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Experimental depression treatment is nearly 80% effective in controlled study

med.stanford.edu

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Re: Experimental depression treatment is nearly 80% effective in controlled study

#301

Post by smaddox »

raindeer2 wrote: post #181
mysecretaccount wrote: post #122

Earlier quoted context omitted.

I have some questions if you don't mind: Was it expensive? Are there any downsides? Do you think TMS is, like psychedelic therapy, potentially useful for people without depression (i.e. the "betterment of well people")?

Re. How expensive it is. There are cheap home-use alternatives to TMS. For instance tDCS. Here is a great comparison of noninvasive brain stimulation techniques for depression treatment: https://www.bmj.com/content/364/bmj.l1079 A company that offers tDCS as a home treatment for depression can be found here: https://flowneuroscience.com/

Very interesting. And there are tDCS home kits for $149, e.g. https://apexdevice.net/shop/apex-type-a-4ma-std/. This is low cost enough that I'm willing to give it a shot. Worst case, I end up with a decent DC current source that I'm sure I can find a use for at some point.

Re: Experimental depression treatment is nearly 80% effective in controlled study

#302

Post by carabiner »

oneoff786 wrote: post #298
AlexCoventry wrote: post #147

Case size 14, control size 15. It's 2021; you shouldn't be able to publish a psychology result with statistics this weak.

That’s an aggressive take for someone who hasn’t bothered to consider the effect size when claiming to know statistics better than these authors.

The heart of the middlebrow dismissal is the assumption that the dismisser understands a field/industry better than a person who's spent their entire adult lives studying it.

Re: Experimental depression treatment is nearly 80% effective in controlled study

#303

Post by hkt »

NotVerstappen wrote: post #272
hkt wrote: post #252

Earlier quoted context omitted.

Not a doctor but have experienced something like what you're describing. It is important to be open with your doctor about this stuff because it allows them to accelerate getting you help. Differentiating between suicidal thoughts and intentions (the former of which I had, the latter I did not) made me comfortable enough to have the conversation. Really though, seek help. It is unlikely you'd lose choices (eg be sect…

That's a good point - thanks. "Thoughts" rather than "intentions" is definitely more aligned with where I am. Part of the trouble for me and presumably a lot of people is untangling those things - for example, would my thoughts be intentions if not for having a spouse, who I could never imagine hurting in that way by leaving? Moreover, does the mere presence of that kind of "blocker" represent a positive sign? I pick…

Yes, the presence of a blocker like that is a good thing. What ifs aren't the most useful thing though.

GPs have been enormously helpful to me with this stuff. Most are very understanding. If you can do an online appointment booking that might help too - so the immediacy isn't an issue so you can write the appointment reason very clearly and revise it as much as you want before hitting the button. Otherwise, tell the receptionist you'd like a phone appointment (for the distance that gives psychologically) and that it is for a mental health issue. The diagnostic criteria for depression are fairly easy to satisfy - it is mostly about low mood for 4+ weeks. Keep details to a minimum you need to get a prescription but be cooperative if they probe.

Whatever you do though, don't just suffer. Tell your spouse how you feel too. Get some help.

Re: Experimental depression treatment is nearly 80% effective in controlled study

#304

Post by smaddox »

smaddox wrote: post #301
raindeer2 wrote: post #181

Earlier quoted context omitted.

Re. How expensive it is. There are cheap home-use alternatives to TMS. For instance tDCS. Here is a great comparison of noninvasive brain stimulation techniques for depression treatment: https://www.bmj.com/content/364/bmj.l1079 A company that offers tDCS as a home treatment for depression can be found here: https://flowneuroscience.com/

Very interesting. And there are tDCS home kits for $149, e.g. https://apexdevice.net/shop/apex-type-a-4ma-std/ . This is low cost enough that I'm willing to give it a shot. Worst case, I end up with a decent DC current source that I'm sure I can find a use for at some point.

Okay, sounds like some people trying this at home have had seriously bad side effects. So will definitely have to do some reading before giving this a shot.

Re: Experimental depression treatment is nearly 80% effective in controlled study

#305

Post by nebula8804 »

avidiax wrote: post #166
nebula8804 wrote: post #112

Earlier quoted context omitted.

