3 ms·

Much salt: “fluoxetine pretreatment” “in a mouse model of sepsis.” I’d be interested to see how this holds up in EHR data with the caveat that anyone with ment

by fny 2y ago

Much salt: “fluoxetine pretreatment” “in a mouse model of sepsis.” I’d be interested to see how this holds up in EHR data with the caveat that anyone with mental health issues likely has a million confounders. I’m not even sure how this would be implemented in practice: at what point would patients be given SSRIs?

criddell 2y ago
Are there any signals that a person may be in danger of developing sepsis? If so, wouldn't that be the time to consider prescribing fluoxetine?
- readthenotes1 2y ago
  Apparently 15% of cases start in hospital so that would be one signal https://www.verywellhealth.com/sepsis-while-hospitalized-8584171 https://www.verywellhealth.com/sepsis-while-hospitalized-858...
  - Pxtl 2y ago
    There's probably a whole cocktail of meds that should be administered when somebody is admitted, considering that hospitals are kind of inherently dangerous and people who are admitted are there because they're in a vulnerable state. ... well, the other thing that comes to mind like that is staph infections, but I guess preemptively giving everybody antibiotics to prevent that would be a good way to breed superbugs.
cogman10 2y ago
Yeah, seems like an easyish study to do. "Does EHR data show that patients on Prozac have a lower mortality rate from sepsis than the general population." > I’m not even sure how this would be implemented in practice: at what point would patients be given SSRIs? Perhaps right before and after a surgery when infection is possible?
- BobbyJo 2y ago
  Fluoxetine has an insanely long half life, and your brain is sensitive to its affects. Not really a viable option for acute treatment.
  - cogman10 2y ago
    > Fluoxetine has an insanely long half life The half life is 7 days. > your brain is sensitive to its affects. It takes time for SSRIs to take effect. Acute usage is probably ideal as you wouldn't be dealing with withdraw symptoms.
    - BobbyJo 2y ago
      1) 7 days is a long time. 2) I believe you are confusing the common progressive dosage regimens with delayed effects. The reason fluoxetine typically takes time before you feel effects is because you take a small daily dose that build up in your system over time. It builds up since dosing is more frequent than the drugs half life. 3) Acute intake is associated with side effects, not just acute withdrawal.

by fny 2y ago

criddell 2y ago

Are there any signals that a person may be in danger of developing sepsis? If so, wouldn't that be the time to consider prescribing fluoxetine?

readthenotes1 2y ago
Apparently 15% of cases start in hospital so that would be one signal https://www.verywellhealth.com/sepsis-while-hospitalized-8584171 https://www.verywellhealth.com/sepsis-while-hospitalized-858...
- Pxtl 2y ago
  There's probably a whole cocktail of meds that should be administered when somebody is admitted, considering that hospitals are kind of inherently dangerous and people who are admitted are there because they're in a vulnerable state. ... well, the other thing that comes to mind like that is staph infections, but I guess preemptively giving everybody antibiotics to prevent that would be a good way to breed superbugs.

cogman10 2y ago

Yeah, seems like an easyish study to do. "Does EHR data show that patients on Prozac have a lower mortality rate from sepsis than the general population." > I’m not even sure how this would be implemented in practice: at what point would patients be given SSRIs? Perhaps right before and after a surgery when infection is possible?

BobbyJo 2y ago
Fluoxetine has an insanely long half life, and your brain is sensitive to its affects. Not really a viable option for acute treatment.
- cogman10 2y ago
  > Fluoxetine has an insanely long half life The half life is 7 days. > your brain is sensitive to its affects. It takes time for SSRIs to take effect. Acute usage is probably ideal as you wouldn't be dealing with withdraw symptoms.
  - BobbyJo 2y ago
    1) 7 days is a long time. 2) I believe you are confusing the common progressive dosage regimens with delayed effects. The reason fluoxetine typically takes time before you feel effects is because you take a small daily dose that build up in your system over time. It builds up since dosing is more frequent than the drugs half life. 3) Acute intake is associated with side effects, not just acute withdrawal.