Lavender's Game: Silexan for Anxiety | Hacker News Reader

Lavender's Game: Silexan for Anxiety

astralcodexten.substack.com

144 pointsandsoitis79 comments

My doctor suggested I take this last year for my GAD. I've been taking it since September, and it's definitely been a huge change for me. Previously, I was really "on edge" and would get panic attacks semi regularly. I haven't had a full panic attack since starting to take in, and day to day I feel much more like I'm able to function like a regular person instead of always having that "on edge" feeling.

I guess it's possible it could be a placebo? Previously I was on lexapro for a while, and that didn't seem to be as effective as this, and had some side effects.

How long do you think it took to start working?

It took a couple weeks for me because I started with taking one daily at night, didn't notice much benefit, then took two per dr. recommendation. After that noticed benefit pretty quickly.

One thing I did not expect which the article mentions is the "burps that taste like lavender". It was quite unexpected for me but I personally quite like them. I think my stomach might have gotten used to the lavender though because I would get them ever single time I took them for the first few weeks, and now it's maybe once a week some minor burp.

Yeah, I figured there'd be lavender burps... Did you grow breasts (assuming you didn't already have them)? (That seems to be a prevalent side effect)

I did not.

Be cautious, lavender has compounds that interfere with hormones.

https://www.sciencedaily.com/releases/2018/03/180318144856.h...

It would be surprising if it was effective and had absolutely 0 side effects.

I believe mint and licorice root have similar issues.

About a decade ago I acquired some lavender extract which looked something like cannabis extract. I can confirm that it was sedating and obviously anxiolytic, both vaporized and dissolved in hot water.

Vaporized the effect is instant and lasts only perhaps 20 minutes.

Notably, it was not euphoric like some benzodiazepines can be. So I would say recreational/"abuse" potential was virtually non-existent for me personally.

Qualitatively I would describe the experience as a mental and physical shift towards moderate relaxation, not unlike the feeling after a brief shoulder rub.

I tried the exact same product as mentioned in the article, and used it for several months. But for me it only worked as a way to reduce depression. For anxiety it did little to nothing. Your mileage may vary, of course.

Isn’t reducing depression a pretty impactful outcome? Given the prevalence, it seems like that’s a big deal.

Yes, but for me certain foods already helped to reduce depression. The effect could be highly specific to me.

That is interesting. Out of curiosity did those foods have a lot of PUFAs? More MUFAs? Saturated fats?

Sardines, vitamin c, walnuts, green olives. And oddly, drinks containing aspartame.

I've been learning about adrenal health the past few days, and those happen to be foods that are great for overworked adrenals (which can cause anxiety and depression). Something to look into.

Lavender is also a classic remedy for the adrenals.

I’m on a cut cycle and I just love kalamata, green, and black olives. I’ll have to try sardines, they seem like an excellent protein source.

Anyone suffering from Restless Leg Syndrome, big caution. This drug, like SSRIs, can make the condition worse and/or trigger it.

Will use this comment to say: Anyone suffering from Restless Leg Syndrome, some people report that iron supplement helps, some people report that flush niacin (pure vitamin B3 in primal form; NOT inositol hexanicotinate, NOT nicotinamide, NOT slow release) help.

Be careful with advice on the internet (for all you know, I'm a dog). Iron overload is harmful. Niacin may cause a "flush" which is transient, but feels like your skin is sunburned for 20-30 minutes. Do your own research about amounts etc. Consult a medical professional if you don't feel qualified to do your own research. This is not medical advice, just some random info. (Though, it helped me a lot)

I get the symptoms when I go to bed dehydrated. Chugging water helps me.

Start with 100mg Niacin or less. I can report that 500mg might induce an urge to go to the ER.

My regime is 100mg first thing in the morning resulting in minor flushing 20-30 after taking. Throughout the day, 500mg at a time with often no flushing, staying at or under 2000 mg total for the day. It's very effective at managing my cholesterol and seems to improve joint inflamation. I'll do this for 3 months then stop for a month to 6 weeks.

