![[dr. bob]](/dr-bob-sm.gif)
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 25 of 26. This is the beginning of the thread.
Posted by linkadge on August 3, 2022, at 16:41:19
I had a doctor's appointment today and we decided to try changing the effexor with escitalopram (again). For some reason, effexor is making me feel increasingly isolated and detached. My depression has been worsening in the last 6 months.
I don't hold high hopes, but (in the least) maybe I can tolerate it better than effexor.
Linkadge
Posted by Jay2112 on August 3, 2022, at 21:02:40
In reply to Retrying escitalopram, posted by linkadge on August 3, 2022, at 16:41:19
> I had a doctor's appointment today and we decided to try changing the effexor with escitalopram (again). For some reason, effexor is making me feel increasingly isolated and detached. My depression has been worsening in the last 6 months.
>
> I don't hold high hopes, but (in the least) maybe I can tolerate it better than effexor.
>
> LinkadgeHi Linkadge,
Escitalopram, in particularly at high doses, enabled me to deeply emote, to work through the core of my depression and anxiety. I was on approx 30mg at one time, and I would take it a bit later in the evening. I engulfed myself in deeply, almost mystical music, like Enigma and Madonna's Ray of Light albums...and I cried, so, so intensively. But, I felt so in touch with my deeply sensitive side, and it sounds odd...but it actually made me feel good, after a long, hard cry. I never used to believe that catharcism was of any use, but now, I KNOW it helped me get the tears, and the pain out, into the open.
I think this is especially useful if you have trauma in your life..and sounds similar as to what MDMA does. Ironic that both MDMA and escitalopram act strongly on serotonin.
I may just ask my pdoc about an escitalopram trial, again, as I too am stuck on Effexor, which has been bringing the worst out in me lately. We tried Trintellix, with poor results, as well as Viibryd.
So please, post your regular results.
Jay
Posted by linkadge on August 3, 2022, at 21:28:11
In reply to Re: Retrying escitalopram » linkadge, posted by Jay2112 on August 3, 2022, at 21:02:40
To me effexor is puts me into a kind of military mode. I.e. I just power through problems and don't process them emotionally AT ALL. It makes me very focused on earning money and 'moving forward' with my life.
The problem is that, I am almost robotic. I don't feel anything.
Don't get me wrong. There are times in my life where this mode has been sorely needed. I have been an 'island' so to speak and wanted to keep it that way.
This past spring (out of the blue) I get hit with the most overwhelming sense of loneliness I can describe. This is something I've almost never felt before. Perhaps this is an early mid-life crisis. I don't know.
Basically, my depression keeps morphing. It's like it's an entity in and of itself that desperately wants to explore the darker side of life.
What I think is going on is this. I have never been able to process emotions in a healthy way. Unfortunately, the meds haven't really helped with that. So it's like my brain keeps swinging between numb and driven and 'emo' and paralyzed.
Linkadge
Posted by SLS on August 4, 2022, at 7:00:39
In reply to Retrying escitalopram, posted by linkadge on August 3, 2022, at 16:41:19
Linkadge.
I want to reiterate that my experiences with Pristiq and Effexor were not the same. I found Pristiq to feel milder than Effexor. It was less stimulating.
Of course, Pristiq might treat you as badly as At kinetic equilibrium, Effexor yields two active compounds: venlafaxine and desvenlafaxine.. However, when one takes Pristiq, the only active compound to be found in the blood stream is desvenlafaxine. It is possible that venlafaxine is the offensive drug, and not desvenlafaxine.
Another personal experience with medication is that 300 mg/day of lithium is absolutely necessary for the robust improvement in depression I am experiencing. In reality, it was dumb luck that I was taking lithium while combining the other three drugs I'm taking. My rationale for continuing it for almost a decade is that I wanted to attempt to prevent the emergence of Alzheimer's disease. In addition, whereas dosages of lithium 450 mg/day and higher makes my depression worse, 300 mg/day hits the bullseye. I experience *none* of the mental side effects that I experience at 450-1500 mg/day. This includes a cognitive numbing, affective blunting, and a passivity that feels much like apathy, but not exactly.
If low-dosage lithium is going to provide an improvement, it should show itself within 2-7 days at what will ultimately be your optimal dosage if you start at 300 mg/day and move up from there. According to the literature I have come across, 150 mg/day is not likely to produce a therapeutic response. However, given your sensitivity to so many drugs with respect to mental side effects, you might want to start at 150 mg/day and give each dosage increase 7 days before increasing it. Harvard played with adding low dosage lithium to Prozac 60 mg/day. The dosages used were 300-600 mg/day. The response rate for the combination of Prozac and lithium was higher, but not hugely so. However, if all of the subjects had been given 300-450 mg/day, I suspect that the response rate would have been higher.
