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Asexuality or hyposexuality as a result of SSRI / SNRI drugs


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anacleta

Hi all,

 

There are drugs widely prescribed for various disorders, starting with depression, anxiety and other psychological disorders, but also other types such as fibromyalgia, pain therapy, premature ejaculation and others....

 

The most common side effects include sexual dysfunctions of various kinds: lowering of libido (desire, craving) and excitatory response to sexual stimuli, but also reduced sensitivity of the genitals, i.e. the erogenous sensation (of sexual pleasure) in the genitals is reduced or absent, and sometimes even tactile, a kind of numbness that can be more or less intense from person to person. As for orgasm, it becomes unattainable (anorgasmia) or more difficult to achieve and mechanical, without pleasure (anhedonic).

 

These sexual dysfunctions affect the majority of people taking these serotonergic drugs. Here the results of the various studies vary greatly, but we approximate by saying over 50%.

 

The most important thing, however, which is less well known, is that for some people (and here there are no statistics yet) these effects are not reversible when the treatment is discontinued, as one would expect. There are in fact people who are left with their pre-SSRI sexuality completely impaired by the drug treatment even after stopping it, and in some cases sexual dysfunctions appear, or worsen, only at the time of discontinuation. It can happen to men and women, even very young ones, following 'regular' use (i.e. non-abuse of the drug), and there is currently no cure, and people who experience it not returning to the way it was before are quite upset and distressed, because they feel sort of 'castrated' and deprived of their sexuality.

 

These persistent symptoms are called Post-SSRI Sexual Dysfunction (PSSD).

 

My thoughts, inspired by a recent article I read, which I will link to later, are as follows:

In the case of adults who contract PSSD, the before and after is usually obvious and upsetting, you realise you've ruined yourself.
But what happens if these drugs are taken while growing up?

 

To go even further: studies have observed that the administration of SSRIs to the mother-rat during pregnancy resulted in hyposexual behaviour of the adult rat-children. Could the same thing happen in humans? Some authors think so.

 

This is the part about Post-SSRI Asexuality of a recent published and open access scientific paper (this one).

Quote

 

7.Post-SSRI asexuality
Animal studies have found that exposure to an SSRI during pregnancy or at an early age produces sexual deficits in adulthood [42]. A recent study in humans found evidence that there may be similar implications for people exposed to an SSRI in childhood [43]. Given that these problems develop prior to sexual maturity, the person may have no pre-drug baseline for comparison, making it difficult to recognise symptoms such as low sexual desire, reduced genital sensation and pleasureless orgasm. We propose the introduction of a new term, Post-SSRI asexuality, to describe a dampening of sexual interest and pleasure resulting from a pre-natal or pre-teen exposure to a serotonin reuptake inhibitor. At present there are no data on the proportion of people who define themselves as asexual and have a condition that may be linked to medications.

Criteria:

  • Clear evidence of maternal SRI intake in pregnancy or
  • Evidence of extended pre-teen SRI intake.
  • Lack of sexual interest in either the same sex or the opposite sex.
  • No experience of pleasure from masturbation or sexual activity ever.
  • Identification as asexual

 

All these molecules have numerous trade names of drugs:
SSRIs: fluoxetine, sertraline, citalopram, escitalopram, fluvoxamine, paroxetine, dapoxetine

SNRIs: venlafaxine, duloxetine

 

The article I was talking about is this testimony of a girl who took SSRIs while growing up and now can't figure out if her hyposexuality depends on it.

https://rxisk.org/sex-please-but-we-are-on-antidepressants/

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Reading the testimony, I'm not sure what, if anything, this has to do with asexuality. She clearly articulates her desire for sex, and it's clear she is sexually attracted to people. She doesn't even identify as asexual. She just has an issue with her libido because of SSRI's. That's a completely different thing. (Yes, there are some nonlibidoist asexuals, though that's for sure not the majority of asexuals.)

 

Anyways, as a lifelong asexual who has only started taking SSRI's at 26, they haven't had an effect on the downstairs bits. Works fine as always.

