I had the inability to climax when I was on SSRIs too. It made me wonder if this is what male pornstars take to do what they do.
Also couldn’t control my drinking. Normally I just have a few drinks and go to bed. On the SSRIs I would drink until I got black out drunk.
The final straw was when I went on a three day binge and remembered none of it. Was horrified when my roommate told me all the crazy shit I was doing.
Going onto SSRIs was my last resort. I’ve done CBT and an assortment of other talk therapies (and stuff like mindfulness etc) over the years, and while they certainly helped in a variety of ways they didn’t really address the omnipresent low mood in the same way the medication has.
MAOIs are the really last resort, SSRIs have minor side effects at the worst comparatively. Glad you didn’t need to take it that far.
So what happens? Are you just supposed to get used to it? Shit out of luck? I can’t even imagine.
Electro convulsive therapy and Transcranial magnetic stimulation are options:
You live with it…or you don’t.
This is why the antidepressant pharmaceutical industry is a US$21B market, and why they lobby so vigorously in opposition to research on psilocybin and ketamine treatments.
Stranger
One of my sisters had this done many years ago. At the time it sounded extreme, but it really worked for her. Must be over 20 years ago and she is still doing fine. Way less medication than she was on before.
ETA: Snuck in on me there. I’d heard about self-medicating with psilocybin, but I didn’t know about ketamine. I’ll have to read up a bit.
Not ‘self-medicating’ (which is quite dangerous, particularly for people with schizophrenia or schizoaffective disorder); research into clinical treatment regimes using these substances which have, at least anecdotally and in limited studies, been shown to have far greater efficacy in treatment of chronic and severe depression, as well as PTST/c-PTSD, anxiety disorders, et cetera.
Stranger
MAOIs got a bad rap largely because of the risk of potentially serious hypertensive episodes, caused by interactions with medication and certain non-fresh foods with increased levels of tyramine (aged cheeses, cured meats etc.) and drinking alcohol (note that not all patients are affected this way, but it’s something to be cautious about). Otherwise, MAOI’s side effect profile is fairly similar to that of other antidepressants that affect neurotransmitter levels.
If other drugs aren’t effective against depression, MAOIs can be considered a reasonable alternative.
ECT is problematic too. There’s evidence that not only does it cause irreversible brain damage, but that’s actually the source of whatever efficacy it does have.
The process wasn’t vetted through the kind of hoops that any modern treatment would have to undergo. It was more like “gee I wonder what this would do to these people?” followed by “hey yeah, the outcome looks positive”, all based on exterior analysis of the subjects’ behaviors. No MRIs of the brain, no six-month and two-year followups.
The “pharmaceutical industry” is made up of millions of people (in research, tech, sales, executive and other positions), many of whom suffer from incompletely or poorly controlled major depression, and who would love to have new, highly effective drugs available to them with a low incidence of side effects. Not to mention that developing new drugs with such a profile would be extremely lucrative. And patentable tweaks to psychedelics (such as diminution of hallucinatory effects with enhancement of brain action to lower depressive symptoms) would also be highly profitable for Big Pharma.
The claim that They are suppressing cheap, safe, highly effective drugs (“natural” or otherwise") is a favorite among the woo crowd, but it doesn’t stand up to logical examination.
This is mostly true. There are plenty of companies that specialize in manufacturing inexpensive generic drugs. The anti-pharma crowd doesn’t understand that even if Bristol-Myers would choose not to advocate or encourage some inexpensive alternative, there’s another company out there only too happy to do just that. I’ve been in this business for 30 years, including lots of those years in Development. I’ve absolutely watched one of my products go from $250 million in sales to $30 million as a generic hit the market (I’m not interested in doxxing myself, so I won’t name names, and yes I know that in pharma $250 million is peanuts). That drop happened in two years. That’s fast.