The deleterious effects of lithium are dosage-dependent. The risk of major side effects are practically nil. Thyroid and kidney dysfunctions are not concerns of mine.
If low-dosage lithium is tolerable for you, I would suggest that you keep it in the background indefinitely. You never know what treatment you try will need lithium to work magic. As I've indicated, 300 mg /day of lithium is my sweet-spot. I relapse at 150 mg/day and 450 mg/day.
Sometimes, I think of lithium as being aspirin for the brain.
- Scott.
Posted by linkadge on August 4, 2022, at 7:48:26
In reply to Re: Retrying escitalopram » linkadge, posted by SLS on August 4, 2022, at 7:00:39
Hi SLS,
Thanks for the post. I am currently taking 300mg of lithium (although, more recently, I have been cutting this back to experiment).
I am also prescribed ritalin (20mg) and mirtazapine (7.5mg) as well as the mentioned escitalopram (5mg).
The real problem is that I am not taking these meds at the prescribed doses. So, in a sense I have not been compliant with my treatment.
BTW: I am not sure if you are still taking nortriptyline. If so, are you aware that it may have an anti-parkinson's effect? Nortriptyline has the unique ability to be able to declump alpha-synuclein which may make translate to protection from parkinson's and lewy bodies. You can do a google search (nortriptyline + parkinson's). I thought you might be interested if you're concerned about neurodegenerative diseases.
Linkadge
Posted by SLS on August 4, 2022, at 13:04:02
In reply to Re: Retrying escitalopram » SLS, posted by linkadge on August 4, 2022, at 7:48:26
Thank you, Linkadge.
I was not aware of that. I am still taking nortriptyline at a dosage of 100 mg/day. I relapse at 150 mg/day. I think people with chronic depressive disorders are more likely to contract a neurodegenerative disease than are healthy people. This includes Alzheimer's Disease. That's why I have stayed on a low dosage of lithium for all of these years. More recently, my mother contracted Alzheimer's, so it is a concern of mine.
- Scott
> Hi SLS,
>
> Thanks for the post. I am currently taking 300mg of lithium (although, more recently, I have been cutting this back to experiment).
>
> I am also prescribed ritalin (20mg) and mirtazapine (7.5mg) as well as the mentioned escitalopram (5mg).
>
> The real problem is that I am not taking these meds at the prescribed doses. So, in a sense I have not been compliant with my treatment.
>
> BTW: I am not sure if you are still taking nortriptyline. If so, are you aware that it may have an anti-parkinson's effect? Nortriptyline has the unique ability to be able to declump alpha-synuclein which may make translate to protection from parkinson's and lewy bodies. You can do a google search (nortriptyline + parkinson's). I thought you might be interested if you're concerned about neurodegenerative diseases.
>
> Linkadge
>
>
>
>
>
>
>
Posted by linkadge on August 4, 2022, at 17:25:04
In reply to Re: Retrying escitalopram, posted by SLS on August 4, 2022, at 13:04:02
I am sorry to hear about your mother. Unfortunately, my mother too has been recently diagnosed with either Alzheimer's (or severe dementia). It came on fairly rapidly (within the last 2 years). She is currently at a CAMH (Canadian Association of Mental Health) facility and getting good care. She is only 73. She has battled bipolar (with moderate success) for close to 40 years. She had some scans that showed severe atrophy in cortical and cerebellar regions.
As you mention there is a growing understanding of the links between mental illness and neurodegenerative diseases. My hunch is that inflammation plays a role. Some psych meds may reduce the risks, but others may make it worse.
I am personally concerned about the growing apathy I have been experiencing over the past 2 years (as this can be a prodromal symptom that can precede dementia by decades). I have also been experiencing RBD (rem sleep behavioral disorder) which is another flag.
I have kept lithium on board for this, but I have also been pursuing natural MAO-B inhibitors as they do seem to reduce the anhedonia. I also take co-q10, ginger root and a few others in hopes of reducing risks. I also exercise. But, alas many days it feels like I am losing the battle anyway.
Linkadge
Posted by SLS on August 4, 2022, at 20:02:12
In reply to Re: Retrying escitalopram, posted by linkadge on August 4, 2022, at 17:25:04
Hi, Linkadge.
How much lithium have you been taking?