 

SSRI's definitely can have an effect on libido, but completely killing your libido is absolutely not common, and I feel like the wording in your post overestimates the prevalence.

 

I suppose I'm suspicious as to what your motivations are for posting this as your very first post on an ace forum. Are you trying to convince people they're just ill, not asexual? Because if so, you are very wrong. 

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RoseGoesToYale

Medications can possibly affect libido and genital function, but not sexual attraction. There is no medication that can turn you asexual any more than any medication can turn you gay, pan, etc. A person can still experience sexual attraction or desire for sexual contact with another person despite the plumbing not doing what the person wants (which is why a market for Viagra exists). A person who is asexual won't magically experience sexual attraction by going off their medication.

 

It should also be noted that severe depression and anxiety can negatively affect libido, but not a person's sexuality.

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anacleta

Thank you for your answers.

 

I personally have been suffering from Post SSRI Sexual Dysfunction in a rather severe form for 8 years and I am among those who suffer from the loss of the sexuality that had grown up with me. I do not consider myself asexual and I still have some of my libido (everything else in the sexual response cycle has been damaged in my case). There are people with PSSD who report that they have become asexual because their libido has also been completely erased. But they know that this was not part of themselves.
Drugs can erase both libido and sexual attraction in addition to genital function. In fact, post-SSRI syndrome can have numerous symptoms, including emotional ones, which are mentioned among the diagnostic criteria. The side effects (as well as the therapeutic ones) are extremely subjective and this must be remembered. It cannot be said that everyone who takes one of these drugs will necessarily experience a given side effect.

I don't want to convince anyone of anything and I have no interest in doing so, just wanted to highlight a possible aspect that everyone can reflect on if it might relate to their own case. Even if someone thought this might relate to his or her case, there are currently limits of understanding as to how much was the fault of medication and how much is natural subjectivity (as that testimony also reports). Indeed, there is no known biomarker for Post SSRI Sexual Dysfunction or Post SSRI Asexuality and the diagnostic criteria above are only a first attempt at recognition and discernment.

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quaintrelle

I didn’t have much desire for self-pleasure when I was on antidepressants but it came back with a vengeance after withdrawal and it was quite exhausting to “take care” of myself multiple times a day lol. I’m still ace though because sexual orientation isn’t affected my by meds.

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Major West
4 hours ago, anacleta said:

These sexual dysfunctions affect the majority of people taking these serotonergic drugs. Here the results of the various studies vary greatly, but we approximate by saying over 50%.

It's so funny (in a sad way) - because sexual function, orgasm etc, are a vital component of happiness for the vast majority of sexual people. Stripping all that from an already depressed sexual person... can only make them more depressed. You've just taken one more good thing away from them.

 

Hence one of the many reasons why so many people who take those awful meds say not only did they not make them better, they made them worse.

 

For a while there, people were lining up for lobotomies. Doctors were recommending them. Everyone heard about the side effects but they were like, "well I also heard it works great for some people" so went ahead anyway. MOST people only experienced negative side effects, but everyone kept repeating that only some people experience them and the benefits outweigh the risk etc. Which was not true as we now know.

 

SSRIs and the damage they do, but the way people still defend them and doctors hand them out like candy, reminds me of that.

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Janus the Fox

I've never really experienced a difference in libido or arousal with Depression, its treatment of it and the lifting of symptoms.  None before illness or during, none during treatment, none after the symptoms lifted.  I've been on a SSRI an a Mood Stabiliser now.  No real changes for me.  But I know there are possible alternatives if the Libido and sexual desire is extremely important.

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PSSDVictim
7 hours ago, RoseGoesToYale said:

Medications can possibly affect libido and genital function, but not sexual attraction. There is no medication that can turn you asexual any more than any medication can turn you gay, pan, etc. A person can still experience sexual attraction or desire for sexual contact with another person despite the plumbing not doing what the person wants (which is why a market for Viagra exists). A person who is asexual won't magically experience sexual attraction by going off their medication.

