This has been known for more than a decade (this study is just a review of existing research), and is not directly related to the efficacy of SSRIs (although the serotonin “theory” might have led to their adoption, idk).
For a while now, as I understand it, the view has been that SSRIs cause the downregulation (decreased new production of) serotonin receptors in reaction to the excess serotonin buildup they cause in the synapses (this is why they take a few weeks to kick in, despite increasing serotonin levels almost immediately, and is also why they will desensitive you to psychedelics like LSD, which act primarily on serotonin receptors). They decrease overall serotonin signalling, which in turn has downstream effects that alter certain activites of certain regions of the brain that are implicated in depression. (This is based mostly on discussions I had with my psychiatrist a few months ago, so if there are any actual experts here, correct me if I’m wrong.)
That being said, SSRIs suck ass, their side effects are awful, and I think it’s medical malpractice to make them a first-line treatment tbh. It’s really mind-boggling that they’re the go-to given how much shit they fuck up.
That being said, SSRIs suck ass, their side effects are awful, and I think it’s medical malpractice to make them a first-line treatment tbh
I love reading about their effects on libido including doctors “joking” to women about how they won’t need birth control anymore (due to lack of desire for sex) and such side effects can last years after discontinuation very cool definitely not fucked up
Yeah the “chemical imbalance” theory of mental health was literally made up by an advertising agency.
They thought, correctly I imagine, that people would be more likely to take medicine for it if they had a simple theory like that
Oh weird! could it be that rates of depression are higher in more fucked up societies and among more oppressed groups within those fucked up societies? and that it’s not just brain chemicals but also the social environment that causes depression/anxiety/etc that are rampant in the USA?!? And that allowing tons of chemicals in our food/water/air/etc might contribute to it too? But that no one wants to talk about those causes because the solution is social and policy change and not medical?
DUHHHHH.
Capitalism is the cause.
Communism is the cure.
Simple as.
I had it bad, like almost 0 functioning ability, and nothing worked before ketamine. So personally checks out.
I read one reason ssris could still work for some people is because for one they are actually pretty good at reducing anxiety symptoms, but also just because serotonin deficiency isn’t the cause of depression doesn’t mean that increasing serotonin can’t improve your mood at all.
Hey! Would be curious about your experience with ketamine. My partner is looking to get treatment. Personally I’ve done tons of mushrooms , a little LSD, but never ketamine. Shes used mushrooms once and it was really difficult but ultimately healing (her words). She’s resistant to trying SSRIs entirely (i support this 100%) and is looking for alternatives to approaches that medicalize/pathologize trauma.
To start I have to say it can be pretty expensive. I’m in the US and insurance won’t cover it, they can’t get IV ketamine “approved” for depression because there’s no money to be made off the drug itself because of how old it is. It’s one of the cheapest drugs to make so the money is just for the people watching you sit there I guess. There’s nasal spray “esketamine” which my doctors don’t recommend bc with IV its easier to control the dose, that got approved because it has a patent, so it’s technically possible to get that covered but in my experience providers of that also choose to not take insurance.
I’m sure you could find a doctor with any kind of opinion but mostly they don’t use it as a first line of treatment because of how involved it is. So I’m not sure if someone who hasn’t been on any antidepressants before would have good chances getting it prescribed. A couple years ago I read a lot of things where they were recommending it to treatment resistant patients mostly, which is 3+ meds unsuccessful. Also most doctors will want you to be on another antidepressant aside from the ketamine. I stopped taking mine without mentioning it because it wasn’t doing anything. lol
As for the actual treatment. It takes like an hour and they give you a little bit every 10 minutes or so and then just let you sit until you’re good to leave. It’s an anesthetic so she should have someone go with her because she’ll probably be disoriented for a little bit. The half life is very short though so any side effects should be gone within a couple hours. I’ve seen people online talk about it like being high or about “k holes” or w/e but I think they’re being dramatic. When I get it I feel a little out of it, kinda physically numb, and the room does look a bit strange as if the distance between everything and/or size of objects has been altered slightly, but nothing too serious. You mentioned she has trauma. If she has any significant amount of dissociative symptoms from that then her brain probably hits her with way more heavy experiences than the small amount of ketamine would, at least that’s how it is for me. I usually text or read things online the whole time idk.
Symptom relief is pretty immediate. Your mood improves within a few hours usually. For people currently in an episode getting treatment for the first time they get a bunch of treatments every few days for a couple weeks. It’s not always long lasting, some studies say there’s a drop off after like 2 weeks no treatment. But most doctors that do it say people can usually start spreading out appointments much longer than that. I get a headache afterwards until I sleep it off so usually I notice the difference in symptoms from when I wake up from that. lol Since I started it I can kinda enjoy things again whereas before treatment I had stopped bothering to even try playing video games anymore, and those things are designed to keep your constant attention with little dopamine hits. I can hold a job now, even if it’s not always easy (I do have other physical and mental health issues so I can’t say how much is lingering depression). I even can focus enough to read sometimes. No suicide attempts since, almost no self harm and if it was it from ptsd so it had a clear trigger. I remember to eat more often and take care of hygiene. I socialize more. Pretty much everything is much better, not perfect of course but yeah.
I think that about covers what I can say without being prompted by more specific questions. lol
There is still benefit for many people who take SSRIs and other antidepressants/antianxiety. I have found sertraline to be pretty helpful, personally. That said, this review is consistent with the notion that depression is not simply a serotonin deficiency. I’ve seen some arguments that neurotransmitter reuptake inhibitors work for more complicated chemical reasons because of the way that serotonin and other neurotransmitters interact with each other. I’ve also heard the argument that while SSRIs are good, it’s no better than a true active placebo that mimics the side effects of an SSRI. I’m certainly not a medical expert, but I’d caution against telling people that a medicine someone is taking is actually doing nothing. It’s not uh…it’s not really what you want to hear someone else put on you, especially for political reasons. Much better I think to simply acknowledge that the drugs can help some people’s symptoms, and then pivot into the myriad social material causes of depression and anxiety, namely being human in an inhuman capitalist hellscape.
IIRC, antidepressants work better for worse conditions, while barely helping mild depressions.
idk how i feel about medical doctors on reddit dot com
they are supposedly verified
but they’re also reddit users