I'll write more about Alzheimers later. I wanted you to see this, though.
"Forty seven severely depressed patients who failed to respond to 300-375 mg/day venlafaxine were, in addition, given lithium carbonate in low dosage (300-450 mg/day). The Clinical Global Impression Improvement scale was used as the treatment outcome. A score of 1 or 2 was considered as non-response. All patients gave informed consent to participate in the study. Ratings were performed at baseline and after 1,2 and 5 weeks. Lithium plasma concentration measurements were performed after 1 and 4 weeks. After 5 weeks of augmentation, 51% of the patients were rated as "much" or "very much" improved. Bipolar patients showed a better response than unipolar (64.3% vs 45.5%, p<0.038). Most patients (76%) showed a rapid response (up tp 7 days), and only 2 patients (4.6%) responded after more than 2 weeks The mean lithium plasma level was 0.33±0.09 mEq/L. "
https://pubmed.ncbi.nlm.nih.gov/22796912/
Also, regarding the bimodal effect of lithium on glutamate concentrations:Low Li+ = High GLU
High Li+ = Low GLUhttps://pubmed.ncbi.nlm.nih.gov/25522399/
- Scott
Posted by linkadge on August 4, 2022, at 21:06:36
In reply to Re: Retrying escitalopram » linkadge, posted by SLS on August 4, 2022, at 20:02:12
I'm just taking 300mg. Some days that feels like too much.
Lately, everything just seems to be making me feel more dead inside (lithium included unfortunately).
Linkadge
Posted by linkadge on August 4, 2022, at 21:07:37
In reply to Re: Retrying escitalopram » linkadge, posted by SLS on August 4, 2022, at 20:02:12
I'm only on 5mg and I already feel significantly worse. Numb as hell and really bad akathesia.
Linkadge
Posted by Jay2112 on August 4, 2022, at 23:46:38
In reply to Re: This was a mistake, posted by linkadge on August 4, 2022, at 21:07:37
Linkadge,
I am sorry you are feeling so bad. Perhaps you need some different meds to help? Have you tried Cogentin for your akathisia? There are tons of med combos to try. Did your gene test not tell you what the best meds for you may be? Do you use your cannabis every day? I am, and it works best at crushing the anxiety. Do you not take benzos? I know...there is the worry with dementia...I have the same worry. But I really think you need "here and now" anxiety relief, and a benzo WILL do that for you. What other meds have you tried??
Hospitalization is also another option. You DO have many options, and I know you are scared.But don't be afraid to experiment with different meds. I am far from perfect, and yes I have major financial fears as I am on poverty line gov't disability, but I am now actually considering part-time work to start. I don't have much material stuff, but I have a little kitty I love, food on my table, and a roof over my head. Do you know what mindfulness is? It's an excellent form of meditation, and will work when you get your meds straightened out. You know how to reach me if you want to talk.
Best,
Jay
Posted by undopaminergic on August 5, 2022, at 5:11:16
In reply to Re: Retrying escitalopram » linkadge, posted by Jay2112 on August 3, 2022, at 21:02:40
>
> I think this is especially useful if you have trauma in your life..and sounds similar as to what MDMA does. Ironic that both MDMA and escitalopram act strongly on serotonin.
>Why is it ironic?
-undopaminergic
Posted by undopaminergic on August 5, 2022, at 5:36:08
In reply to Re: This was a mistake » linkadge, posted by Jay2112 on August 4, 2022, at 23:46:38
> But I really think you need "here and now" anxiety relief, and a benzo WILL do that for you.
>It did nothing for me in terms of anxiety-relief. Opioids did but I never used them repeatedly.
The only effects I get from benzodiazepines is sleepiness and amnesia. Even the sleepiness didn't manifest last time I tried (temazepam) and the amnesia is also intermittent. Possibly, benzos (and alcohol) may lower the treshold for my alter personalities coming out (I have DID that is mostly dormant). I was told I vandalised my room at the hospital, but I have absolutely no memory of it; I remember taking a massive dose of clonazepam before (maybe up to a few days) it.
-undopaminergic
Posted by SLS on August 5, 2022, at 15:41:25
In reply to Re: This was a mistake, posted by linkadge on August 4, 2022, at 21:07:37
Hi, Linkadge.
> I'm only on 5mg and I already feel significantly worse. Numb as hell and really bad akathesia.
>
> Linkadge
Not a mistake. Just an act of desperation.Yours is a hard one to figure out. I did not like escitalopram, even though I got a few good days out of it. I found it numbing and simply didn't like how I felt. It was almost like I had a mild to moderate malaise. It was yucky.