 

It should also be noted that severe depression and anxiety can negatively affect libido, but not a person's sexuality.

You're wrong and not sure why you're gas lighting other peoples experience with SSRI/SNRI drugs and PSSD.  Unless you have PSSD you have no idea what your talking about.  PSSD isnt as simple as the plumbing not working so just take viagra.  These meds shut down or turn off a persons desire for intimacy, attraction, and sex.  Before I learned what PSSD was I thought these drugs turned me asexual. 

 

Yes depression can negatively effect libido,  but this is different it shuts something down inside people.  

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RoseGoesToYale
5 minutes ago, PSSDVictim said:

You're wrong and not sure why you're gas lighting other peoples experience with SSRI/SNRI drugs and PSSD.

Where in my post did I gaslight anyone? Asexuality and PSSD are two different things. An asexual person can experience PSSD, but PSSD can be experienced by a person of any sexual orientation. That's literally all I explained.

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Personally, if a person can't see themselves as being able to feel sexual attraction again, as far as I'm concerned, they could call themselves as asexual. Especially if said person has decades left to live, and don't expect it to ever return under any circumstances. Functionally, for all intents and purposes, they are one and the same as those who always been that way.

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22 hours ago, anacleta said:

Thank you for your answers.

 

I personally have been suffering from Post SSRI Sexual Dysfunction in a rather severe form for 8 years and I am among those who suffer from the loss of the sexuality that had grown up with me. I do not consider myself asexual and I still have some of my libido (everything else in the sexual response cycle has been damaged in my case). There are people with PSSD who report that they have become asexual because their libido has also been completely erased. But they know that this was not part of themselves.
Drugs can erase both libido and sexual attraction in addition to genital function. In fact, post-SSRI syndrome can have numerous symptoms, including emotional ones, which are mentioned among the diagnostic criteria. The side effects (as well as the therapeutic ones) are extremely subjective and this must be remembered. It cannot be said that everyone who takes one of these drugs will necessarily experience a given side effect.

I don't want to convince anyone of anything and I have no interest in doing so, just wanted to highlight a possible aspect that everyone can reflect on if it might relate to their own case. Even if someone thought this might relate to his or her case, there are currently limits of understanding as to how much was the fault of medication and how much is natural subjectivity (as that testimony also reports). Indeed, there is no known biomarker for Post SSRI Sexual Dysfunction or Post SSRI Asexuality and the diagnostic criteria above are only a first attempt at recognition and discernment.

Ouch, I'm sorry you've had the misfortune of getting this issue too.

 

I got PSSD from SSRIs pretty recently, but in my case, it is clearly unrelated to my partner preference - in fact, I'd identified as ace for an entire decade before getting afflicted with the condition. Before having this conversation and reading this article written by someone who thinks this may apply to them, I would've regarded the two as completely separate from each other, but I guess if there is any upside to this experience, it's the realization that the relationship between asexuality and sexual dysfunctions may be a bit more nuanced than the black and white view I had before, although in my defense, it was formed in response to haters insisting that asexuality itself is a dysfunction, which I still don't think is necessarily true.

 

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Kernel.Panic

I sometimes wonder if my depression treatment somewhat contributed to me leaning towards sex averse instead of sex positive/neutral that I used to identify as before. I don't take SSRI nor SNRI though, but NDRI, which is not connected to any 'sexual side effects', and in some cases it is even supposed to help with problems of this nature.

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anacleta
18 hours ago, Frac said:

Ouch, I'm sorry you've had the misfortune of getting this issue too.

 

I got PSSD from SSRIs pretty recently, but in my case, it is clearly unrelated to my partner preference - in fact, I'd identified as ace for an entire decade before getting afflicted with the condition. Before having this conversation and reading this article written by someone who thinks this may apply to them, I would've regarded the two as completely separate from each other, but I guess if there is any upside to this experience, it's the realization that the relationship between asexuality and sexual dysfunctions may be a bit more nuanced than the black and white view I had before, although in my defense, it was formed in response to haters insisting that asexuality itself is a dysfunction, which I still don't think is necessarily true.

