new | show | ask | jobs Github

lemming 21 hours ago

Do you have a plan to get her off, or is she on the maintenance drug for life?

It's too early to say. Obviously the idea is to get her off it if possible.

SSRIs never help because of boosting serotonin.

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

▲ blast 7 hours ago | parent | next [-]

https://www.nature.com/articles/s41380-022-01661-0

▲ jacobgkau 5 hours ago | parent | prev | next [-]

> It's too early to say. Obviously the idea is to get her off it if possible.

You understand that the people who sold you that drug have a vested interest in making sure it's not possible and/or that you & she think it's not possible, right?

▲

amanaplanacanal 4 hours ago | parent [-]

You think the pediatrician is getting a kickback for prescribing it?

▲

mrguyorama 4 hours ago | parent [-]

I'm big on medications for brain stuff but uh yes, in the US, doctors get lots of kickbacks for prescribing drugs.

Usually this takes the form of "I'm prescribing you with <Brand> instead of generic" or "I'm prescribing you this specific drug from this class of drug"

https://openpaymentsdata.cms.gov/

	▲	dragonwriter 30 minutes ago \| parent \| next [-]
		> doctors get lots of kickbacks for prescribing drugs. From your own source: "In 2024: $172 or more in general payments have been received by half of physicians." Even if all of those payments count as kickbacks, a median of $172 in a year (significantly less than 0.1% of the median physician's annual pay) is not "a lot of kickbacks".
	▲	ksenzee 35 minutes ago \| parent \| prev [-]
		Okay, but nobody is paying doctors to prescribe medications like sertraline and fluoxetine that have been generic for years and are cheap as dirt.

▲ tcj_phx 11 hours ago | parent | prev [-]

> > 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.

	▲	flatline 6 hours ago \| parent [-]
		The chatbot is great as a first-line of research for many things, but something like this needs to be backed up by actual research to make a concrete claim. It will absolutely fabricate falsehoods or misrepresent truths based on an unknown number of stochastic factors behind any response. Shame on your for propagating a bunch of mumbo-jumbo that every reader must go verify for themselves if they want to substantiate or refute your claim - in response to a request for substantiation!