I wonder if it's time for you to move away from serotonin reuptake inhibitors for awhile. Maybe just a vacation. You may have developed a sensitization (as happens with cocaine) to SRIs. However, that doesn't mean that other serotonergic modulating agents won't be effective. Receptor ligands, for example.
I think reducing your dosage of lithium from 300 mg/day to 150 mg/day is a worthwhile experiment. You can pay attention to both its therapeutic effect, and perhaps separate out mental side effects as being from either lithium or some other intervention. You might want to review your nutriceutical regime. Megadoses of calcium exacerbated my depression within an hour of taking it.
* I am thinking of adding DHEA for low testosterone levels and reduced libido. Do you know anything about it, or perhaps some other substances?
Thanks.Remain your vigilant self. Take a walk every now and then. I find that it clears my head.
- Scott
Posted by Jay2112 on August 5, 2022, at 16:07:10
In reply to Re: This was a mistake, posted by undopaminergic on August 5, 2022, at 5:36:08
> > But I really think you need "here and now" anxiety relief, and a benzo WILL do that for you.
> >
>
> It did nothing for me in terms of anxiety-relief. Opioids did but I never used them repeatedly.
>
> The only effects I get from benzodiazepines is sleepiness and amnesia. Even the sleepiness didn't manifest last time I tried (temazepam) and the amnesia is also intermittent. Possibly, benzos (and alcohol) may lower the treshold for my alter personalities coming out (I have DID that is mostly dormant). I was told I vandalised my room at the hospital, but I have absolutely no memory of it; I remember taking a massive dose of clonazepam before (maybe up to a few days) it.
>
> -undopaminergic
>Does cannabis work for you? I think you mentioned you have a schizoid disorder? Benzo's don't usually do anything for those with that type of illness. Benzo's do have proof of strong efficacy for anxiety and panic, overall, though. Low dose cannabis can do the same as well.
Jay
Posted by linkadge on August 5, 2022, at 17:15:44
In reply to Re: This was a mistake » undopaminergic, posted by Jay2112 on August 5, 2022, at 16:07:10
Basically, I just feel a sense that my life has no value and that if we're all going to die then what's the point of going on anyway. I just can't see any SSRI as being capable of changing that core belief. I seem completely incapable of making any meaningful connections. Don't worry. There are no plans on doing anything rash.
Linkadge
Posted by undopaminergic on August 6, 2022, at 10:17:26
In reply to Re: This was a mistake » undopaminergic, posted by Jay2112 on August 5, 2022, at 16:07:10
> > > But I really think you need "here and now" anxiety relief, and a benzo WILL do that for you.
> > >
> >
> > It did nothing for me in terms of anxiety-relief. Opioids did but I never used them repeatedly.
> >Actually I did use buprenorphine daily for a while. I just didn't associate that with anxiety or even pain relief.
> > The only effects I get from benzodiazepines is sleepiness and amnesia. Even the sleepiness didn't manifest last time I tried (temazepam) and the amnesia is also intermittent. Possibly, benzos (and alcohol) may lower the treshold for my alter personalities coming out (I have DID that is mostly dormant). I was told I vandalised my room at the hospital, but I have absolutely no memory of it; I remember taking a massive dose of clonazepam before (maybe up to a few days) it.
> >
> > -undopaminergic
> >
>
> Does cannabis work for you?I don't know, I've never tried it.
> I think you mentioned you have a schizoid disorder?
>I think I have schizoid personality disorder, which got diagnosed as Asperger's. And they say I have schizophrenia but I'm skeptical -- the psychoses I've had have not been very chronic, with or without antipsychotics. I do have persistent negative symptoms, but that could be better explained by the SPD, the depression, and the dissociative disorder.
I guess the schizoid tendency to solitariness is why I haven't tried cannabis. I've not been to many parties where I might have run into it, and I don't have many friends or acquaintance to introduce me to substances.
> Benzo's don't usually do anything for those with that type of illness.
>Interesting. I've come across a number of schizophrenics who find benzos helpful. Maybe SPD is different in that regard?
-undopaminergic
Posted by undopaminergic on August 6, 2022, at 10:21:31
In reply to Re: This was a mistake, posted by linkadge on August 5, 2022, at 17:15:44
> Basically, I just feel a sense that my life has no value and that if we're all going to die then what's the point of going on anyway. I just can't see any SSRI as being capable of changing that core belief. I seem completely incapable of making any meaningful connections.
