Comment by tcj_phx | Hacker News Reader

Comment by tcj_phx | Hacker News Reader

SSRI drugs (sold as 'anti-depressants') have always been known to cause suicide ideation... While they do seem to help some people, it is now known that this is because of the drugs' effects on the neurosteroids [1], NOT because of 'increased serotonin'. Anti-serotonin drugs (LSD, various MAOIs, etc) are much more effective anti-depressants.

[1] https://en.wikipedia.org/wiki/Neuroactive_steroid#Role_in_an...

There are some good articles in the Boston Globe's archives about Prozac, circa 2000. "Prozac, Revisited", etc [2]. Robert Whitaker [3] worked for the Boston Globe, before he wrote Mad in America and Anatomy of an Epidemic.

[2] http://www.narpa.org/prozac.revisited.htm (the boston globe's official archives site is not so easy to use, but I've previously verified that these stories exist)

[3] https://www.madinamerica.com/robert-whitaker-new/

The first patient in this BBC article could also have been diagnosed as 'exhausted':

> She had begun taking [SSRIs] while caring for her seriously ill mother and studying for her final exams at Cambridge University, but suffered severe side-effects after her GP prescribed a stronger dose of tablet. (emphasis added)

I think 'exhaustion' is a frequent cause behind the symptoms labeled "depression".

In May of this year, I watched Lexapro (an SSRI) destroy all the progress I'd made with my girlfriend... She'd asked for this drug a month after she'd escaped from her court-ordered tranquilization, because she thought it had helped her years ago. Really it just helped her relapse on cocaine then. This time it caused rapid heartbeat, and much anxiety. Her last benzodiazepine turned her into an anxious wreck... The psychiatrists got hold of her again, and they're making sure that she will never recover.

About a week ago I went through videos on my phone... and found one of my girlfriend about a week before she was taken to the hospital. The video proves, beyond any doubt, that she is not "persistently" disabled, that the symptoms that originally put her in the hospital were entirely due to quitting her addictions cold-turkey, and not due to 'defective genes' or other pseudo-scientific rationalization for forcing her to use palliative drugs.

If you think that SSRIs don't affect serotonin, you should halt your amateur medical career now. I send my best wishes for you and your girlfriend and I hope she feels better soon, on her terms and not via a formula. However, SSRIs are highly specific to serotonin receptor bindings. LSD is specific to a relatively sparse type of serotonin receptor, and MAOIs will bind with anything in your brain which is why they are so dangerous and require a strict diet to minimize tyrosine.

Honestly, her coke habit is the lede here, not the scare story that might turn other people off to treatments that work for them.

> If you think that SSRIs don't affect serotonin

I didn't say that, I said that "increasing serotonin" is not why these drugs sometimes help people feel better.

> Honestly, her coke habit is the lede here,

Yes. In the long term, cocaine use wrecks the mitochondia, which contributes to exhaustion. The proper therapy in this case is to restore the mitochondria density. Etiology (" a branch of medical science concerned with the causes and origins of diseases") is thrown out the window when a patient is prescribed an SSRI.

> not the scare story that might turn other people off to treatments that work for them.

The BBC story that this submission links is about how SSRI treatments sometimes wreck people's lives. You should read it. My comment was that adverse effects of these defective drugs (SSRIs) have been known from the very beginning, and I said a few words about alternatives that work better.

> I didn't say that, I said that "increasing serotonin" is not why these drugs sometimes help people feel better.

Yes it is. Only some people don't have too little serotonine.

Then, can the lack of serotonin really be the main, or only cause of depression ? If people with sufficient serotonin levels can get depression, then how can we argue that the actual increased seratonin levels is what helps people recover from it ? It seems like a quite strange argument to me.

Because depression, like most psychological diagnoses, is defined as a pile of symptoms, not as a specific illness like the flu. We don't know all the different things that can cause depression.

