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Comment by selexin | Hacker News Reader

I don’t usually post here, especially on such personal topics, but feel I should. I’ve been on SSRIs and SNRIs for some time now (Pristiq, and now Zolof), and can definitely attest to the some of the changes described in the article. I clearly remember reading the documentation in full that came with both drugs before starting each, and the mentioned side effects were only mentioned in passing, along with possibly every other side effect imaginable, so it was very easy to dismiss - especially when you are in a place you know you need help out of. There was also no real warning of long term side effects from both doctors that have prescribed me. I guess I don’t have any real point, other than if you are considering anti-depressants do more research than I did before taking what you’ve been prescribed - and if in doubt get answers from your doctor, and failing that find a better doctor (if you can).

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When I was in my mid-20s my doctor wanted me to take blood pressure medication because when I went to her office in the morning I had blood pressure of 150/110. I told her I wanted to see what I could do on my own first.

I cut out salt and caffeine, increased potassium and exercised every day. I went back in two months and my blood pressure was 120/80. She took it four times because she didn't believe it. I think the primary thing was the caffeine - it just gives me a temporary but strong spike in blood pressure.

Years later, a doctor prescribed me Lexapro. I actually picked up the prescription. But I never took it. I started exercising every day, started mindful meditation, removed sugar from my diet, read the book Learned Optimism and did the CBT-like work in there. Ended up never taking the SSRI but haven't had anxiety in 7 years. (btw Learned Optimism was recommended to me on HN).

Some people definitely need medication - I worked with a guy in his early 20s that had cholesterol of 400+. I saw him eat oatmeal every day for breakfast and lunch and then saw his cholesterol go up to 420. I'm sure there are people that need SSRIs. But it does seem like doctors at least prescribed it to me when I didn't need it.

Probably eating the oatmeal that made his cholesterol get higher.

There are now tons of research coming out about how cereals (wheat and corn specially) are basically the culprit of a lot of diseases that in the past were blamed on "fat", and also that this past blame was partially due to corruption (for example coca-cola literally gave six digits money to Harvard scientists so they would lie and say sugar was safe and the culprit for people problems was meat).

> Probably eating the oatmeal that made his cholesterol get higher.

I... don't think so

https://www.health.harvard.edu/heart-health/research-were-wa...

https://www.sciencedaily.com/releases/2016/10/161007085247.h...

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5885279/

https://www.sciencedaily.com/releases/2008/01/080108102225.h...

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5394769/

> There are now tons of research coming out about how cereals (wheat and corn specially) are basically the culprit of a lot of diseases

Care to share more on what you are referring to?

(not op) for reference, 39g of oats contains 28g of carbohydrates.

https://www.hsph.harvard.edu/nutritionsource/what-should-you...

  - The biggest influence on blood cholesterol level is the mix of fats and carbohydrates in your diet—not the amount of cholesterol you eat from food.
  - Although it remains important to limit the amount of cholesterol you eat, especially if you have diabetes, for most people dietary cholesterol is not as problematic as once believed.

What’s up with the conflicting info on carbohydrates? Should I skip the bowl of oatmeal every morning?

This seems to be a thing for pretty much every food/nutritional category. I've decided for myself to just "ignore" the science since the definition of "healthy" seems to change so often. Instead I try to use common sense for picking my meals.

any nutrition advice that makes sweeping statements about entire macronutrients (protein/fat/carbohydrates) should be ignored and is mostly used to sell fad diets. "Carbohydrates" could be HFCS or leafy greens. "Fats" could be shortening or avocado. The nutrition of the individual food is much more important than the macronutrients.

dietary cholesterol has a negligible effect on blood cholesterol levels. Almost all cholesterol in the body is endogenously created

There's a U-shaped curve for all cause mortality with cholesterol levels, just like anything else. Cholesterol is not bad, it's literally the building block of steroid hormones, vitamin D, etc.

Similarly, there's a good argument to be made that most people actually eat too little salt. If you compare most sodium guidelines to data of sodium intake versus all cause mortality, you're more at risk of death following the guidelines.

Lifestyle changes are the best treatment there is. Shame they can't make a pill out of it. Statistically most people fail to maintain lifestyle changes over the long term. Especially dietary changes.

Pharmacological treatments allow doctors to help those people.

I have never had a doctor recommend lifestyle treatments to me. They don't make any money on those. I have osteoarthritis in my hip and multiple doctors recommended an immediate hip replacement. I did a ton of research and ended up on the anti-inflammatory index diet in combination with changing exercises from running and golf that put high impacts on my hip to cycling which does not. All of my pain was gone in three months and has stayed gone for the last two years.

Have you heard of white coat syndrome? https://www.healthline.com/health/white-coat-syndrome

Recently learned about it, and based on my own measurements, seems I have it to some extent.

I got back from the doctor last week due to some chest pains. He was more worried about my high blood pressure 130/90.

Every time i measure it at home its 110s/70.

As a herbal observation, it seems like such a scam that medical pamphlets will list possible side-effects, but not frequencies.

Knowing that one person in one thousand saw some issue is very different from 20% of people. Especially as almost every medication I've ever seen advertised has a list two pages long of possible side effects.

How is a person supposed to make an informed judgment?

I don't know if it's the law here in France or just nice manufacturers, but I've seen side effects broken down by occurence rate ( 1 in 100,000: X, Y, Z; 1 in 1,000,000: A, B, C, etc.) multiple times.

All US drugs have to include the rate of side effects in their clinical trials.

Google "Product name prescribing information"

The frequencies are there, they were in all pamphlets I read. It is a law.

> herbal observation

What does this mean?

Autocorrected from honest or personal I believe.

Yup, and I didn't catch it in time.

In my case (Pristiq), it was a net positive. My libido decreased (but never desapeared) and I've never had erectile disfuncion so far. Totally worth it for me, with my specific metabolism.

Sertraline (Zoloft) often causes more sexual side effects in males than it does in females. I have seen this used at the max dose to control hypersexual behaviour in a patient with dementia.

I spent about 18 months on sertraline. Even on the 'therapeutic' dose that I started off with, it basically nuked my ability to perform. Could still get an erection easily enough, the frustration was being unable to do anything with it.

It wasn't that much better with fluoxetine, but with that I found that I could at least wait a few days to sort of build up the energy.

As with another poster here, I'm happy being open about this stuff too. The first hurdle is opening up about mental health, I think that already puts you on a good track to take the shame away from the sexual aspect.

It's also used to treat premature ejaculation. Side effects can be really useful in the right context.

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