>For me, a short 3-4 month course of a particular SSRI lets me beat back the worst of it Can you elaborate which one are you using? I was prescribed Wellbutrin/bupropion (along with some therapy sessions) about a month ago and I seem to notice no changes. I'm going to continue to be hopeful but it seems like this wasn't the one for me so just wondering what you were using.

Buproprion is quite good at removing false reward loops. Made me really tone down video games. It's used also for smoking cessation. It's quite subtle. The other SSRI/SNRI meds have strong side-effects. I will say that the effect is permanent. It's rewiring your brain when you use it. If it's helping you to spend some time on harder but more important self-improvement, then great. If not, you should consider switchin…

>Buproprion is quite good at removing false reward loops. Made me really tone down video games. It's used also for smoking cessation. It's quite subtle. The other SSRI/SNRI meds have strong side-effects.

That would be a miracle if it did that. My doctor put me on this precisely because it is less strong than other drugs like Adderal. He does not want me going down an addicting road unless necessary. (my summary of what he told me)

So far I have been taking it for about a month although I have missed days here and there and while I try to take it at the same time, sometimes the window varies by +/- 1-3 hrs. I am on the 150mg XR version. What is typical time frame we are talking about before we notice changes? 1 month? 6 months? How long did it take you?

The fact that I am on HN/Reddit/youtube for a couple hrs each day instead of exercising/coding/tidying up/working on my life seem to indicate that no reward loops have been broken thus far. In fact I am slowly sinking in the other direction(but i'm not sure if buproprion is causing it). I have broken another all time record for weight gain despite increasing my exercise regime somewhat.

Was considering stopping treatment after a month if no changes are noticed and wait some time to clear it out of my system before trying something like ayahuasca or psilocybin.

Re: Experimental depression treatment is nearly 80% effective in controlled study

#306

Post by nebula8804 »

girvo wrote: post #156
nebula8804 wrote: post #112

Earlier quoted context omitted.

>For me, a short 3-4 month course of a particular SSRI lets me beat back the worst of it Can you elaborate which one are you using? I was prescribed Wellbutrin/bupropion (along with some therapy sessions) about a month ago and I seem to notice no changes. I'm going to continue to be hopeful but it seems like this wasn't the one for me so just wondering what you were using.

Escitalopram is what I found worked for me. None of the SNRIs did (Effexor and so on), and bupropion isn’t even prescribed where I am for depression for what it’s worth, but I’ve heard some people have decent luck with it, typically as an adjunct with an actual SSRI though. It took me months to find the right one for me though. Worth talking to your doctor about it if it’s not helping much!

I tried Lexapro 6 years ago when I first attempted to work on this issue. I was prescribed some minimum dosage(I forget what). I will never forget the first day. I didn't feel happy or sad or even anxious. It was as if every emotion was stripped out of my head and instead it was replaced with perfect neutrality. Nothing mattered int he world anymore. I had no thoughts or opinions, just complete neutrality of thoughts and emotions. This also became my most productive week in years. The thought process was literally "Ok I have this task to do, let me do this task, I am done with this task, ok lets do the next task. Repeat until there are no more tasks." No breaks, no distractions were noticed while the task is being performed.

Unfortunately, the side effects were so bad I gave up after a week. Horrible nausea all the time. Such extreme fatigue that i'd sleep 16 hours and still feel exhausted. Not to mention other side effects that are not appropriate to discuss here.

I am considering trying this nightmare of a drug again because I still remember that productivity but man that first experience literally felt like poison was seeping into all areas of my body.

Re: Experimental depression treatment is nearly 80% effective in controlled study

#307

Post by nebula8804 »

xapata wrote: post #208
nebula8804 wrote: post #112

Earlier quoted context omitted.

>For me, a short 3-4 month course of a particular SSRI lets me beat back the worst of it Can you elaborate which one are you using? I was prescribed Wellbutrin/bupropion (along with some therapy sessions) about a month ago and I seem to notice no changes. I'm going to continue to be hopeful but it seems like this wasn't the one for me so just wondering what you were using.

I found medications ineffective, but my last therapist helped me tremendously. If your therapist isn't helping, find a new one. There's no shame in switching.

