per reputable online sources, side effects inculde:
Bloating (More Common)
Stomach/Pelvic Pain (More Common)
Diarrhea
Nausea
Feelings of Indigestion
Swelling of extremeties
Weight Gain
Trouble Breathing
Vomiting
In addition, 7 of the 150 participants total reported a crash. They were not isolated to just one diagnosis.
HCG is usually given as in injection subcutaneously or intramuscularly. It was originally developed as a treatment for cryptorchidism in 1931 by physicians in Charité Hospital in Berlin, Germany. Urine-derived HCG was first approved by the FDA in 1939 and received subsequent approval for additional indications in 1973.
PEF Official HCG Database
Last Updated: 13/04/2026, Credit to u/Major-Ranger6720 for partial HCG and inspiration/design
Cyproheptadine
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Cyproheptadine is a first-generation antihistamine with potent serotonin antagonist properties, available generically worldwide and commonly used off-label for appetite stimulation, migraine prophylaxis, and serotonin syndrome. In many countries, it does not require a prescription.
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Blocks H1 histamine receptors and multiple serotonin receptor subtypes reducing serotonergic tone. 5-HT2 antagonism in particular is thought to disinhibit dopaminergic and noradrenergic signaling, and may modulate neuroactive steroid synthesis downstream.
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The exact mechanism between PSSD and other post-exposure syndromes (PES) is not fully understood.
It is theorized that PES involve upregulation of 5-HT2A and/or 5-HT2C receptors, which normally regulate mood, cognition, and neurosteroid synthesis.
Cyproheptadine antagonizes these receptors, reducing serotonergic tone and potentially restoring downstream hormonal and dopaminergic signaling.
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A number of research papers, both official and informal, document Cyproheptadine as a treatment for PSSD with mechanistic rationale. They can be found here.
Other than that, evidence is largely anecdotal.
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A collection of 41 entries of self-reported experiences with Cyproheptadine below depict the outcome of trials across four diagnoses– PSSD, PFS, PAS, and Undertermined PES Phenotype (UPP).
37 with PSSD
1 with PFS
1 with PAS
2 with UPP
Overall, 54% had some sort of improvement, with 41% having a substantial improvement or recovery.
The data for PES sufferers with a diagnosis apart from PSSD is quite limited (n=4). 3 of 4 saw an improvement.
Overall, the crash risk is low with Cyproheptadine, with 4 out of 41 participants experiencing one.
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Per reuptable online sources, common side effect include weight gain and somnolence.
Serious side effects can occur, but are rare.
Cyproheptadine is a first-generation antihistamine and serotonin antagonist originally developed in the 1960s that has found a second life as an off-label treatment across a range of conditions. By blocking both H1 histamine receptors and serotonin (5-HT) receptors, it modulates signaling pathways implicated in appetite, sleep, and hormonal regulation. It remains one of the few inexpensive, widely available compounds with documented anecdotal benefit in post-exposure syndromes including PSSD and PFS.
PEF Official Cypro Database
Last Updated: 13/04/2026
Lithium
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Lithium is a mood-stabilizing mineral salt available in both prescription form (lithium carbonate) and over-the-counter low-dose supplements (lithium orotate), with decades of use in psychiatry for bipolar disorder and depression augmentation. It has attracted growing interest in post-exposure syndromes for its inhibition of GSK3β, a kinase implicated in neuroinflammation and synaptic plasticity.
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Per the NIH, Lithium’s exact mechanism is not fully understood yet. It is thought to Lithium acts as a mood stabilizer by modulating signaling pathways, inhibiting enzymes like GSK-3 and IMPase. It reduces excitatory neurotransmission (dopamine, glutamate) while increasing inhibitory GABA transmission and boosting neuroprotective proteins to stabilize mood and enhance neurogenesis.
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Some theorize that inhibiting the GSK-3 enzyme pathway has mechanistic rationale for PSSD and other post-exposure syndromes.
The GSK-3 pathway is implicated in neuroinflammation and impaired synaptic plasticity. It is important to note that this theory is merely speculative at time of writing.
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Evidence consists solely of anecdotes and informal theories.
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The lithium database contains 34 entries across four diagnoses:
18 with PSSD
4 with PFS
9 with PAS
3 entries with unknown diagnoses, speaking about improved sexual function
The database includes a multitude of lithium entries– Lithium Carbonate, Lithium Oroate, Lithium Sulfate, Lithium (Unknown)
Overall, 73.5% of the entires reported an improvement, with 41.2% having a substantial improvement or recovery
Of the specific diagnoses:
7 of 8 PAS patients reported an improvement
3 of 4 PFS patients reported an improvement
12 of 18 PSSD patients reported an improvement
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Lithium Carbonate is an established prescription drug in most countries worldwide, typically indicated for Bipolar disorder. Lithium Carbonate should not be taken without the guidance of a phyisican and requries regular blood monitoring.
Lithium Oroate is an over-the-counter (prescriptionless) supplement in most countries. Therefore, it does not explicitly require a physician’s guidance.
Lithium Sulfate is a research chemical not available for purchase in most municipalities.
