My usual warning when these stories reach the front page: If you feel you might need medical help for a mental illness, please don't let stories like this dissu

My usual warning when these stories reach the front page: If you feel you might need medical help for a mental illness, please don't let stories like this dissuade you from seeking appropriate care. The author notes that the medications were effective at treating their condition. Too many people delay necessary treatment for years for fear of side effects, only to later discover that their underlying depression was far worse than any medication side effects. Medications aren't perfect, but untreated depression is no joke. The author's experience is also unlikely to match the average patient's, as their medications were also chosen to treat their very painful trigeminal neuralgia. That said, it's strange that the author's doctors didn't notice this earlier. The topic of which antidepressants cause somnolence is hardly new research. Even the author's own doctor knew that Medication 2 was responsible for the daytime sleepiness. I suspect they may have underestimated the degree of fatigue reported by the patient. From the article: > I did in fact know that fatigue was a possible side effect of the medication, but I was taking it off label at a drastically lower dosage than is typically prescribed (<1/20th), so it didn’t seem very applicable Counterintuitively, some medications are more sedating at lower doses than higher doses. Trazodone, for example, is frequently used for insomnia at low doses when taken only at night, but can also be an effective antidepressant at higher doses when taken multiple times per day. Mirtazapine is another example of a medication that can be very sedating at lower doses but become activating at higher doses. Low doses primarily antagonize the histamine H1 receptor (similar to antihistamines like Benadryl), while higher doses activate a wider range of receptors that can become stimulatory. With pharmacology, it's not safe to assume that a lower dose of a drug simply produces reduced effects relative to a full dose. The effects can change throughout the dosage range.