>You might consider trying memantine. Under its influence (you do have to take enough, which may be more than conventional doses) I found meaningful connections everywhere. In retrospect, I regard it as some form of (hypo-)mania.
-undopaminergic
Posted by Jay2112 on August 6, 2022, at 13:26:08
In reply to Re: This was a mistake, posted by undopaminergic on August 6, 2022, at 10:17:26
> > > > But I really think you need "here and now" anxiety relief, and a benzo WILL do that for you.
> > > >
> > >
> > > It did nothing for me in terms of anxiety-relief. Opioids did but I never used them repeatedly.
> > >
>
> Actually I did use buprenorphine daily for a while. I just didn't associate that with anxiety or even pain relief.
>
> > > The only effects I get from benzodiazepines is sleepiness and amnesia. Even the sleepiness didn't manifest last time I tried (temazepam) and the amnesia is also intermittent. Possibly, benzos (and alcohol) may lower the treshold for my alter personalities coming out (I have DID that is mostly dormant). I was told I vandalised my room at the hospital, but I have absolutely no memory of it; I remember taking a massive dose of clonazepam before (maybe up to a few days) it.
> > >
> > > -undopaminergic
> > >
> >
> > Does cannabis work for you?
>
> I don't know, I've never tried it.
>I only started using it once it became legal here in Canada. I don't smoke, so they make them in little capsules, with THC and CBD. I was afraid of it triggering a psychosis, so I started low, and pretty much stay at a low dose.
> > I think you mentioned you have a schizoid disorder?
> >
>
> I think I have schizoid personality disorder, which got diagnosed as Asperger's. And they say I have schizophrenia but I'm skeptical -- the psychoses I've had have not been very chronic, with or without antipsychotics. I do have persistent negative symptoms, but that could be better explained by the SPD, the depression, and the dissociative disorder.I was diagnosed as being on the ASD spectrum when I was very young, but this was before it was more widely explored these days. I know you said you didn't respond well to Risperdal, as that is often the go-to med for autism. But, I have a good friend, also autistic, who did not respond to Risperdal. How about Abilify? It has that D2 partial agonism..which actually turned up my irritability. Any older antipsychotics? Haldol, etc? Is your DID really problematic? I know it may seem 'odd' to some, but as long as it's not causing you any distress, do you really have to worry about it?
> I guess the schizoid tendency to solitariness is why I haven't tried cannabis. I've not been to many parties where I might have run into it, and I don't have many friends or acquaintance to introduce me to substances.
>The solitary aspect, for sure...I honestly thought that was part of my autism. My social anxiety, unmedicated, is through the roof!! Growing up, I was as 'square' as they come. I had just one or two friends, and we often sat in our parent's basements, played D&D, drank soda, and ordered out for pizza's. lol.
> > Benzo's don't usually do anything for those with that type of illness.
> >
>
> Interesting. I've come across a number of schizophrenics who find benzos helpful. Maybe SPD is different in that regard?Again, no hard and fast rules, but I have worked with a lot of kids with SPD, and ASD, and benzo's brought out the worst in many, with their relaxing inhibition. I honestly think it's possibly genetics, and for some AP's calm them, and some benzo's calm.
So, what meds/drugs have helped you best? You mentioned Latuda before. Did that poop out on you?
> -undopaminergic
>Jay
Posted by linkadge on August 7, 2022, at 7:56:43
In reply to Re: This was a mistake, posted by undopaminergic on August 6, 2022, at 10:21:31
I hear what you are saying, but unfortunately (here in Canada) it is next to impossible to access a psychiatrist (don't believe the 'free health care crap', our system is a disaster right now). Anyhow, I am working with a GP who is afraid to prescribe anything but (essentially) escitalopram.
Linkadge
Posted by linkadge on August 7, 2022, at 8:01:07
In reply to Re: This was a mistake, posted by linkadge on August 7, 2022, at 7:56:43
When you go on to pubmed, every single friggen study seems to suggest that escitalopram is God's gift to psychiatry. It's better than this.....it's better than that. It's got no side effects. 90% of patients have a full remission. It beats venlafaxine. It beats everything....
How can this miracle seem like such garbage to me?
Posted by undopaminergic on August 7, 2022, at 8:15:21
In reply to Re: This was a mistake » undopaminergic, posted by Jay2112 on August 6, 2022, at 13:26:08
>
> > > I think you mentioned you have a schizoid disorder?
