221–230 of 282 posts
You shouldn't take any form of medication unless it's necessary to save your life. Period. Doctors are still mostly quacks, except in some exceptional circumstances
I think this article is a little alarmist. Warnings like these scared me away from SSRIs for a long time despite their likely efficacy in helping treat my symptoms. I sent a number of articles like this one (and several of the medical publications it cites) to my psychiatrist. To her credit, she read them, and her response was that she agreed this kind of permanent change is possible, but it is extremely unlikely. (A…
He has a major conflict on this topic in particular though.
Livejournal-era Scott (squid314) expressed eugenicist views on the mentally ill (paying schizophrenics to get sterilized): https://www.twitter.com/ArsonAtDennys/status/136101934712109...
So I would not trust his claimed views whatsoever on the libido effects of other psychiatric medication and would look for other sources.
I think this article is a little alarmist. Warnings like these scared me away from SSRIs for a long time despite their likely efficacy in helping treat my symptoms. I sent a number of articles like this one (and several of the medical publications it cites) to my psychiatrist. To her credit, she read them, and her response was that she agreed this kind of permanent change is possible, but it is extremely unlikely. (A…
I think this article is a little alarmist. Warnings like these scared me away from SSRIs for a long time despite their likely efficacy in helping treat my symptoms. I sent a number of articles like this one (and several of the medical publications it cites) to my psychiatrist. To her credit, she read them, and her response was that she agreed this kind of permanent change is possible, but it is extremely unlikely. (A…
This is the tough thing. The article says that this happens to almost everyone whereas your doctor says it happens to almost no one.
Earlier quoted context omitted.
> That's not true. From what I understand, sessions are coded e.g. "Intake" or "Meds check" when billed to insurance. They know roughly what you're talking about. You are correct that CPT codes give some insight into what was provided, but you are wrong about what codes providers use in this case. To check myself, I pulled my insurance provider's EOBs for my last two visit to a psychiatrist and my last visit to a psy…
Talk therapy where I am pays 75 dollars for 50 minute session on my insurance. Someone who has been through med school would not typically lower themself to that rate, nor do I buy the idea that some insurers are inexplicably more generous and pay doctor rates for non doctor work. Remember, talk therapy does not require as much education, you do not need a phd or md to do it. An MD would not get doctor level payouts…
Insurers aren't more generous - they have negotiated rates. They're never paying 100% of what's charged. Some providers are better at negotiating, or have more leverage, than others.
Earlier quoted context omitted.
> This is completely consistent with the patient never telling the doctor that, to their surprise, after waiting months the SSRI side effects never go away. That's true, that could certainly happen. I'm more skeptical about the rate at which it happens -- but also, if it is happening, presumably a patient will eventually go back to someone in the medical system and mention it. Whether they connect the dots is a quest…
Well, you might look for data on how many patients discontinue any sort of treatment for starters. "Patient compliance" would be a starter for such a search. I get the impression that you have an "attachment" style relationship with your doctors, I don't mean that as an insult, I think that leads you to think that other people are interacting with them like you are, and would not possibly discontinue their long term…
Conceding your analysis of my particular situation, "not everyone is like me" is a far cry from "nobody is like me." If this condition has high incidence, and even a fraction of people were like me, it would be much more common knowledge than it seems to be given the quality and volume of evidence available.
Earlier quoted context omitted.
I was on SSRIs for a time until my thoughts became so irreversibly cloudy that I weened off and stopped. After that I coincidentally stopped drinking, my weight dropped, and now I've stopped using weed for the most part. My anxiety doesn't go away, even if I go ride my bike for hours. The things that give me anxiety are largely social. How people think of me at work, my appearance, what women think of me, and how the…
> I was on SSRIs for a time until my thoughts became so irreversibly cloudy that I weened off and stopped. After that I coincidentally stopped drinking, my weight dropped, and now I've stopped using weed for the most part. My anxiety doesn't go away, even if I go ride my bike for hours. You may want to try a primarily anaerobic exercise like lifting weights to supplement your cardio. Your mileage may vary, but I pers…
Traffic and the dispersion of people across a wide area, driven by rent and jobs and just it being a huge metro region with some of the worst traffic in the country. The transactional costs in even the effort required to be there; let alone having time to make that effort.
I think this article is a little alarmist. Warnings like these scared me away from SSRIs for a long time despite their likely efficacy in helping treat my symptoms. I sent a number of articles like this one (and several of the medical publications it cites) to my psychiatrist. To her credit, she read them, and her response was that she agreed this kind of permanent change is possible, but it is extremely unlikely. (A…
> Alexander has his issues, but this is an area where he's actually an expert and his approach to the topic helped me a lot. He has a major conflict on this topic in particular though. Livejournal-era Scott (squid314) expressed eugenicist views on the mentally ill (paying schizophrenics to get sterilized): https://www.twitter.com/ArsonAtDennys/status/136101934712109... So I would not trust his claimed views whatsoeve…
But with regards to the SSRI article, Siskind says the libido effects are significant and that "[the effects] usually go away a few weeks to months after stopping the medication, but in rare cases they might linger for months or years, and there are a few people who say their sexual side effects never went away. These cases are very unusual and still not well understood."
So he's almost completely agreeing with the posted article. He disagrees on how common these events are but doesn't offer any more evidence than the posted article does, and I think his disagreement is one the current medical establishment shares.
I think his SSRI article therefore remains credible; it is if anything a more mainstream view than the one presented in the posted article. I'd be more than happy to refer people to somebody other than Siskind if some other non-alarmist summary of SSRIs existed that was comparable. I've looked, but haven't found much.
Earlier quoted context omitted.
There are two medications on the market that have FDA approval for the claim that they have lower incidences of sexual side effects than other similar medications. One is vortioxetine and the other is vilazodone. In addition to acting as SSRIs, they have high affinities for 5HT1A autoreceptors, activation of which disinhibits the release of neurotransmitters. SSRI sexual side effects are hypothesized to be the result…
Vortioxetine (Trintellix) is expensive as fuck, most insurance plans have it under multiple restrictions (step therapy (ST), prior auth (PA), others). They have a manufacturer discount card to take off $100 max but if your prescription benefits don't kick in until after you're deductible you will max out every year pretty quickly. I just paid $900 for a 3 month supply. But... Anecdotally, it does have less sexual sid…
A different anecdotal experience from my own use (10mg Lexapro) - I've always had a problem with premature ejaculation. Was trying all kinds of tricks like doing math problems in my head during sex or trying different breathing techniques - all of that was useless, once I started taking Lexapro it's like it flipped some switch in my head and I can basically go as long as I like now, and finish almost on command. Abso…
Ummm I’m pretty sure the cialis is keeping the blood engorged where it needs to be. Why not try an experiment, lose the cialis and see if you can “keep it up” so to speak. (This is not medical advice, I’m speaking hypothetically fyi)