I am on my second therapist. The first was was a remote therapy based out of Israel. He was great and convinced me to quit my terrible job at the time and reorient my life. His therapy worked to an extent but I never could relay my deep insecurities to him. When I tried to explain deeper concepts to him it nver really registered. I just found myself wasting 120$ per session with no real payback. I continued with him on and off for 5 years before just giving up this year after my father passed away and I gained no comfort from talking to him about it.

A second remote but local(because of covid) therapist was assigned to me as part of this Wellbutrin trial. A total of 10 sessions are to be done with this trial. So far she has only told me what I already know: that I should keep trying little steps every day like increasing my exercise. She gives me little goals but I don't like the fact that since these sessions are 45 mins with no way to extend, there always seems to be a time crunch.

There are tons of therapists in my area with no way to evaluate the differences. This is an expensive proposition as it stands and so I don't know how I will find the perfect one without evaluating each and every different therapist in my area. :/

Re: Experimental depression treatment is nearly 80% effective in controlled study

#308

Post by girvo »

nebula8804 wrote: post #306
girvo wrote: post #156

Earlier quoted context omitted.

Escitalopram is what I found worked for me. None of the SNRIs did (Effexor and so on), and bupropion isn’t even prescribed where I am for depression for what it’s worth, but I’ve heard some people have decent luck with it, typically as an adjunct with an actual SSRI though. It took me months to find the right one for me though. Worth talking to your doctor about it if it’s not helping much!

I tried Lexapro 6 years ago when I first attempted to work on this issue. I was prescribed some minimum dosage(I forget what). I will never forget the first day. I didn't feel happy or sad or even anxious. It was as if every emotion was stripped out of my head and instead it was replaced with perfect neutrality. Nothing mattered int he world anymore. I had no thoughts or opinions, just complete neutrality of thoughts…

Yeah that absolutely apathy is what kept me alive when I was so close to the edge.

But the side effects (and primary effects!) are also why I only ever stay on it for 3 to 4 months. The sexual side effects alone are enough to impede my recovery, let alone some of the other ones.

So I use it like a bandage to get through the worst parts, rather than a “take every day for years” drug. The “take every day” bit for me is CBT exercises to rewrite my mind, and it’s worked :)

The physical sides for Lexapro at least for me disappeared. I also got the nausea initially. It’s rough, I know.

There are other more modern SSRIs that might be worth trying too, but if escitalopram seemed to work then it might be worth trying to stick it out to see if the sides get better. They usually do

Re: Experimental depression treatment is nearly 80% effective in controlled study

#309

Post by nebula8804 »

girvo wrote: post #308
nebula8804 wrote: post #306

Earlier quoted context omitted.

I tried Lexapro 6 years ago when I first attempted to work on this issue. I was prescribed some minimum dosage(I forget what). I will never forget the first day. I didn't feel happy or sad or even anxious. It was as if every emotion was stripped out of my head and instead it was replaced with perfect neutrality. Nothing mattered int he world anymore. I had no thoughts or opinions, just complete neutrality of thoughts…

Yeah that absolutely apathy is what kept me alive when I was so close to the edge. But the side effects (and primary effects!) are also why I only ever stay on it for 3 to 4 months. The sexual side effects alone are enough to impede my recovery, let alone some of the other ones. So I use it like a bandage to get through the worst parts, rather than a “take every day for years” drug. The “take every day” bit for me is…

Can you expand on what these CBT exercises are?

I gave up after the Lexapro until this year where I am trying to tackle this issue again with the Welbutrin. I keep reading that maybe ayahuasca or psilocybin might be the miracle key that solves the underlying issues.

Re: Experimental depression treatment is nearly 80% effective in controlled study

#310

Post by jjeaff »

Jim_Heckler wrote: post #288
jjeaff wrote: post #237

Earlier quoted context omitted.

Yes, there are much better options like Vyvanse or extended release Adderall or Concerta.

Note that these are still stimulants tho. Vyvanse is unique in that its a slightly modified dextroamphetamine (adderall) molecule that gradually gets metabolized by the liver into dextroamphetamine, sort of a "natural" extended release and has a much smoother (side) effect curve. Concerts and XR are just cleverly designed pills that release two doses of plain methylphenidate/amphetamine spaced out, so there's two dis…

Yes, that's correct. The slow release makes a big difference for a lot of people compared to traditional Adderall/Ritalin
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