Poorpush maxxing (Hepatic Encephalopathy and it’s commonalities with PFS/PSSD)
Hi Dr P, this write up is from Discord user @jungledude2004 (he doesn’t have Reddit anymore as doesn’t want to ruminate, so I am posting on his behalf).
He believes these findings will be helpful.
(He wanted me to note that he didn’t use AI. He originally wanted to format it with AI, but ExcellentPush said you would rather him write it up naturally and leave it as is).
As always, appreciate the work and focus you give to our community. You have given so many of us hope.
“Dearest William,
I found this fuckass condition on the internet and it’s really similar to what PFS/PSSD people deal with.
One of the most harrowing symptoms of post-drug syndromes is the sheer mental torture many individuals face, such as: anhedonia, low motivation, and a lack of thrill, to name just a few. While these symptoms can cause huge changes to someone's lifestyle, they need not be permanent.
An interesting aspect of PFS/PSSD is how much it shares in common with another condition: Hepatic Encephalopathy (HE). HE is characterized by the liver's inability to get rid excess of neurotoxic substances accumulating in the brain, with symptoms including mood disturbances, anhedonia, and tremors.¹ This overlaps closely with what's reported in PFS/PSSD. Excess GABA-A activity has been linked to the cognitive impairment and sedation seen in HE patients.²
Neurosteroid changes appear to drive this effect. In one study, brain levels of pregnenolone, allopregnanolone, and THDOC were elevated 2.6-fold, 1.7-fold, and 4.7-fold, respectively, in a rat model of HE — concentrations high enough to meaningfully enhance GABA-A receptor activity.³ Similarly, allopregnanolone and THDOC levels in mice with toxic liver injury induced HE produced sedation and elevated allopregnanolone has also been found in autopsied brain tissue of cirrhotic HE patients. THis has lead researchers to propose that the increased GABAergic tone seen in HE stems from these elevated neurosteroid levels.²
One of the key boogeymen in Dr Powers Theory is THDOC. Potential treatments for this kind of neurosteroid buildup include NSAIDs such as indomethacin.³⁻⁵
References
Mayo Clinic Staff. "Hepatic Encephalopathy." Mayo Clinic, 31 May 2025, mayoclinic.org/diseases-conditions/hepatic-encephalopathy/symptoms-causes/syc-20583828. Accessed 18 Aug. 2026.
Ahboucha, Samir, Gilles Pomier-Layrargues, and Roger F. Butterworth. "Increased Brain Concentrations of Endogenous (Non-Benzodiazepine) GABA-A Receptor Ligands in Human Hepatic Encephalopathy." Metabolic Brain Disease, vol. 19, nos. 3–4, 2004, pp. 241–251.
Ahboucha, Samir, et al. "Increased Brain Levels of Endogenous Neurosteroids in a Rat Model of Hepatic Encephalopathy." Neurochemistry International, vol. 52, no. 4–5, 2008, pp. 605–612. PubMed.
Butterworth, Roger F. "Neurosteroids in Hepatic Encephalopathy: Novel Insights and New Therapeutic Opportunities." The Journal of Steroid Biochemistry and Molecular Biology, vol. 160, 2016, pp. 94–97. https://doi.org/10.1016/j.jsbmb.2015.11.006.
Ahboucha, Samir, et al. "Neurosteroids and Hepatic Encephalopathy: An Update on Possible Pathophysiologic Mechanisms." Current Molecular Pharmacology, vol. 1, no. 2, 2008, pp. 127–135.”