Hacker News Board Hacker News, browsed like a classic message board
Live data from Hacker News

Schizophrenia drugs may have been off target for decades, study finds

msn.com

Post reply on HN
Print view View original

91–100 of 131 posts

Re: Schizophrenia drugs may have been off target for decades, study finds

#91

Post by 11235813213455 »

tredre3 wrote: post #35
11235813213455 wrote: post #32

I was diagnosed with schizophrenia, given some strong antipsychotics, it was a disaster I could barely talk or hand-write properly, gained 15kg. Fortunately I didn't listen the advices and stopped after 4 months, my therapy now is just walking, running, cycling, outdoor, trees, vegetable, minimalism

> Fortunately I didn't listen the advices and stopped after 4 months, my therapy now is just walking, running, cycling, outdoor, trees, vegetable, minimalism Over-medication is a big problem, but you have to recognize that you are extremely lucky to be able to function without it. Not everybody can. I couldn't. I share your experience regarding side effects, it would likely kill my career. Thankfully anti-psychotics…

Right,my case is light (I've always had a job, at least between major burnouts), and the injections were way too big for my weight. It was efficient as I was calm at that moment, I started reading books again, but I lost all my passion for things, my brain was like mostly turned off, that's why I preferred returning to the previous state and finding other solutions

Re: Schizophrenia drugs may have been off target for decades, study finds

#92

Post by pseudalopex »

faeriechangling wrote: post #66
mtlmtlmtlmtl wrote: post #24

Earlier quoted context omitted.

The "serotonin model", actually called the monoamine hypothesis, hasn't really been taken seriously in the field for decades, except by naysayers like yourself who continue to use it as a strawman.

I see patients still take it seriously because of the heavy marketing of Zoloft in particular. The drugs are literally have serotonin in the name. I still hear people regularly refer to mental health problems being due to a "Chemical imbalance", often as a way to defend their use of pharmaceuticals and dismiss the efficacy of any other intervention. It's that they see people justify a non-falsifiable in the efficacy…

SSRIs are popular because they are effective and safer than older antidepressants. And what depression interventions are incompatible with SSRIs but other drugs not understood completely also?

What should SSRIs be called if the SSRI part is how they work indirectly? What would you call them now? And SNRIs? And MAOIs?

Re: Schizophrenia drugs may have been off target for decades, study finds

#93

Post by calibas »

cududa wrote: post #72
calibas wrote: post #52

I have a theory. Antipsychotic medications just need to make the person more "manageable" to be considered effective. It doesn't need to eliminate the psychosis directly, it could just make the person more sedated, and it would appear to be "working" properly.

That's not really your own theory, that's like, the specific goal of psychiatric treatment? You can't "cure" schizophrenia or bipolar, the goal is to manage it. My dad developed severe mental illness later in life, destroyed his life, and never found a regiment that worked for him before his death (undiagnosed congenital heart condition is what ended up getting him). I think anyone who has schizophrenia or bipolar (a…

You're mixing up managing a disease and managing a person. Managing (treating) mental illness is not simply about making the person more manageable for others.

There's drugs that reduce or eliminate hallucinations for many schizophrenics, so it's something you can treat (except in unfortunate situations like your dad or my uncle). There's a big difference between a medication that actually removes the symptoms over one that sedates a person, they're not the same and one is obviously preferable.

There hasn't been enough concern about how the drugs work, or why they often cause serious side-effects like tardive dyskinesia. It's simply enough that the person becomes manageable for others.

These drugs have been around for a long time and only now is someone investigating deeply into how they actually work.

Re: Schizophrenia drugs may have been off target for decades, study finds

#94

Post by FollowingTheDao »

hinkley wrote: post #19
whats_a_quasar wrote: post #5

The brain is really complicated, and all psychiatric medications affect multiple receptors and subsystems. Framing this study as "antipsychotics were off target" is an editorial choice. The title could just as easily have been "Improved understanding of antipsychotic action means we may be able to design better antipsychotics." Edit: It also ought to be noted that the study was on mice that had been given amphetamine…

The serotonin model of antidepressants just doesn’t pass a sniff test. Something else is going on there. How they say they should work would mean they work in the first dose and possibly that don’t require tapering off. But that’s not what happens in the real world. If we understood what’s really happening we could target pathways better.

As someone living with schizoaffective bipolar disorder and has studied his own genetics over 15 years I can tell you serotonin plays a role in mood disorders but it is secondary. (Tryptophan is pushed down the kynurenine pathway during illness and therefore none is available to make serotonin.)

https://www.mdpi.com/ijms/ijms-22-11714/article_deploy/html/...

My mood disorder is caused by an immune disorder. How do I know this? When I take TNF Inhibitors my mood disorder goes away. But it is all over my genetics (PNP, CACNA1C, EARP1, TNPAIP3, SLC18A2, SLC1A2, SLC23A2 are the most relevant) and I have found rescue in high dose zinc and ascorbic acid not only for my mood, but also for my Ankylosing spondylitis.

Note as well that I had my worst paranoid delusional states both time I had COVID.

Here is a tip from a two time suicide survivor; Doctors can only treat the symptoms, and most do its poorly. Use medicine to get stable and stay alive but figure out the rest on your own.

Re: Schizophrenia drugs may have been off target for decades, study finds

#95

Post by FollowingTheDao »

astrange wrote: post #48
dontknowwhyihn wrote: post #40

Earlier quoted context omitted.