 

Hi, I read the first post of your topic in which you say that in addition to your asexual orientation you had real sexual dysfunctions caused by a drug. It seems to me that you have not mentioned which drug or its type and if so I am surprised and wonder why.
I haven't read everything because I don't speak English and long English texts weigh me down even with an automatic translator, but I have read reflections on asexuality haters. I think a lot of things cannot be proven with science at the moment, but I understand the annoyance of feeling judged and being alluded to by others. I'll give you an example: those who explain their case of PSSD often receive in reply that "sexual dysfunctions are very common in those who suffer from those problems for which SSRI and SNRI drugs are prescribed"... What? If I have just told you that I was functioning perfectly well sexually before the medication, you come and say that? Is your brain asleep or do you not accept/want to deny what I say is happened to me?
It takes patience to explain one's own vicissitudes and unfortunately it can be taken for granted that someone will not even understand what is clear to us and will dare to give explanations with unfounded conviction. Clarity on issues such as PSSD or sexual orientation will perhaps be made a little at a time, by talking, comparing, and through scientific research. If it makes sense to do so. For PSSD there should be as people suffer terribly from it especially in severe forms that have a traumatic effect.

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I understand why a lot of a-specs are adverse to the concept of PSSD "turning" people a-/nonsexual, but I think many people in general underestimate how libido and genital-function is linked to sexuality and attraction itself. Yes, you can be alloromantic and a-spec, and many people consider themselves to be libidinal and lack sexual attraction to people at the same time, but sexual attraction is normally described as being aroused by and desiring sexual interaction with another person (correct me if this is somehow inaccurate), and having the physical capability of that taken away complicates attraction further (EDIT: Viagra and Cialis is also not guaranteed to work for AMABs with PSSD, and if you're AFAB you are out of luck if you want some kind of go-to pill for genital-function, since the controversial Addyi works in the brain and has risky side effects). Going by this definition of sexual attraction, I cannot feel it now, due to PSSD. Before I found out that SSRIs can impact sexual functioning (low libido and rare feelings of attraction can be a symptom of depression, but I've known a lot of high-libido clinically depressed people personally), I thought I might've been a-spec, but that prospect was uncomfortable to me, you can write that off as possible internalized aphobia but it felt frustrating to say, "I struggle with this" and the only response is to be introduced to a new label that masks the problem as opposed to providing comfort, or told there's nothing I can do about it. In the PSSD community there were people who were put on SSRIs at a young age and therefore never experienced a typical sexuality development and have resigned themselves to a form of acquired a-spec-ness. Outside of those circles, in real life, I had a friend who was on SSRIs the same time as me when we were teenagers, although they comfortably consider themselves demi-pansexual and don't appear to have any distress over it. That doesn't make my feelings, or the friend's less "valid" but it's frustrating to be told repeatedly from various people there's no correlation. Saying that this influenced me and might be a factor for *some* people doesn't mean everyone is.

 

On 1/6/2022 at 3:24 PM, PanFicto. said:

It's so funny (in a sad way) - because sexual function, orgasm etc, are a vital component of happiness for the vast majority of sexual people. Stripping all that from an already depressed sexual person... can only make them more depressed. You've just taken one more good thing away from them.

 

Hence one of the many reasons why so many people who take those awful meds say not only did they not make them better, they made them worse.

I didn't realize that my sexuality struggles and trauma that impacted it were the psychological root of my clinical depression until PSSD. Now psychiatrists have no idea what to do with me when I report feeling depressed and/or suicidal, and the alleged "pro-sexual" medications like Wellbutrin had no affect on me, because the mainline treatment contributed to it.

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Major West
8 hours ago, Chry said:

I didn't realize that my sexuality struggles and trauma that impacted it were the psychological root of my clinical depression until PSSD. Now psychiatrists have no idea what to do with me when I report feeling depressed and/or suicidal, and the alleged "pro-sexual" medications like Wellbutrin had no affect on me, because the mainline treatment contributed to it.