Taking ALA (e.g. flax seed oil, or an ALA supplement) 20 minutes before niacin reduces or eliminates flush for some people (me included). As do a few mg of melatonin (which, after a week or so, are not even making me sleepy)

Source? (Asking, not accusing)

Counter-point? https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4733501/

A naturopath prescribed lavender oil for my anxiety early on in the pandemic. I think it might have helped a little, but it wasn't a game changer. But she only had me taking 1 80mg pill per day. I'm going to get some of the recommended brand and try 160mg/day as suggested in the article.

Edit: not directly relevant to Silexan, but I'm not surprised that the lavender oil didn't work, especially if it came from a naturopath.

The Massachusetts Medical Society states, "Naturopathic practices are unchanged by research and remain a large assortment of erroneous and potentially dangerous claims mixed with a sprinkling of non-controversial dietary and lifestyle advice."

https://en.wikipedia.org/wiki/Naturopathy#Evidence_basis

Sure, I get that. I'm pretty skeptical of a lot of stuff that goes on in naturopathy, but the best doc I've ever had was a naturopath (not the doc I mentioned above, unfortunately, I'm still looking for a replacement for that best doc) - why do I say he was the best?

1) he wasn't into the woo-woo stuff - he'd present papers on efficacy. So if I were talking to him about a specific issue he'd quickly look things up on his laptop "I was just reading a paper on this the other day, here let's take a look..."

2) he'd actually take time to listen - appointments were at least 45 minutes. Sometimes 1 hour. All the MD's I've been to since seem to be in a huge rush - you're lucky to be in there for 10 minutes (not the fault of the MDs, likely, more the fault of our healthcare system)

3) he taught complementary medicine to MD students at a local Medical School so he wasn't anti-MD as some NDs are. He was well aware of the limits of naturopathy and didn't hesitate to send me to a specialist when needed.

4) Very comprehensive blood tests. I haven't had an MD who tested for so much. And just because some parameter was in the normal range he didn't necessarily consider that everything was ok. He'd say stuff like "this is considered the normal range [for this parameter] but it's right on the edge of normal, we need to look into this further... (or we need to keep a watch on this)"

5) he thought like an engineer - most doctors aren't great at troubleshooting, in my experience. This guy was a good troubleshooter. He got me through some digestive issues that I'd been dealing with for a long time because nobody else seemed to dig into it like he did.

Unfortunately he retired a few years back - because of his reputation he was in huge demand and I think he just kind of burned out. In the years since I haven't found a replacement doctor that I've been happy with (either MD or ND).

Man, that’s too bad, you had a diamond in the rough. Hoping to find a practitioner like that myself.

Seems like a non-sequitur in response to his specific statement- OP isn't endorsing naturopathy (nor am I), the discussion is about the specific efficacy of silexan. The linked article is a meta-analysis of silexan by a board-certified psychiatrist. No one here is pro-naturopathy.

If silexan isn't effective, surely you can prove that empirically and without resort to an argument from authority. If a naturopath says drinking water is good for you too, that doesn't mean that specific claim is wrong because naturopathy is pseudoscience (which it is). We're evaluating silexan here.

Larger discussion is that a lot of modern medicine is not based on well-replicated studies, either

Lavender oil != Silexan

Anecdata: based on a blood lab I was horribly GABA deficient, which explained my weekly (out of the blue) panic attacks. She put me on a hero dose of 1000mg daily and the panic attacks immediately stopped. After a year I stopped supplementing and haven't had panic attacks since. I'd probably still be on Xanax if I had gone to a doctor first (to be clear, I would have had the naturopath not worked out).

A friend of mine had issues with irregular menstruation: months with nothing, and doctors weren't able to help. The same naturopath identified a deficiency by ways of a blood lab, and those problems have also been solved.

Naturopaths are a worthwhile starting point, the one I visited could even prescribe if all else failed, but I'd walk out if one didn't start with a blood lab/science.

> She put me on a hero dose of 1000mg daily

Of GABA? What form? I've heard that it's not well absorbed or gets destroyed in digestion, but then others say it's best absorbed orally by sucking on a lozenge.