Now, there are sins committed by this industry, and one of them is that they’ve got very good at managing patent portfolios. Things like filing critical patents slowly over time so that they don’t all expire at once. This can allow you to stretch out the exclusive period, and I think it’s shitty. There’s also more collusion between the generic makers and the innovators, and that’s causing generics to be less of a bargain than they once were. It’s a good case study in why lobbying is a problem.
The other thing to understand is that much of the off-label use happens when researchers decide to study whether (say) Ivermectin can treat plantar’s warts. They do a study and publish results. If the results are good you’ll see more studies and more publications, and eventually people will just prescribe Ivermectin for plantar’s warts. There are many, many standard treatments that were never envisioned by the original drug innovator. Remember, any doc can prescribe any drug for any indication.
Consider T1 diabetes. Among that community, there’s a very prevalent belief that the drug companies prefer selling insulin, test strips, needles, and so-on every day for the rest of the patient’s life. And for Bayer or Lilly, that’s no doubt true. But if I can develop a true cure, reversal, or other less persistent treatment, well I have no incentive to keep Bayer’s gravy train running, and indeed I’ll be a billionaire if I can bring that product to market. I’ll be entirely happy to eat Bayer’s lunch.
Yeah, what they said ^^^.
There’s no advantage to suppressing a pharmaceutical that would actually work in order to market one that won’t. And too many depressed people would spread the word if they ever encountered some simple cheap omnipresent substance that worked, so it doesn’t make sense that the pharma companies are keeping something hidden because it is too cheap or too readily available for them to market it and charge lots of money for it and hence they are instead marketing expensive stuff that doesn’t work very well, instead.
No, the problem is that emotional states aren’t directly and universally caused by one’s brain and its biochemistry or neurological pattern. Emotional states are interactive and we evolved in such a way that we depend on that interaction for our cognitions about our lives and our environment.
No one will ever find a magic pill that will make depression “go away” for everyone always, permanently, dependably. Not unless the pill can reach out and change people’s life-circumstances while also reaching inside and rearranging people’s coping strategies, memories, beliefs about themselves, and understandings of the world in which they live. All of these things affect one’s own biochemistry and over time affect the actual wiring patterns of neurons within one’s brain. Certainly the brain is involved, and admittedly sometimes things go awry within the brain and the latter can indeed be the most direct cause of one’s immediate miseries, but it isn’t always the case and probably isn’t most often the case.
The fact remains that what you dismiss as a “magic pill” has been highly effective for lots of people who cannot “magically” reverse brain chemistry acquired through genetics and/or as as a result of life stresses.
While non-pharmaceutical interventions have a place in therapy, few who’ve been through major, black depression would tout (for example) developing better coping mechanisms and self-image as front-line treatment.
I would never want to make them not available to those who find benefit from them. I often told Guinastasia the same.
But they purport to know things they do not know, and to have solutions they don’t actually have. What they do have does indeed work for some people. That should not be the grounds for giving them as much power as they currently have to shove those same solutions down the throats of people who don’t find the same benefit from them.
They are a class of drug you can try, and see if they work for you, and stop taking off they don’t. Yes, you might need to taper off, but people routinely stop taking them.
I think they are useful enough for enough depressed people that most depressed people should give them a try and see if they are helpful. For me, a tiny dose of Prozac (or estrogen, as it turned out) magically lifted the thick gray clouds over my psyche, and allowed me to fix some of the other issues in my life. My brother found them useless and after trying several doesn’t take any drugs.
Medium gray clouds overriding my horizon can be tolerated for limited stretches. Other types are harder to handle.
I think in those cases they try adding in additional drugs on top of the anti-depressants (either a second class of antidepressants, or drugs that will make the anti-depressants work better, like second geneeration antipsychotics).
Also there are options like transcranial magnetic stimulation and ketamine therapy for treatment resistant depression.
Sadly even those when used for treatment resistant depression are not guaranteed to work. I think something like 40% of people who get ketamine or TMS have depression remission.
We’re still in the early stages of understanding the brain.