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Correction: they work _for you_. This may sound pedantic but I see this blanket assertion all the time from people who take psych meds and have them work for t

by dimal 2y ago

Correction: they work _for you_. This may sound pedantic but I see this blanket assertion all the time from people who take psych meds and have them work for them. There is a very large group of people for whom they do not work, and others in which they cause serious harm. I’m glad they work for you, but please don’t assume that they work for everyone. They don’t.

burnished 2y ago
Thats clear from context, not every personal account needs the PSA, especially since your access is mediated by layers of professionals.
- dimal 2y ago
  I disagree. It’s not clear from the context. People often generalize their experiences to think they apply to everyone. With psych meds, this is very common. I don’t expect a PSA, just a recognition that “they work” cannot be stated as an absolute. I don’t know what you mean by access being mediated by layers of professionals.
  - burnished 2y ago
    You have to first see a doctor who will prescribe the medication followed by a pharmacist. I don't see a claim by OP that their experience generalizes absolutely. I'm also having a hard time seriously believing you don't think people are aware that folk can have varied reactions, people become aware of allergies as a concept usually well before psychiatric medication. Just to be clear - I don't mind you adding in that additional context/reminder, I think additional perspective like that is frequently helpful, but I do resent you demanding others add it in your stead like they've missed an obligation or made a mistake.
- esperent 2y ago
  > mediated by layers of professionals. In the developed world, yes. In much of the world (perhaps even most of the world) you can simply walk into a small local pharmacy and buy pretty much anything. Antidepressants, valium, antibiotics, whatever. Only uppers tend to have stricter controls, but I've heard you could find them with a bit of legwork.
hnpolicestate 2y ago
"There is a very large group of people for whom they do not work" - many people are unwilling to wait the proper amount of time "4-6 weeks" for efficacy to manifest *especially* when for the first 2-3 weeks you many times feel much worse than baseline. First month on Effexor made me feel miserable. More anxious but much, much more irritable and depressed. Then one day a month in I'm sitting at my desk and I suddenly feel high as a kite lol. Melting bliss. That feeling too fades and then you just feel better than baseline until you build tolerance to current dose. Raise, rinse and repeat. Better than having to be near an exit whenever inside a structure!
- heavyset_go 2y ago
  Doctors I've talked to have said it's 4 to 6 weeks to reach a baseline, where the medication reaches a steady level in the blood and receptor changes in the brain reach a new equilibrium, but even up to 2+ months for the real effect to kick in. Those 4-6 weeks are when your brain is adapting to an ever increasing serum level of antidepressants, and it takes about ~2 weeks for serotonin receptors to downregulate in response. That time can be very uncomfortable, specifically because SSRIs indirectly activate 5HT2C, leading to dysphoria, anxiety, etc, before the receptor is sufficiently downregulated. tl;dr: it can take longer than 4-6 weeks for efficacy to manifest
  - mylastattempt 2y ago
    This is what I've heard from those I know that take anti depressants - the time that is suggested before you would be able to look back and say: "I'm doing much better than four weeks ago", is a bit daunting. First and foremost because you take them at a point in your life where you're, well, depressed (used as a blanket term here). So patiently waiting for the effect to manifest is a burden in itself, in addition to hoping it works and not being sure if you're experiencing a placebo or actual effect. But what scares me more, personally, is that it takes such a long time to get on and ween off. It seems to fundamentally change something in the human body or brain. As opposed to e.g. amphetamines, and benzos, which may have long lasting effects from prolonged use, but otherwise appear to be pretty straight forward. Having never needed antidepressants, I'm curious if others who have taken them, worried about this before or afterwards?
olyjohn 2y ago
This is the same for every drug. None of them work the same for everybody all the time. Like they say everybody is different.

by dimal 2y ago

burnished 2y ago

Thats clear from context, not every personal account needs the PSA, especially since your access is mediated by layers of professionals.

dimal 2y ago
I disagree. It’s not clear from the context. People often generalize their experiences to think they apply to everyone. With psych meds, this is very common. I don’t expect a PSA, just a recognition that “they work” cannot be stated as an absolute. I don’t know what you mean by access being mediated by layers of professionals.
- burnished 2y ago
  You have to first see a doctor who will prescribe the medication followed by a pharmacist. I don't see a claim by OP that their experience generalizes absolutely. I'm also having a hard time seriously believing you don't think people are aware that folk can have varied reactions, people become aware of allergies as a concept usually well before psychiatric medication. Just to be clear - I don't mind you adding in that additional context/reminder, I think additional perspective like that is frequently helpful, but I do resent you demanding others add it in your stead like they've missed an obligation or made a mistake.
esperent 2y ago
> mediated by layers of professionals. In the developed world, yes. In much of the world (perhaps even most of the world) you can simply walk into a small local pharmacy and buy pretty much anything. Antidepressants, valium, antibiotics, whatever. Only uppers tend to have stricter controls, but I've heard you could find them with a bit of legwork.

hnpolicestate 2y ago

"There is a very large group of people for whom they do not work" - many people are unwilling to wait the proper amount of time "4-6 weeks" for efficacy to manifest *especially* when for the first 2-3 weeks you many times feel much worse than baseline. First month on Effexor made me feel miserable. More anxious but much, much more irritable and depressed. Then one day a month in I'm sitting at my desk and I suddenly feel high as a kite lol. Melting bliss. That feeling too fades and then you just feel better than baseline until you build tolerance to current dose. Raise, rinse and repeat. Better than having to be near an exit whenever inside a structure!

heavyset_go 2y ago
Doctors I've talked to have said it's 4 to 6 weeks to reach a baseline, where the medication reaches a steady level in the blood and receptor changes in the brain reach a new equilibrium, but even up to 2+ months for the real effect to kick in. Those 4-6 weeks are when your brain is adapting to an ever increasing serum level of antidepressants, and it takes about ~2 weeks for serotonin receptors to downregulate in response. That time can be very uncomfortable, specifically because SSRIs indirectly activate 5HT2C, leading to dysphoria, anxiety, etc, before the receptor is sufficiently downregulated. tl;dr: it can take longer than 4-6 weeks for efficacy to manifest
- mylastattempt 2y ago
  This is what I've heard from those I know that take anti depressants - the time that is suggested before you would be able to look back and say: "I'm doing much better than four weeks ago", is a bit daunting. First and foremost because you take them at a point in your life where you're, well, depressed (used as a blanket term here). So patiently waiting for the effect to manifest is a burden in itself, in addition to hoping it works and not being sure if you're experiencing a placebo or actual effect. But what scares me more, personally, is that it takes such a long time to get on and ween off. It seems to fundamentally change something in the human body or brain. As opposed to e.g. amphetamines, and benzos, which may have long lasting effects from prolonged use, but otherwise appear to be pretty straight forward. Having never needed antidepressants, I'm curious if others who have taken them, worried about this before or afterwards?

olyjohn 2y ago

This is the same for every drug. None of them work the same for everybody all the time. Like they say everybody is different.