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Comment by throwaway__123 | Hacker News Reader

Zoloft

I am afraid of sounding like a shill, but the fact is I'm 30 engineer, who has been trying to feel better my whole life through experiments with: ketamine, CBD, various nutrients, various dietary changes, exercise, being more social, meditation. None of them made lasting improvement like sertraline has, I wish I had been open-minded enough to try it years ago.

In retrospect, maybe it was ridiculous to try to find happiness with all methods other than the ones there are best medical evidence for... I guess I was afraid that somehow I'd be conceding there was something "wrong" with me (which is wonk). I was wondering why nobody had ever mentioned this before, and I realized people who use prescription medications are probably afraid to admit it. So I'm just putting out my sincere recommendation out there, as I wish somehow had done for me.

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I'd like to offer a story of caution, and I do so with some hesitation because it sounds like it's been good for you so far. A friend of mine lost his life after committing suicide a month after starting Zoloft. His last messages to me were a discussion of what serotonin syndrome was like. He was excited and curious as always, which after reading online is common. I know I shouldn't blame the drug since he was depressed before... but it sucks to lose someone when it seems like their life was on the upward climb. Anyways, stay safe and be careful.

This is a well documented reaction to the beginning of treatment for depression. Essentially the reason is that before they started treatment, they had no motivation to do anything. After they start the treatment, but before they've waited long enough to realize the benefits, they have enough motivation to end their lives.

> Essentially the reason is that before they started treatment, they had no motivation to do anything. After they start the treatment, but before they've waited long enough to realize the benefits, they have enough motivation to end their lives.

Which is why in the UK they've experimented with giving patients MDMA for an instant seratonin rush needed to curb depressive symptoms until the antidepressants kick in.

Wow. That sounds like a sick joke.

I'll offer this tidbit.

I started taking Prozac and not long after I got on it, things started to seem a little better. I recall, one day, actually having the thought, Hey, maybe suicide isn't such a bad idea after all. Consider the fact that still having a good bit of depression yet feeling relief from anxiety actually made suicide seem like a viable option. I still get chills when I think about it.

SSRIs aren't for everyone, that's for sure.

The problem with SSRIs is that they can have wildly different effects on different people. Compounding that issue is clinicians misdiagnosing patients quite frequently because it's all subjective. You take a few questionnaires and they score them and say "this number means you're mildly/moderately/severely depressed."

In my case, as with many others with bipolar, Zoloft sent me into a hypomanic episode where I didn't sleep for 3 days and was severely agitated. I had never been diagnosed with bipolar in the ~15 years I had been in treatment. A change in my medication resulted in serious complications.

Recommending specific medications without experience is dangerous. Even doctors with years of experience can't get it right. It turns out for me SSRIs are a poor choice. I was prescribed lamotrigine and it changed my life. I no longer feel depressed for months at time, I sleep well, my libido is normal and I can ejaculate whenever I want.

True that, lamotrigine has been life changing as well, it took the edge off the depressive features. I initially dismissed lithium, but with long-term use, it has reduced episodes, agitation, with mild emotional blunting that I have learned to deal with. I've had to cycle off lamotrigine three times so far due to poopout, they call the protocol a washout, and it gets reintroduced at a starting dose until it is effective again, with a typical dose around 100 mg after washout.

How you deal with Zoloft killing your libido?

It came back in about 6 weeks for me. Never had any issues after that.

I'd be careful recommending any specific anti-depressant. The overall advice to seek a doctor about depression is solid though, as the right medication can literally be life saving. The thing with anti-depressants is you kind of need to experiment at first to find the one that works best for your body and mind. There are some types that will either not work at all, or even make you feel significantly worse - this doesn't mean it's not still the right avenue to pursue, you just need to find the medication that's effective for you. There's really no transient high that is going to change your overall mood and pull you out of depression. It's a topical cure for a systemic issue, but it sure can be fun.

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