Sadly I've seen this way too many times. Doctors seem to not care that some of the sexual side effects can be permanent and cannot be fixed by other medication. They're like "well if the person isn't depressed anymore then it doesn't matter if they lose their sexual arousal/ability to orgasm/desire" - But for most sexual people, if given the choice: you can have ten million dollars right now but lose all sexual function, or you can keep sexual function but not get ten million dollars - the vast majority would choose to keep their sexual function, because no matter how great their life is not having sexual function will be a sense of sadness and emptiness they can never escape. I don't understand how or why doctors cannot acknowledge this, or why they don't at least explain to patients before prescribing them the meds. 

 

8 hours ago, Chry said:

but I think many people in general underestimate how libido and genital-function is linked to sexuality and attraction itself.

 

And yes I agree with you that arousal etc is greatly tied up in sexual attraction/sexuality. I can still find people attractive and even experience a level of desire for them when not aroused, BUT I have no desire to actually connect sexually with someone (no matter how attractive I find them or even how in love with them I am) if I am not aroused.

This is part of the reason sexual relationships are almost (maybe totally?) impossible for me - I have arousal issues. It's that simple. I'm unable to be drawn to actually have sexual activity without arousal... and sometimes I can go for months and months without becoming aroused. Nothing can "make" me aroused, I can't be stimulated to arousal, I'm just "dead down there". Other times (a lot more rarely) I might become aroused two or three times a day (it's hormonal or something) and when that happens I'm capable of desiring sexual intimacy but again the arousal can't be forced, it just happens or it doesn't. 

So the ability to experience arousal really is tied integrally into my ability to desire sexual intimacy. Without that, I'm effectively asexual in having no desire to connect sexually with anyone regardless of whether I find them attractive or not.

 

But yeah despite all that, on some level, (for me anyway) as a sexual person, that "want" is still there - your body just can't follow through with that want and that leads to a sense of emptiness and sadness. You can "force" yourself to have sex, but you get no joy or pleasure from it so it's pointless for both you and the person you have it with.

 

Then eventually it all just fades away and you're left with nothing.

 

Yet somehow doctors still think someone who experiences this can be happy "as long as their depression is gone" - how can the depression freaking be gone when someone is experiencing that??

 

Also, sorry you have had to go through this :c

 

 

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On 1/8/2022 at 5:13 PM, PanFicto. said:

Sadly I've seen this way too many times. Doctors seem to not care that some of the sexual side effects can be permanent and cannot be fixed by other medication. They're like "well if the person isn't depressed anymore then it doesn't matter if they lose their sexual arousal/ability to orgasm/desire" - But for most sexual people, if given the choice: you can have ten million dollars right now but lose all sexual function, or you can keep sexual function but not get ten million dollars - the vast majority would choose to keep their sexual function, because no matter how great their life is not having sexual function will be a sense of sadness and emptiness they can never escape. I don't understand how or why doctors cannot acknowledge this, or why they don't at least explain to patients before prescribing them the meds.

The craziest thing is that I've spoken to psychiatrists who believed me and sympathized, but all they could say is "I'm so sorry, but I can't help you. Maybe give Wellbutrin another chance? Another SSRI?", which ended with me leaving the office entirely. When I told the one I was seeing that I had PSSD and I was suicidal now, I was shrugged off as something that just happens. Duh, I know they cause libido and orgasm issues, I lived with that my whole life. But genital issues? I didn't know that was possible. But I guess that's my fault, I guess. I can understand not being informed as a kid, but not when I was an adult? I figured they would go away after it's out of my system (it didn't).