Don’t people still talk about “low seratonin levels?” I always found it suspect that we say someone’s levels are low without actually measuring them.

Yes, and psychiatrists never believed it was "low serotonin" at all, or at least claim to have never believed it. For ADHD, stimulants actually do treat it by fixing "low dopamine"… in specific areas of the brain. But "low dopamine" is also a description of Parkinson's disease. But SSRIs don't work like stimulants do; they take a lot more than half an hour to take effect. We don't actually know how SSRIs work in the…

> But SSRIs don't work like stimulants do; they take a lot more than half an hour to take effect.

Sorry, need to be an anecdote for you. Prozac makes me manic in about 5 hours. We know how SSRIs work, the problem is they are treating a symptom not the cause of depression which is immune dysfunction.

If SSRIs did not increase serotonin there would be no risk of them causing serotonin syndrome, and they do.

Re: Schizophrenia drugs may have been off target for decades, study finds

#96

Post by FollowingTheDao »

m_0x wrote: post #46
11235813213455 wrote: post #32

I was diagnosed with schizophrenia, given some strong antipsychotics, it was a disaster I could barely talk or hand-write properly, gained 15kg. Fortunately I didn't listen the advices and stopped after 4 months, my therapy now is just walking, running, cycling, outdoor, trees, vegetable, minimalism

Pardon my ignorance and prejudice, but how are you not a danger to the people that surround you? Or is schizophrenia a spectrum very much alike as autism?

hey, that was a pretty, uh, stigmatizing statement. schizophrenics are no more of a danger to others than the general population. It is because society treats them like shit and so they take drugs to cope that makes them violent.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6852683/

"Patients with schizophrenia without comorbid substance abuse have only a slight increased risk of violent crime compared with the general population, suggesting that substance abuse plays a mediating role."

Re: Schizophrenia drugs may have been off target for decades, study finds

#97

Post by FollowingTheDao »

thrw238592 wrote: post #47
justsomeguyhere wrote: post #11

So I've tried half a dozen antipsychotics, here are my 2 cents: The only things those drugs did to me were making me comatose, poop my pants, sleepy, dumb and hungry. You can't be declared psychotic or paranoid, when the only thing you can do is sleep, drool, poop yourself, and make 3 words sentences, so lazy doctors think these drugs work. But they don't, there was zero change in my beliefs, fears, anxieties, I was…

[dead]

SO glad to hear someone bring this up!

All these meds are metabolized by CYP 450 genes which need heme. The more drugs to take the lower your heme. To make heme you need B6, Zinc and Riboflavin.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3034403/

Re: Schizophrenia drugs may have been off target for decades, study finds

#98

Post by FollowingTheDao »

rybosworld wrote: post #6

It's amazing how far the medical world has come in treating ailments of the body, but we've made comparatively little headway in ailments of the brain.

Last I checked my brain was part of my body. And that is why so little headway has been made, people keep thinking the body and brain act independently of each other.

Re: Schizophrenia drugs may have been off target for decades, study finds

#99

Post by M1ch431 »

The entire paradigm for treating schizophrenia and other chronic mental states is flawed.

Mental distress/disorder cannot be treated properly because of the strong for-profit motive (unrestricted greed) that these privately-owned (sometimes publicly traded) mental hospitals and pharmaceutical companies have.

Mental hospitals are effectively a prison. Locked doors, removal of rights once committed, coercive and sometimes forced treatment and restraints, being told that you have a lifelong disease (with no measurable physical damage -- fMRI scans are not indicative of damage) that needs drugs for the rest of your life, and getting billed an exorbitant amount - to name a few things that are wrong.

If your rights are violated and you are declared incompetent (which is pretty common if you are unstable or in crisis), it's an uphill battle in special courts called Mental Health Courts. It's difficult to get a second opinion from a third-party psychiatrist, or to contest treatment orders (such as mandatory intramuscular antipsychotic injections or ECT which respectively have a very potent and long-term effects).

The conversation needs to be shifted towards the Soteria House paradigm.

This article sums this model of care pretty well: https://www.madinamerica.com/2019/09/soteria-house-heal/

They have very impressive results, particularly in regards to schizophrenic and psychotic patients, and do not use life-long tranquilizer prescriptions to achieve their results. It needs more study, it needs more implementation, but the core of the model is that it builds a supportive community around vulnerable people -- instead of caging and viciously profiting off of these people.

I spoke on this matter in the past, and you can read my thoughts here: https://news.ycombinator.com/item?id=34029719

Re: Schizophrenia drugs may have been off target for decades, study finds

#100

Post by _Wintermute »

Ezku wrote: post #23
A_D_E_P_T wrote: post #2

Situation normal. Consider the discovery of valproic acid: "Valproic acid is a carboxylic acid, a clear liquid at room temperature. For many decades, its only use was in laboratories as a "metabolically inert" solvent for organic compounds. In 1962, the French researcher Pierre Eymard serendipitously discovered the anticonvulsant properties of valproic acid while using it as a vehicle for a number of other compounds…

Your point is a very important one. Do we check the interactions of a tentative drug molecule against every single molecular target in the body, and do we track what happens as a result of all those interactions? It’s quite common that a group of ”usual suspects” on the researchers’ radar get checked for — but by necessity, a lot of ground goes uninvestigated. > Consider valproic acid: For many decades, its only use…

That's what controls are for, you're always comparing against the DMSO control. I also don't think anyone who's doing small molecule screens thinks DMSO is inert.
Post reply on HN