I don't think GABA in the bloodstream crosses the blood-brain barrier

You can level "practices are unchanged by research and remain a large assortment of erroneous and potentially dangerous claims mixed with a sprinkling of non-controversial dietary and lifestyle advice" at conventional medicine too, though. Particularly if you're a man, where any visit to your GP will only result in an attempt to give you SSRIs, statins, or dick pills regardless of what's actually wrong with you.

That’s not really an unbiased source lol

I suppose the downside here is that lavender reduces testosterone.

Then again I’m sure chronic anxiety and stress do as well.

I’ve found beta blockers at low doses help quite a bit with low grade anxiety. I’m prescribed them for other reasons, but they do seem to be another class of drugs that can help for anxiety just a bit.

I have bigtime anxiety so I ordered some of this stuff after reading this blog post a couple days ago. I took my first dose this morning, and I gotta say it really does feel like it helped. Obviously this could be placebo effect so I will reserve full judgment until I've taken it for a few weeks at least, but having tried all sorts of stuff for anxiety—both prescriptions and supplements—I can say it's not typical for something to work right away the lavender seemed to. Very promising!

Examine.com says it may be anticholinergic (that would explain some properties). If it's the case then it's not very good for longterm use, it may make you demented

The Amazon referral link is suspicious, but I don't know anything about the author and they may very well be an unbiased critic simply trying to make some additional income from their blog.

If you look at the link in the piece, you'll notice it isn't an affiliate link. If it were an affiliate link, it would have a linkcode section, or more likely just use the amzn.to link shortener that Amazon automatically applies to all its affiliate links unless you stop it.

(source: I am the OP, I do have an Amazon affiliate link, and I chose not to use it in the article to avoid concerns like this one)

Dang, sorry to wrongly call you out then! I saw "sr=8-2-spons" in the link which looked sponsor-related. But looking online, referral links generally have a tag parameter.

This is Scott Alexander, previously from Slate Star Codex. He's highly respected as a blogger about psychiatry

To be clear- he isn't just a "blogger about psychiatry", he is a licensed, practicing psychiatrist with an MD.

and also an influential figure in the Effective Altruism/ LessWrong communities. Interestingly enough, he also wrote a really enjoyable and clever fiction novel.

https://unsongbook.com/

im not going to tell you you're wrong for respecting him, but i feel this comment is only telling half the story. He's very well respected in the "rationalist" community, but he and that community are pretty controversial and definitely not universally respected

The operating point is that Scott Alexander isn't looking for a few extra dollars selling potentially fake health products.

He makes a *lot* of money on Substack, enough that this concertn isn't valid.

Also, "So and so isn't respected in the whole world, only in the people that know about them" isn't a super helpful argument anyways.

Well, the point was that he (or at least the community he is in) is actively disrespected by some people as well, so it's a bit more pointed than just "not known about".

Mentioning this only for completeness' sake. I think he's good, on net. But somewhat adjacent to some more dubious and distasteful stuff.

I heard he's been known to wear white after labor day.

Yeah, that's not it.

Well, he is trustworthy on psychiatry even if he’s a member of a religion that worships nonexistent AIs and Bayes’ theorem.

But his main posting hobby is that he wants to be friends with weird internet right-wing intellectuals and that you should too. So every time I glance at the comments there someone wants to give their opinions on exactly who is genetically less intelligent than the commenter.

Would you write the same comment about a Catholic psychiatrist who wrote a blog about both Catholicism and psychiatry?

Catholicism is definitely pretty controversial and definitely not universally respected, but I think most people would have pretty strong pushback against a commenter who felt the need to bring up an author's Catholicism regarding a blog post that had little to do with catholicism.

If anyone is curious about the controversy, here's the NYTimes piece on Scott Alexander: https://www.nytimes.com/2021/02/13/technology/slate-star-cod... It's a decent article, and the few attempts at pearl-clutching fall pretty flat.