One of the things that we're reasonably sure can cause depression is decreased levels of serotonin. That doesn't mean there's not other things which cause more-or-less the same set of symptoms.

EDIT: On a note related to your girlfriend... people can appear externally happy while being seriously depressed. From talking to me irl, you'd likely never guess that I self-harm, have no motivation to do anything, and wish I were dead. You can't blame someone for wanting an escape from that.

Do you have a citation for your claims? Specifically that low serotonin levels CAUSE depression in humans?

> In the long term, cocaine use wrecks the mitochondia, which contributes to exhaustion. The proper therapy in this case is to restore the mitochondria density.

In mice, when given super high doses. The data for humans is much shakier and the effects of this are unknown, or if there are any, or if it even matters. AFAIK, none of the long term studies from reputable sources have shown long term effects on wakefulness or motivation past the initial withdrawal syndrome. This is just some new "meth neurotoxicity" hysteria bullshit to scare people into thinking drugs are bad.

Going on my observations, cocaine is a much safer drug than meth amphetamine. She recovers quickly from cocaine, but it takes 3-4 days for her to recover from meth amphetamine use.

That doesn't have much to do with safety, more with half-life. Methamphetamine has a longer half-life (averages about 15 hours) than cocaine (about 5 minutes to an hour depending on route of administration). With long term regular use they both have problems. Methamphetamine can be neurotoxic in higher doses without the protection of tolerance and might cause Parkinson's disease later in life. Cocaine has circulatory effects long term, and if smoked causes damage to the lungs. With short term or occasional use they really aren't that bad for you in general (as is true with almost all drugs).

There's no doubt that antidepressants are more of an art than a science, and that they are not the silver bullet the pharmaceutical companies claim.

But trying to say they're all bad because they didn't work on your girlfriend, whom appears to have had some serious issues long before using an SSRIs, is disingenuous.

There are millions of people who are helped with SSRIs, and even some who'd long ago have been dead were it not for the use of MAOIs and others that work when absolutely nothing else will.

But I do agree that SSRIs can have powerful effects, and they're over prescribed to the general population which demands easy solutions to tough problems.

> But trying to say they're all bad because they didn't work on your girlfriend, whom appears to have had some serious issues long before using an SSRIs, is disingenuous.

I started the comment with generalities, offered supporting references and links, then mentioned my girlfriend as a case-study. I have other case studies too.

> There are millions of people who are helped with SSRIs, and even some who'd long ago have been dead were it not for the use of MAOIs and others that work when absolutely nothing else will.

MAOIs are generally safe enough to use temporarily, to get someone out of an intense depressive funk. SSRIs are modern snake oil: they are addictive palliative drugs that do not address fundamental problems. Sometimes they seem to help, but not for the reasons given.

Getting excess serotonin under control is much more beneficial than increasing serotonin levels.

Making blanket generalisations when it comes to mental health is extremely reckless and misinformed. There are lots of SSRIs and their interactions will manifest differently in each person.

Doctors aren't in the business to kill people. SSRI do save lives. We just know they kill a tonne of people as well.

> Making blanket generalisations when it comes to mental health is extremely reckless and misinformed.

The SSRIs are modern snake oil. I gave a reason why they seem to work for some people. Other people think that they're helped, but really their SSRI has only helped them "not care" about circumstances in their life that they're not happy about. I've posted this link in earlier comments.

> Doctors aren't in the business to kill people.

Pharmaceutical companies are in business to pay dividends to their shareholders. Their researchers are employed to make new patent drugs, not to figure out fundamental causes of disease. For these businesses, killing people is par-for-the-course: not the ideal outcome, not unexpected. Doctors' credibility is just collateral damage.

> SSRI do save lives. We just know they kill a tonne of people as well.

Robert Whitaker disagrees with you - he's found that, over the long term, most psychiatric medications are very harmful. Look at his website [1], read his books, and get back to me with specific reasons why he's wrong.

[1] https://www.madinamerica.com/

>blanket generalizations

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