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songchick

I've been on medication since age 14, I'm 36 now. During the 1 time I went off all my meds cold turkey, I had hooked up with someone and had a physical response more than before when on meds. But this still didn't "blow my world" or "make me happy." I still felt indifferent about the experience, and being more sexually sensitive didn't make me more excited about sex, or make me crave it more than I normally do. In terms of side effects (if there are any), I actually welcome them, because it helps me focus on other things that are important to me instead. Recently, I had a series of acupuncture treatments, and I feel that it made my libido more present. I then mustered up the motivation to go on a date with someone off of Hinge, which was pleasant although I am not interested in taking it further. I had some thoughts of craving, yet while having them I also felt a tremendous emptiness. People seem to want sex yet it is an empty experience for me, and I feel inclined towards celibacy as a spiritual practice, aside from not being terribly aroused. I think it's a blessing, I am not getting frequent acupuncture atm because it's fairly expensive anyway.

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  • 2 weeks later...
1 hour ago, Wi1son said:

 

Hi, I just wanted to say that this isn't true. Medication can affect sexual attraction. There are also rare cases of certain drugs "making people gay" by altering their sexual desires. You are free to doubt the experiences of those that claim this if you want, but why speak with such conviction about something that is not understood?  We simply don't know how sexual attraction works in the brain and really have no idea of the effects of some drugs on it.

I think I read of a tetracylic antidepressant making one individual go from homosexual to heterosexual (or the other way around), but it was an individual case I think? A part of me is skeptical but also would love to know more, I wish an interview with this person was done or if things "went back" if they ever stopped taking it. I know this has happened to some (but not all) transgender people who were on HRT but had to stop for one reason or another. Which may bring me to my next point;

 

This will probably be considered a controversial opinion in this space (I know some opinions from reading this site's FAQ but obviously I don't know every single person's opinion about sexuality), but I think that label-usage and interpretation of feelings are fluid, but the actual feelings attached to one's sexual/romantic orientation is innate; but at the same time, a-spec and aro-spec can be orientations by itself or modifiers to one's sexuality ("demi pan", "gay aromantic", "bi-asexual", etc.) and it's possible for the latter to be acquired through various means. I've seen people become functionally a-spec (and the opposite) from trauma and never recovered even with therapy, so I would also consider severe PSSD (no libido, nonfunctioning genitals, no romantic attraction, which I went through) to a form of acquired aromantic asexuality (with no grey area), but mild PSSD (lowered libido, rare feelings of attraction, situational anorgasmia) could technically be a form of acquired demisexuality (like my pansexual real life friend) since some individuals with mild PSSD still only care for their partners. Recovery can be a matter of fluidity, in my opinion, but not always.

 

I actually initially made this account when my PSSD was as it's most severe and I was strongly aromantic and sexually anhedonic (I have only recovered from the former, I'm incapable of sexual attraction in the form of "being aroused by and wanting sexual interaction" - not sure if there's a description of sexual attraction that doesn't rely on genital-functioning, so who knows if I do experience it), but reading the forum made me uncomfortable and feel a bit invalid because it reminded me that a-spec doesn't inherently mean "physically cannot enjoy sex", and the fact that most a-specs I knew had a higher libido or even more experience than me, so I realized this likely isn't the space for me (however PSSD spaces are very uncomfortable for me too, so I left those). I just logged back in because I saw a link to this thread, and thought that maybe my opinion as someone who has struggled with sexuality confusion my whole life (which led to "flirting" with the concept of some a-spec labels because people introduced the concept to me), that became even worse due to PSSD, might be interesting or insightful for some people. I don't think @anacleta had bad intentions with this, but what "asexual" means among the a-spec community varies by individual and is the opposite of what the wider society thinks it does ("celibate", basically), so you may have come to the wrong place to talk about PSSD, unless you want to reach out to people with PSSD who join here because they have decided to use a-spec labels for comfort.

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RoseGoesToYale
41 minutes ago, Wi1son said:

There are also rare cases of certain drugs "making people gay" by altering their sexual desires.

Do you have any peer-reviewed scientific research to support this claim?

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(Below is an official, green, mod message.)

 

Hi, everyone. I know: no one likes a locked thread. However, I'm going to have to lock this, pending Admod review.

 

Thank you, for your understanding and patience.

 

LeChat,

Welcome Lounge moderator

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