Millions Use Antidepressants. We Still Don't Understand How They Work | Hacker News Reader

Millions Use Antidepressants. We Still Don't Understand How They Work

nytimes.com

9 pointsgumby9 comments

Is there an argument that anything whose workings are not understood should not be on the market?

If, for a generally known population, it causes positive result and does not have too many (and all tolerable) negative side effects, why not use it?

If you think of all of biology as being an area about the size of the surface of our Sun, all of human biological knowledge would take up about a square millimeter. We're still in the stone knives and bearskins era, especially in neurology, the topic of the posted article.

Prozac was the revolutionary, groundbreaking, miraculous cure for depression. The first in its class of "SSRIs" where the makers told fairy-tales of serotonin as a neurotransmitter (ignoring that over 80% of it is found in the GI tract). Patients, caregivers, and especially prescribers are wont to believe fairy tales when they are dressed up in scientific jargon, even when they diverge completely from the realities of biochemistry that we know.

In reality, Prozac is fluoride. That is its active ingredient: fluoride. So, if you're fluoridating your water supply, and using fluoride toothpaste, and taking Prozac, all of these modalities are essentially delivering the same molecule to the patient.

It doesn't matter how "antidepressants" actually work. It doesn't matter whether or not they work at all. What matters is that they tick a checkbox on the list, saying "patient is being treated for X disorder" and "patient is compliant with treatment, appointments, prescription". SSRIs, at their inception, carried black-box warnings about homicidal ideations. Of course, those warnings were wildly unpopular and eventually needed to be suppressed. But they're still true. That's right, not merely suicidal, but the users of SSRI-class drugs are driven to thoughts and actions of homicide. Just ask the Columbine Kids.

Paxil also had that problem; it made me suicidal, and I had to go into a mental hospital and get my medication changed.

So in your case, no drugs would have been a lot better, correct ?

Going off of paxil was absolutely horrible, and at the time I did it, the psych community didn't believe that you experienced side effects during taper or discontinuing.

I have never in my life felt worse than when I was getting off paxil. Beyond the head zaps, it pervaded my intellectual with depression and anxiety.

Only after a few "head zaps" and other papers got published did the psych folks even listen to me about it, and then they were just sympathetic and tried to find me something else.

Tamar Oostrom did a paper on drug sponsorship effect. Prozac was one of the examples (see page 3 of her feb 2024 pdf). Closest thing I've read to an explanation of how Prozac works is that it activates and drives to the nucleus TFEB, upstream regulator of autophaggy/lysosomal genesis. Which many other molecules do as well, for example trehalose. I wonder if the long half life might cause problems. Seems like proteins like TFEB are usually conserved. Activated for some period of time then auto regulated into an off state. If they're just finding out the method of action now on some of these antidepressants decades after they put them out, they probably didn't factor that in (or much of anything besides profit sadly).

> drug sponsorship effect

> activates and drives to the nucleus TFEB, upstream regulator of autophaggy/lysosomal genesis

> trehalose. I wonder if the long half life

> proteins like TFEB are usually conserved

> Activated ... then auto regulated into an off state

This is exactly what I mean by "fairy tales" and nobody really cares how/if/why the drugs work. The blithering word salad of tech jargon above means nothing to a "patient" who is suffering clinical depression. They call these "mood disorders", yet mood is something that is quite ill-defined. It is not a biochemical process. Mood is not something like digestion or pregnancy that can be empirically measured, observed, and described by physicians.

"Mood disorders" are the result of a feminization of mankind. The chief psychological symptom of menstruation is said to be "a bad mood" just before the flow arrives. Rather than address this bad mood in patient-centric terms, women are blamed and singled-out for being fertile or "hysterical", and the bad mood is seen as an obstacle and a detrimental effect. If a woman is having "bad moods" that aren't synchronized with the menstrual period, or heaven forbid, a man has "bad moods", then this must also be a "chemical imbalance" that can be addressed by the writers of fairy-tales and the manufacturers of bizarre, mysterious, but patentable substances.

Mood has nothing to do with this bullshit collection of conjectures. Nobody cares about the mechanism, and it is basically inventing a story to explain something that is immeasurable and unobservable in these terms. It is peak pseudoscience; phrenology and homeopathy are better rooted in reality than psychiatric pharmacology.

It is, ultimately, a bizarre mockery of Christianity, the priesthood, and sacraments. Since hospitals, medical treatment, and the vocation of physician were given their start in a Christian context, as well as the spiritual treatment of the soul. It stood to reason that eventually, they would cross the streams. That they would essentially photocopy the white coats, the prescription pads, the sterile clinics, the scientific diagnostics, and the mysterious substances, and apply them to a system that purports to heal the individual's soul.

Sadly, the mind and spirit do not always respond in the same way that a physical body responds to this sort of treatment. The real Achilles Hell is that spiritual maladies are never individualistic or limited to one unique human being. Mental health treatments are more akin to the Department of Corrections, and operate on a "Divide and Conquer" strategy that seeks to sort people into pigeonholes that are progressively smaller and smaller, dividing us and preventing us from any meaningful unity or communion.

What do you mean "prozac is fluoride"? Its chemical structure contains a trifluoro group, but it's not fluoride... and you don't end up with extra fluoride in your system.

As a side note: I take prozac and it's far better than paxil (for me and many others). Has been transformative in my life.

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