> > >
> >
> > I think I have schizoid personality disorder, which got diagnosed as Asperger's. And they say I have schizophrenia but I'm skeptical -- the psychoses I've had have not been very chronic, with or without antipsychotics. I do have persistent negative symptoms, but that could be better explained by the SPD, the depression, and the dissociative disorder.
>
> I was diagnosed as being on the ASD spectrum when I was very young, but this was before it was more widely explored these days. I know you said you didn't respond well to Risperdal, as that is often the go-to med for autism.
>I was prescribed Risperdal for a presumed problem with obsessive perfectionism. It was the worst neuroleptic I've tried; it stimulated appetite but the worst thing was that it made me feel weak. However, that was a long time ago (decades) so I would probably not have the same reaction today.
> But, I have a good friend, also autistic, who did not respond to Risperdal. How about Abilify?
>No effect, other than disturbing my accomodation (focussing the eyes) and apparently stimulating salivation.
> It has that D2 partial agonism..which actually turned up my irritability. Any older antipsychotics? Haldol, etc?
>I tried haloperidol for a short time. I did not notice an effect, but the dose was probably low.
> Is your DID really problematic? I know it may seem 'odd' to some, but as long as it's not causing you any distress, do you really have to worry about it?
>The switching is not a problem, as it generally happens less than once a year, and indeed I would like it to happen more often, maybe just to make life more exciting. The dissociation is a problem, however, because it keeps me from recalling important (but undoubtedly unpleasant) memories of traumatic experiences, and it gives me depersonalisation and derealisation, which means my experience of reality is watered down as if in a movie, and I'm emotionally numbed.
> > I guess the schizoid tendency to solitariness is why I haven't tried cannabis. I've not been to many parties where I might have run into it, and I don't have many friends or acquaintance to introduce me to substances.
> >
>
> The solitary aspect, for sure...I honestly thought that was part of my autism. My social anxiety, unmedicated, is through the roof!! Growing up, I was as 'square' as they come. I had just one or two friends, and we often sat in our parent's basements, played D&D, drank soda, and ordered out for pizza's. lol.
>My social anxiety used to be pretty bad -- I was extremely shy, but it's been getting better with time, especially after I had my first psychosis.
> > > Benzo's don't usually do anything for those with that type of illness.
> > >
> >
> > Interesting. I've come across a number of schizophrenics who find benzos helpful. Maybe SPD is different in that regard?
>
> Again, no hard and fast rules, but I have worked with a lot of kids with SPD, and ASD, and benzo's brought out the worst in many, with their relaxing inhibition. I honestly think it's possibly genetics, and for some AP's calm them, and some benzo's calm.
>Amphetamine-like stimulants (in my case phenylethylamine (PEA) with selegiline) calm me down amazingly, at least if I don't take them chronically. This is one of the things that suggest I have ADHD.
> So, what meds/drugs have helped you best? You mentioned Latuda before. Did that poop out on you?
>Yes, I tried Latuda. It didn't poop out, but in fact I'm not sure it had any effect at all. The most effective drug treatment was a combination of methylphenidate (Concerta) and buprenorphine. Stimulants in general make me feel better, and also help me intellectually (I get a lot more interesting ideas). I've encountered some one hit (or few hits) wonders, including sulpiride (stronger stimulant response than methylphenidate!) and pramipexole (the only relief from anhedonia).
-undopaminergic
Posted by undopaminergic on August 7, 2022, at 8:22:51
In reply to Re: The most annoying part, posted by linkadge on August 7, 2022, at 8:01:07
> When you go on to pubmed, every single friggen study seems to suggest that escitalopram is God's gift to psychiatry. It's better than this.....it's better than that. It's got no side effects. 90% of patients have a full remission. It beats venlafaxine. It beats everything....
>
> How can this miracle seem like such garbage to me?
>Frankly I believe it's a case of particularly successful marketing on the part of Lundbeck and its partners.
-undopaminergic
Posted by linkadge on August 7, 2022, at 12:30:55
In reply to Re: The most annoying part, posted by undopaminergic on August 7, 2022, at 8:22:51
That would be my hunch too, except the fact that there are many (seemingly independent) studies confirming the finding.
Linkadge
Posted by Jay2112 on August 7, 2022, at 15:33:26
In reply to Re: The most annoying part, posted by linkadge on August 7, 2022, at 12:30:55
> That would be my hunch too, except the fact that there are many (seemingly independent) studies confirming the finding.
>
> LinkadgeI think the biggest problem us the lack of "real world" studies. There they can't fudge the numbers in their fav.
Jay
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