tcj_phx

> I've tried 19 antidepressants over about 15 years. Stuck with mirtazapene [...]

Have you tried any anti-serotonin interventions? (chatbot in comment link below)

Mirtazapene is a "tetracyclic antidepressant". I think the development of antidepressants went MAOI -> Tricyclic -> tetracyclic -> SSRI. My chatbot transcript said the SSRI's are marginal drugs, but "SSRIs are much safer in overdose" than the earlier drugs.

My understanding is that the MAOIs were reasonably-effective at bringing people out of an acute depression, but they interacted with high-tyramine foods (fine cheese, etc) to cause high blood pressure. Reversible MAOIs are less problematic than the non-reversible ones. Methylene Blue [MB] is the most ubiquitous of the reversible MAOIs. I felt a definite warming effect with my first MB microdose (a fraction of a milligram), but I've never noticed anything from larger doses.

Because this class of drugs was so heavily promoted for such a long time, the side effects have always been swept under the rug.

My comment above proposed that the 11yo girl's depression could actually be caused by precocious puberty. Another possibility is that she's a poor methylator (#MTHFR) who's poisoned by fortified flour and other sources of shelf-stable provitamins.

I haven't yet found a comprehensive SSRI-truth resource that makes SSRI advocates pause their advocacy, so I just shared the chatbot link. This was supposed to provide the father enough of the background terms and anti-SSRI thinking for him to search for his own resources.

Someone else posted a link to "The serotonin theory of depression: a systematic umbrella review of the evidence" [2022] at Nature [1]. This is okay, but it still dances around the core issue: whether ECT and Serotonin-enhancers sometimes benefit people because of how the brain responds to brain damage.

> Somehow, I doubt there is much motivation to look for economically inconvenient and unnerving side-effects in some demographics,

Robert Whitaker examined the pharmaceutical industry's ideological capture of conventional psychiatry in his third book, Psychiatry Under the Influence.

> That's a hell of a claim, which could use some evidence.

My experience with the chatbots is that they start with the conventional marketing tropes, but if you ask pointed questions they'll dig into the actual research.

This thread started with a generic question about why ECT seemed to help some patients. It had a really good reasoning about why SSRIs are still the first-line treatment for depression, even though the MAOIs were much better drugs.

Dr. Palmer recommends the ketogenic diet, but not all people need this specific intervention to improve their metabolism. I think the best place to start for most people is simply eliminating their consumption of white flour, or at the least, fortified white flour [2].

Dr. Palmer tweeted about anemia and Vitamin B-12 deficiency [3]. Many patients are prescribed synthroid (T4) for their thyroid, but they often still have all the symptoms of hypothyrodism because their body doesn't activate T4 -> T3. Adding a source of T3 to patients' Synthroid treatment can make a big difference in their behavioral symptoms.

I have a book by some psychiatrists who were active in the 1940's -> 1950's, which is before the first 'psychiatric' medications were released. I didn't know this book was compiled by psychiatrists when I ordered it - I thought it was going to be a general book about the pro-metabolic intervention.

It's unfortunate that the prescription drug industry never figured out why some of their chemicals help with the symptoms labeled 'depression'. The MAOIs were reasonably-effective at helping acutely-depressed people out of bed. Each generation of antidepressants was less effective than the previous, until the SSRI's arrived. Now we're stuck with antidepressants that have always been known to cause people to commit suicide. At least the psychiatrists are now revisiting MAOIs as an option for people who don't respond well to the suicide pills (SSRIs).

Antipsychotics are a tragedy: anti-dopamine drugs make patients feel terrible. The one exception to the anti-treatment received by psychotics is an anti-serotonin drug approved for parkinsons psychosis [4].

Most states had AMA-approved licensing laws by the early 1900's. After outlawing competition, the Carnegie foundation (a proxy for the early pharmaceutical industry) financed the Flexner Report (1910) to help the M.D.s improve their standards for medical education. The report said, essentially, that all medical schools should be like John Hopkins.

The Doctors of Osteopathy (D.O.) was the only medical philosophy that was organized enough to secure equivalent licensing laws. Osteopathy founder A.T. Still required his students to at least be aware of pharmaceutical options as a 'last resort' for their patients. The modern D.O. license is legally equivalent to the M.D. license.

The AMA standardized on "allopathic medicine". While a lot of progess has been made at understanding and improvinghuman health, modern medicine still has sacred cows, which are quite profitable for the medical-industrial complex (Statin drugs, anti-dopamine drugs, overuse of steroids, etc).

At least modern doctors only bleed people when it's a useful treatment - for hemochromatosis (excess iron stores) and the use of leeches for limb reattachment, etc.

Most of the "mental health" diagnoses have to do with metabolic problems. Emotional stress is one of the drains on the body's energy reserves.

Chris Palmer MD wrote a book [0] about how he discovered 70+ years of research establishing that mental health conditions are caused by metabolic deficiencies. Dr. Palmer's book documents his patients responding well to a ketogenic diet, but there are plenty of other interventions that can improve metabolism.

Emotional and physical stress increases the brain's use of glucose.

Alcohol has 7 calories per gram. I think the main use of alcohol in the brain is as acetate (vinegar) - that is, Ethanol is transformed by the liver into acetate, which is one of the brain's alternative fuel sources.

For people with broken metabolisms, ethanol also provides calories to allow their brain to function.