4 ms·

Yup. There's too much institutional inertia to adopt evidence-based approaches. I've tried 19 antidepressants over about 15 years. Stuck with mirtazapene-induc

• tcj_phx 1y ago
  "Institutional inertia" is a great term, thanks. > 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. My comments on this thread might be helpful: https://news.ycombinator.com/item?id=46000812 https://news.ycombinator.com/item?id=46000812