My only gripe with rationalists is that they suck at running their own conference, CFAR. (:

If somebody's interested, I would strongly suggest checking out both sides of the dispute and not only that, as the NYT story caused quite some ruckus at the time.

https://slatestarcodex.com/2020/06/22/nyt-is-threatening-my-...

https://astralcodexten.substack.com/p/statement-on-new-york-...

I would not trust Scott Alexander on real science. He's a pseudo scientific hack with an agenda

Must really be a pretty bad right winger given that he talks so much about being liberal and donates to Democrats[0].

0. https://astralcodexten.substack.com/p/open-thread-217?s=r

Okay maybe hes not a right winger , just pseudo scientific

Or more likely given that your first claim was clearly incorrect you are just trying to paint him in a bad light and your specific accusations have little real basis.

That article says he donated to what he considered an “Effective Altruist”, so the party affiliation was probably secondary.

Politically, he’s a centrist with some libertarian/communitarian mix-ins. More conservative now than he was in the Archipelago days. [0]

Dude used to love Musk and the other technocrats before that became cringe in actual leftist circles.

[0] https://slatestarcodex.com/2014/06/07/archipelago-and-atomic...

Starting with references to a Daily Mail interview and a podcast (even if from a purportedly reputable source) doesn't exactly fill me with confidence.

The Daily Mail is gutter-level tabloid trash. If anything, it's a pretty strong anti-reference.

None of this shit works. If it did it would be called medicine.

Once it is proven to work, it's called medicine. Prior to that, it's unproven stuff that people are selling to you.

The entire article is about evaluating the trustworthiness of the studies of this particular shit.

> Once it is proven to work, it's called medicine.

Once it's proven to be *marketable*, it's called medicine.

Sometimes it works, sometimes it doesn't.

There are numerous studies supporting it's efficacy, but none that are really independent and conflict-free. This is the start of how something starts to be called medicine.

Caffeine is a very effective supplement that isn’t sold as medicine. So’s creatine.

NAC is a pretty effective supplement which is also coincidentally a medicine sometimes which is why you can’t get it on Amazon anymore.

Yet we have "medicine" that you can buy that in fact is not at all effective (Phenylephrine, for example).

I saw it recently used in the cocktail being administered by an anesthesiologist during surgery. It seems to have a use in staving off hypotension during that sort of thing.

Is it a nasal decongestant? Hell no.

Yeah I was going to say - definitely a real drug just a bad nasal decongestant - and generally overshadowed by other phenethylamines.

A long tail from the ephedra plant, once similarly an unregulated supplement that absolutely does stuff.

If you're unfamiliar, see https://www.science.org/content/blog-post/uselessness-phenyl....

Where do you think Derek goes wrong?

I don't.

I was replying to someone who was dismissing non "medicine"

Phenylephrine is useless, but ephedrine and pseudo are not, derived from a non "medicine."

Ah, I misunderstood you.

I believe that most naturopath are charlatans, selling placebos for more money than they should. However a lot of molecules in use today were discovered in plants and proved their worth in double blind studies.

This is preliminary... you may well be right but it's just a guess at this point.

I disagree just on the grounds that if they're confident it affects serotonin 1A receptors then there's definitely a decent chance it really does _something_. As mentioned Buspar/Buspirone is prescribed for anxiety and affects that exact receptor the most.

Similarly I've seen NAC recommended a lot - by a doctor with a phd in neuropsychology. There's a lot of positive reports about it for several mental illnesses - and there's also reason to beleive it affects glutamate (and in turn GABA).

I think the truth is that many chemicals (or plants) are overlooked. As long as there's a solid idea as to what the mechanism of action is, then I think it has a very real chance of being beneficial to someone.

This wouldn't be the first psychoactive plant/fungus - Cacao, mushrooms, kava, marijuana, acaia (dmt) and opium are all relatively potent (noticable within an hour).

Think of all the "medicine" that we have that came from folk cures or supplements.

A lot of supplements/nootropics don't work, but a lot of them do. The issue is more their efficacy and safety.

This is, of course, addressed in the article and associated comments - namely its second quote and the thread https://astralcodexten.substack.com/p/lavenders-game-silexan... .

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