tcj_phx · HackerTrans

"Institutional inertia" is a great term, thanks.

> I've tried 19 antidepressants over about 15 years. Stuck with mirtazapene [...]

Have you tried any anti-serotonin interventions? (chatbot in comment link below)

Mirtazapene is a "tetracyclic antidepressant". I think the development of antidepressants went MAOI -> Tricyclic -> tetracyclic -> SSRI. My chatbot transcript said the SSRI's are marginal drugs, but "SSRIs are much safer in overdose" than the earlier drugs.

My understanding is that the MAOIs were reasonably-effective at bringing people out of an acute depression, but they interacted with high-tyramine foods (fine cheese, etc) to cause high blood pressure. Reversible MAOIs are less problematic than the non-reversible ones. Methylene Blue [MB] is the most ubiquitous of the reversible MAOIs. I felt a definite warming effect with my first MB microdose (a fraction of a milligram), but I've never noticed anything from larger doses.

My comments on this thread might be helpful: https://news.ycombinator.com/item?id=46000812

tcj_phx

8 ay öncediscuss

The SSRI's have always been terrible drugs. Apparently the trials before their approval found increased suicidality. Another response to this thread shared how his/her mother was given a "murderous impulse" with Prozac in 1989 [0].

Because this class of drugs was so heavily promoted for such a long time, the side effects have always been swept under the rug.

My comment above proposed that the 11yo girl's depression could actually be caused by precocious puberty. Another possibility is that she's a poor methylator (#MTHFR) who's poisoned by fortified flour and other sources of shelf-stable provitamins.

I haven't yet found a comprehensive SSRI-truth resource that makes SSRI advocates pause their advocacy, so I just shared the chatbot link. This was supposed to provide the father enough of the background terms and anti-SSRI thinking for him to search for his own resources.

Someone else posted a link to "The serotonin theory of depression: a systematic umbrella review of the evidence" [2022] at Nature [1]. This is okay, but it still dances around the core issue: whether ECT and Serotonin-enhancers sometimes benefit people because of how the brain responds to brain damage.

[0] https://news.ycombinator.com/item?id=46002561

[1] https://news.ycombinator.com/item?id=46008211

tcj_phx

8 ay öncediscuss

Thanks for sharing your mom's experience with big pharma's then-new wonder-drug.

> Somehow, I doubt there is much motivation to look for economically inconvenient and unnerving side-effects in some demographics,

Robert Whitaker examined the pharmaceutical industry's ideological capture of conventional psychiatry in his third book, Psychiatry Under the Influence.

https://robertwhitakerbooks.com/psychiatry-under-the-influen...

I've written for the Mad in America Foundation's webzine. My latest piece was titled Theodoric of Arizona: State-Sanctioned Pharma-Based Pseudo-Doctor: https://www.madinamerica.com/2024/07/theodoric-arizona/

This was inspired by the old SNL skit, Theodoric of York, Medieval Barber. The article is structured around my proposal of a Theodoric’s Principle of Medical Advancement, to explain why medical progress is so glacial.

tcj_phx

8 ay öncediscuss

> > SSRIs never help because of boosting serotonin.

> That's a hell of a claim, which could use some evidence.

My experience with the chatbots is that they start with the conventional marketing tropes, but if you ask pointed questions they'll dig into the actual research.

This thread started with a generic question about why ECT seemed to help some patients. It had a really good reasoning about why SSRIs are still the first-line treatment for depression, even though the MAOIs were much better drugs.

https://chatgpt.com/share/69207aa3-26a0-8005-8dda-8199da153f...

  The Big Picture

  SSRIs flood serotonin globally, which can suppress 
  dopamine/norepinephrine and blunt mood.
  
  Anti-serotonin strategies (receptor-specific antagonism, 
  reuptake enhancement, or targeted modulation) often 
  result in cleaner antidepressant effects with fewer 
  side effects.
  
  This supports the criticism you mentioned: SSRIs may 
  “work” only because the brain adapts to the serotonin 
  disruption, whereas directly reducing or modulating 
  serotonin is more therapeutic.

The whole 'conversation' is pretty good, and would provide plenty of search terms for helping you figure out what science has actually figured out about depression.

A simple pregnenolone supplement can sometimes be magical, because of the steroidogenesis cascade: https://en.wikipedia.org/wiki/Steroid#/media/File:Steroidoge...

There's a supplement seller that said his pregnenolone powder was made with a newer, cleaner process than is used by most of the pregnenolone supplement vendors, but I don't know if he's still using that supplier. The powders are a much better value than the capsules.

hth.

tcj_phx

8 ay öncediscuss

[flagged]

tcj_phx

10 ay öncediscuss

In 2022 psychiatrist Chris Palmer MD [0] published Brain Energy [1], which shares his discovery of the 70+ years of science establishing that the behavioral/mental symptoms traditionally given 'psychiatric' labels are caused by metabolic problems. When you fix the body's metabolism the symptoms go away.

Dr. Palmer recommends the ketogenic diet, but not all people need this specific intervention to improve their metabolism. I think the best place to start for most people is simply eliminating their consumption of white flour, or at the least, fortified white flour [2].

Dr. Palmer tweeted about anemia and Vitamin B-12 deficiency [3]. Many patients are prescribed synthroid (T4) for their thyroid, but they often still have all the symptoms of hypothyrodism because their body doesn't activate T4 -> T3. Adding a source of T3 to patients' Synthroid treatment can make a big difference in their behavioral symptoms.

I have a book by some psychiatrists who were active in the 1940's -> 1950's, which is before the first 'psychiatric' medications were released. I didn't know this book was compiled by psychiatrists when I ordered it - I thought it was going to be a general book about the pro-metabolic intervention.

It's unfortunate that the prescription drug industry never figured out why some of their chemicals help with the symptoms labeled 'depression'. The MAOIs were reasonably-effective at helping acutely-depressed people out of bed. Each generation of antidepressants was less effective than the previous, until the SSRI's arrived. Now we're stuck with antidepressants that have always been known to cause people to commit suicide. At least the psychiatrists are now revisiting MAOIs as an option for people who don't respond well to the suicide pills (SSRIs).

Antipsychotics are a tragedy: anti-dopamine drugs make patients feel terrible. The one exception to the anti-treatment received by psychotics is an anti-serotonin drug approved for parkinsons psychosis [4].

[0] https://www.chrispalmermd.com/ https://twitter.com/ChrisPalmerMD/

[1] https://brainenergy.com/

[2] Flour manufacturers tend to use the cheapest fortifications possible. For example, the type of iron used for fortification is usually simply 'iron shavings', which usually becomes rust by the time it's absorbed.

[3] https://twitter.com/ChrisPalmerMD/status/1903071654328111413

[4] https://pmc.ncbi.nlm.nih.gov/articles/PMC5819716/