“I don’t have much positive to say about motor neurone disease. But it taught me not to pity myself because others were worse off, and to get on with what I could still do.”

– Stephen Hawking

In short, the prevailing theory on SERT in PSSD connects well with the 5-HT1A autoreceptor desensitization theory that became prevalent in the last few years.

Because decreases in SERT density have been well documented in SSRI treatment, it seems plausible that these changes persist after cessation of medication.

Lasting decreases in SERT density could explain 5-HT1A autoreceptor desensitization that persists beyond stopping SSRIs. If clearance of 5-HT is hindered by lowered SERT levels, increased synaptic 5-HT could keep 5-HT1A autoreceptors desensitized indefinitely. Could SERT be the elusive link between SSRI-induced hormonal changes and 5-HT1A autoreceptor desensitization?

SERT density changes during SSRI treatment are outlined in the following video: