4 ms·

My theory is that most people are taking the wrong antidepressants. I've been depressed for most of my life. It took decades before doctors would prescribe ant

My theory is that most people are taking the wrong antidepressants. I've been depressed for most of my life. It took decades before doctors would prescribe anti-depressants and I struggled trying to find one that worked. It wasn't until I took a DNA test that was specifically developed to help determine if/how one's genes were biased towards/against specific drugs. In my case, all of the ones I had tried so far were listed under "consider alternates" because I have a gene CYP2C19 that metabolizes them faster than other people. What I & my doctors did, was switch drugs until I found one that worked "good enough". I should have taken this DNA test years ago. It cost me $150 out of pocket.

cjbgkagh 4y ago
1000% get sequenced! Should be step number one for everyone. It’s now $200 for a high quality whole genome sequence where you can do all DNA tests simultaneously as well as future tests being developed. We’re walking bags of pathogenic rare conditions.
kar5pt 4y ago
What DNA test did you take?
DaftDank 4y ago
Out of curiosity, which test/company did you go with? A quick search reveals a lot of options, and I'm hoping you may have done some of the legwork already to determine if one is better than others for privacy reasons etc.?
- sandos 4y ago
  I don't know the answer, but as far as I know, 23andme seems to be the most focused on medical conditions?
  - mtlmtlmtlmtl 4y ago
    23andme is little more than a grift to steal your genetic data, providing some vaguely interesting, possibly untrue information in return.
    - cjbgkagh 4y ago
      DNA privacy has already been defeated. In North America it’s pretty easy to find first cousin level relatives by DNA which really shrinks the target pool especially if you find first cousins from different sides of the family.
- Tangurena2 4y ago
  The printout I have in front of me says "Medical Diagnostic Laboratories". Their website gives no info about the "pharmacodynamics" test other than one PDF about how to swab the saliva for it. I had read about it and discussed it with my physician. She ordered it. 0 - https://www.mdlab.com/ https://www.mdlab.com/
sph 4y ago
Depression is such a generic symptom it's often confused with a disease. I maintain that it is not. There are a ton of things that cause depression, and often psychiatrists just prescribe an anti-depressant and off you go, especially in countries where doctors have an incentive to medicate people instead of curing them. I've been mildly anxious and depressed all my life, and it's gotten worse in the past few years. Then I learned I might have ADHD, got diagnosed, medicated with a stimulant, and I'm not depressed anymore. I am pretty sure if I had gone to a psychiatrist instead of investing into long term therapy with a psychologist (that eventually suspected I might have ADHD), I would have probably been given an SSRI and sent on my way. I hate imagining how my life would have turned out, yet the sad stories of undiagnosed ADHD sufferers put on SSRI are very common.
- semeliussemper 4y ago
  Yes, a lot of times people think depression is an illness whereas in fact it is a symptom. It was actually scary to see how easily you can get antidepressants once you mention depression and anxiety. I refused any type of medications because I don't believe there is anything wrong "technically" with my brain, if you gave me $10k it would be perfectly capable of producing hormones of happiness - see no medications were consumed but just the idea of having more money made the brain produce chemicals, so changing the perception of how we see things is crucial imo. I believe only a fraction of clinical cases require antidepressants e.g. major depressive syndrome etc in most cases therapy is the way to go but it is expensive and people don't generally like it they would rather take medications. I think I've made a great deal of progress just being in therapy, practicing meditation, healthy diet etc
- roflyear 4y ago
  Being sad or sad often is not depression. Depression is a varying level of not being able to be happy even during happy events.
- malyalar 4y ago
  The comorbidity of anxiety/depression and ADHD can certainly be hard to disambiguate so I’m sorry it took so long to find the right treatment, but it’s also great that you’ve got it now. I do want to point out that a psychiatrist would perform a targeted history of your presentation and mental status exam, and might very well have provided the “correct” diagnosis much sooner—these people do more than prescribe medications on their first hunch. It generally wouldn’t take two years to do a generic review of mental status symptoms. A GP on the other hand might be more pressed with less time to prescribe an SSRI or medication of a related class and put in a referral.
phphphphp 4y ago
There’s wide range of anti-depressants and many different treatment strategies, including dosage variance. Metabolisation tests may be helpful in some cases to determine if a drug may behave in unintended ways in your body but that doesn’t mean the drug isn’t part of a valuable treatment strategy for you. The process of experimenting with different treatments for mental health conditions isn’t about finding which drugs your body is most capable of metabolising, rather, it’s to find which treatment meets your mental health needs. A drug may have severe physical side effects but address your mental health symptoms so effectively that the treatment is worth it: a gene test won’t highlight that. Unfortunately, we don’t really know why some treatments work for some people and others do not: if you’ve got dozens of options, and not enough time to test them all, then a dna test to rule out a bunch is probably going to be helpful (since you’d have to skip some anyway!) but it’s definitely not a case of, everyone should do these tests before deciding whether a treatment is right for them.

cjbgkagh 4y ago

1000% get sequenced! Should be step number one for everyone. It’s now $200 for a high quality whole genome sequence where you can do all DNA tests simultaneously as well as future tests being developed. We’re walking bags of pathogenic rare conditions.

kar5pt 4y ago

What DNA test did you take?

DaftDank 4y ago

Out of curiosity, which test/company did you go with? A quick search reveals a lot of options, and I'm hoping you may have done some of the legwork already to determine if one is better than others for privacy reasons etc.?

sandos 4y ago
I don't know the answer, but as far as I know, 23andme seems to be the most focused on medical conditions?
- mtlmtlmtlmtl 4y ago
  23andme is little more than a grift to steal your genetic data, providing some vaguely interesting, possibly untrue information in return.
  - cjbgkagh 4y ago
    DNA privacy has already been defeated. In North America it’s pretty easy to find first cousin level relatives by DNA which really shrinks the target pool especially if you find first cousins from different sides of the family.
Tangurena2 4y ago
The printout I have in front of me says "Medical Diagnostic Laboratories". Their website gives no info about the "pharmacodynamics" test other than one PDF about how to swab the saliva for it. I had read about it and discussed it with my physician. She ordered it. 0 - https://www.mdlab.com/ https://www.mdlab.com/

sph 4y ago

Depression is such a generic symptom it's often confused with a disease. I maintain that it is not. There are a ton of things that cause depression, and often psychiatrists just prescribe an anti-depressant and off you go, especially in countries where doctors have an incentive to medicate people instead of curing them. I've been mildly anxious and depressed all my life, and it's gotten worse in the past few years. Then I learned I might have ADHD, got diagnosed, medicated with a stimulant, and I'm not depressed anymore. I am pretty sure if I had gone to a psychiatrist instead of investing into long term therapy with a psychologist (that eventually suspected I might have ADHD), I would have probably been given an SSRI and sent on my way. I hate imagining how my life would have turned out, yet the sad stories of undiagnosed ADHD sufferers put on SSRI are very common.

semeliussemper 4y ago
Yes, a lot of times people think depression is an illness whereas in fact it is a symptom. It was actually scary to see how easily you can get antidepressants once you mention depression and anxiety. I refused any type of medications because I don't believe there is anything wrong "technically" with my brain, if you gave me $10k it would be perfectly capable of producing hormones of happiness - see no medications were consumed but just the idea of having more money made the brain produce chemicals, so changing the perception of how we see things is crucial imo. I believe only a fraction of clinical cases require antidepressants e.g. major depressive syndrome etc in most cases therapy is the way to go but it is expensive and people don't generally like it they would rather take medications. I think I've made a great deal of progress just being in therapy, practicing meditation, healthy diet etc
roflyear 4y ago
Being sad or sad often is not depression. Depression is a varying level of not being able to be happy even during happy events.
malyalar 4y ago
The comorbidity of anxiety/depression and ADHD can certainly be hard to disambiguate so I’m sorry it took so long to find the right treatment, but it’s also great that you’ve got it now. I do want to point out that a psychiatrist would perform a targeted history of your presentation and mental status exam, and might very well have provided the “correct” diagnosis much sooner—these people do more than prescribe medications on their first hunch. It generally wouldn’t take two years to do a generic review of mental status symptoms. A GP on the other hand might be more pressed with less time to prescribe an SSRI or medication of a related class and put in a referral.

phphphphp 4y ago

There’s wide range of anti-depressants and many different treatment strategies, including dosage variance. Metabolisation tests may be helpful in some cases to determine if a drug may behave in unintended ways in your body but that doesn’t mean the drug isn’t part of a valuable treatment strategy for you. The process of experimenting with different treatments for mental health conditions isn’t about finding which drugs your body is most capable of metabolising, rather, it’s to find which treatment meets your mental health needs. A drug may have severe physical side effects but address your mental health symptoms so effectively that the treatment is worth it: a gene test won’t highlight that. Unfortunately, we don’t really know why some treatments work for some people and others do not: if you’ve got dozens of options, and not enough time to test them all, then a dna test to rule out a bunch is probably going to be helpful (since you’d have to skip some anyway!) but it’s definitely not a case of, everyone should do these tests before deciding whether a treatment is right for them.