The common side effects of Lithium Carbonate, by far the most common modality in the database, include: fine hand tremor, polyuria (frequent urination), polydipsia (excessive thirst), nausea, thyroid disturbances, diarrhea, weight gain, cognitive dulling ("brain fog"), fatigue, acne, and edema of the ankles or wrists. Side effects are more likely at a higher dose.
Lithium has attracted interest across post-exposure syndromes for its ability to inhibit GSK3β, a kinase implicated in neuroinflammation, androgen receptor signaling dysregulation, and synaptic plasticity — all pathways relevant to PSSD, PFS, and related conditions. Low-dose lithium orotate (available OTC) and prescription lithium carbonate are being informally explored by some patients, though clinical evidence in this context remains preliminary.
PEF Official Lithium Database
Last Updated: 15/04/2026
FMT
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FMT (fecal microbiota transplant) is a procedure that transfers stool from a healthy, screened donor into a recipient's digestive tract to restore a balanced gut microbiome. It is FDA-approved for recurrent C. difficile infections and can be delivered via colonoscopy, enema, or swallowed capsule.
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FMT works by repopulating the gut with diverse, healthy bacteria that produce metabolites which influence immune function, inflammation, and brain signaling through the gut-brain axis. Correcting dysbiosis may also reduce intestinal permeability, helping to lower the low-grade immune activation seen in many chronic post-exposure conditions.
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While direct evidence of FMT in post-exposure syndromes are solely anecdotal, evidence has shown that there is a microbiome imbalance in previous users of Finasteride and Isotretinoin (Accutane).
Moreove, per Mount Sinai Hospital, SIBO (Small Intestine Bacterial Overgrowth) is known to be a component in post-infectious chronic illnesses which largely overlap with post-exposure illnesses in phenotype. SIBO is known to respond well to FMT.
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Evidence consists solely of anecdotes and informal theories.
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The FMT database contains 7 entries across four diagnoses:
5 with PSSD
1 with PFS
1 with PAS
Of the FMT trials, 4 had a full recovery (including the PFS and PAS entries), 2 had no improvement, and 1 had a crash
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FMT is generally well-tolerated, with mild and temporary side effects like bloating and cramping being most common. Serious risks are rare but include infection from inadequately screened donor stool, making proper donor screening and clinical oversight important considerations.
However, long term safety is unclear. Serious side effects are rare, but have been described, such as aspiration pneumonia, bacteremia, and death.
FMT is a procedure that transfers stool from a healthy, screened donor into a recipient's gastrointestinal tract to restore beneficial gut bacteria, most commonly used to treat recurrent C. difficile infections that haven't responded to antibiotics. It's typically delivered via colonoscopy, though capsule and enema options exist, and requires donors to be screened for a range of infectious diseases. The procedure is generally well-tolerated.
PEF Official FMT Database
Last Updated: 15/05/2026
Bupropion (Wellbutrin)
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Bupropion, often marketed as Wellbutrin, is an atypical antidepressant that works differently from SSRIs and SNRIs. It is known to be pro-libido and works via the dopaminergic system. It is also weight-neutral and is used for smoking cessation. The medicine was first synthesized in 1969 in Britain. Ironically, it is is now approved as an antidepressant almost everywhere in the world except the UK.
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Bupropion primarily blocks dopamine and norepinephrine transporters, increasing synaptic levels of both neurotransmitters. This produces improvements in motivation, reward signaling, energy, and alertness. Unlike SSRIs, it has no significant activity at the serotonin transporter.
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Dopamine plays a role in motivation, reward, and sexual function. Post-exposure syndromes heavily overlap with one another with symptom patterns suggestive of hypodopaminergia including anhedonia, blunted reward and sexual dysfunction. Bupropions pro-dopaminergic and pro-sexual effects is hypothetically coherent in the treatment of post-exposure syndromes. However, anecdotal evidence depicts a much different picture. While there are some that greatly benefit from Bupropion— others claim to have acquired PSSD from it.
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Evidence consists solely of anecdotes at this time.
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The Bupropion database contains of 37 entries across three diagnoses:
33 with PSSD
3 with PFS
1 with PAS
Of the entries:
18% had a substantial improvement or better
18% had a mild or moderate improvement
21% had no improvement
The rest experienced worsening, with two of the entries claiming that Bupropion was the culprit for their PSSD
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Wellbutrin, like most other marketed antidepressants, is claimed to be safe on-paper. However, we at PEF are aware of those who claim to be suffering from PSSD from Wellbutrin, alongside those who crashed from the medication. Therefor, we are not able to guarantee that this medication is safe to try.
Common side effects include:
Insomnia (most common — activating drug)
Dry mouth
Headache
Nausea
Dizziness
Constipation
Increased sweating
Agitation, especially early on
Furthermore, the seizure threshold is lowered while on Wellbutrin. Do not crush or cut tablets. If you suffer from or have a family history of seizures or epilepsy— please consult with a doctor.
Bupropion was synthesized in 1969 but sat unused for over a decade before FDA approval in 1985 — and was then pulled from the market just one year later due to seizure reports, only to be reintroduced in 1989. It is now one of the most prescribed antidepressants in the United States
PEF Official Bupropion Database
Last Updated: 26/05/2026