Earlier quoted context omitted.
Same here, but with Fluoxetine (Prozac). However, I don’t think exactly that fluoxetine made me less depressed. It only made me more „aggressive“ and more risk taking, and the antidepressing effect came from the positive results of taking such risks. I just „don’t care“ about failures as much as I used to. E.g. I finally started talking to girls, because I wouldn’t care about rejection that much. => Got into my first…
Shit I need pills that do the opposite lol.
“No convincing evidence” that depression is caused by low serotonin levels
331–340 of 625 posts
Re: “No convincing evidence” that depression is caused by low serotonin levels
#332Earlier quoted context omitted.
I love reading medical advice on HN. Genetic errors which cause high LDL levels result in significant cardiovascular disease. It's a very strong cause and effect. I won't argue that inflammation doesn't play some role (it seems to play a role in many diseases), but I wouldn't dismiss current medical opinion on LDL. https://en.wikipedia.org/wiki/Familial_hypercholesterolemia Familial hypercholesterolemia (FH) is a gen…
Why aren't you adjusting for LDL subfractions? Seriously, yes having too much LDL can be a sign of having harmful subfractions but that doesn't mean high LDL actually is harmful or low LDL is healthy.
Re: “No convincing evidence” that depression is caused by low serotonin levels
#333Earlier quoted context omitted.
Have you considered that your comment may have been downvoted because you come across unnecessarily hostile, not because of some absurd attack on your person? Similarly, any space is a good space to discuss and spread awareness on mental health — even if only one person finds an idea to help them, whatever their situation may be, it's already a massive positive.
> because you come across unnecessarily hostile And possibly justified. A lot of us are armchair psychiatrist from reading articles. OP that you're replying to lives this type of medication and attributes being alive right now to it while a lot of us who have only read articles sit and debate. A number of these comments can come across as "just eat healthier" to an overweight person or "don't be sad".
Re: “No convincing evidence” that depression is caused by low serotonin levels
#334Earlier quoted context omitted.
> the pop-culture misunderstandings about "low serotonin" Let’s be clear though, I had an actual licensed psychiatrist say this to me last week. It’s not like people are getting this “pop-culture” information via blog articles…
It's possible the psychiatrist is using "low serotonin" as a simple shorthand meant for the layperson
Re: “No convincing evidence” that depression is caused by low serotonin levels
#335At least this is my knowledge from when I last researched this topic in depth.
But that would be a little bit too much for the general public, so it is simplified, to this annoying effect that everyone talks of "low serotonin levels" where in fact the underlying systems are way more complex.
Re: “No convincing evidence” that depression is caused by low serotonin levels
#336This is the key line in the summary.
The concept of attacking an idea no one really believes is really a straw man.
More importantly the modern practice of medicine is "evidence based medicine", not "mechanism based medicine". That means treatments are tested as to if they work, not how they work. Ideally in multiple well run double blinded randomised controlled trials with at least some against treatment as usual. Unlike the past when we thought more about how they might work, theorising something is off about someone's humors and adjusting with leeches.
Anyone looking for a truly mind bending result should look at Hjorth et al. 2021 [0], the study recruited people with social phobia and gave them all an SSRI (escitalopram). Half were told they were getting a sham active placebo and "should not expect to get better", half were told "you're getting the known effective treatment".
Headline result being told you are being treated leads to 4x as much response with brain changes in the dopamin networks.
In the meanwhile, rather than worry about how antidepressants work, why not take a look at electroconvulsive therapy which has proven time and again to be the most effective treatment for depression. Yet we have no idea how it works, other than knowing a decent seizure in those without epilepsy makes you less sad? What on earth.
Re: “No convincing evidence” that depression is caused by low serotonin levels
#337> Other clinicians say, however, that the notion of depression being because of a simple chemical imbalance is outmoded anyway, and that antidepressants remain a useful option for patients alongside other approaches including talking therapies. This is the key line in the summary. The concept of attacking an idea no one really believes is really a straw man. More importantly the modern practice of medicine is "eviden…
Should they be doing both? I can't imagine shipping code that I don't know how it works, but it passes tests...
Otherwise, you'll get pseudoscience - just mix random chemicals and see how patient reacts, rinse and repeat until something works...
Re: “No convincing evidence” that depression is caused by low serotonin levels
#338Earlier quoted context omitted.
Sadness or distress vs not feeling anything and not having motivation?
Yes, this is roughly in the right area.
Re: “No convincing evidence” that depression is caused by low serotonin levels
#339> Other clinicians say, however, that the notion of depression being because of a simple chemical imbalance is outmoded anyway, and that antidepressants remain a useful option for patients alongside other approaches including talking therapies. This is the key line in the summary. The concept of attacking an idea no one really believes is really a straw man. More importantly the modern practice of medicine is "eviden…
> are tested as to if they work, not how they work Should they be doing both? I can't imagine shipping code that I don't know how it works, but it passes tests... Otherwise, you'll get pseudoscience - just mix random chemicals and see how patient reacts, rinse and repeat until something works...
We call that machine learning
Re: “No convincing evidence” that depression is caused by low serotonin levels
#340Oral selective serotonin reuptake inhibitors activate vagus nerve dependent gut-brain signalling (2019): https://www.nature.com/articles/s41598-019-50807-8
Identification of SSRI-evoked antidepressant sensory signals by decoding vagus nerve activity (2021): https://www.nature.com/articles/s41598-021-00615-w