this post was submitted on 15 Jan 2024
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it does say that theres only 20 in the label, but im more pissed about the waste. everything couldve been put on 3 trays

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[–] [email protected] 82 points 10 months ago (1 children)

The only time I've seen something like this is when my doctor really wanted me to try an anti-depressant, so he gave me a perpetual supply of free samples.

[–] Noedel 15 points 10 months ago (3 children)

Don't antidepressants take weeks to start working?

[–] ObviouslyNotBanana 56 points 10 months ago* (last edited 10 months ago) (4 children)

A doctor said this and it was such a good metaphor: imagine that you have a 3000 year old machine (which no one understands anymore) with a bunch of cogs and gears, and you're looking down at it from above. You're trying to fix a gear that is slightly out of alignment further down in the machine, you can't really tell which one it is but you know roughly which area, and to fix it you drop a rock into the machine and watch it fall down.

That's what we're doing with SSRIs. We're dropping a rock that manipulates our serotonin, which gives a bunch of effects but not the one we're after. The one we're after is somewhere down the line. It's affected by processes that are affected by the serotonin somehow. We're not exactly sure which one it is, but we know that if we drop the rock in there it will make the gears align sooner or later.

Which is why it takes time, and why it has some odd effects on people sometimes.

edit: added a detail I missed, to make it clearer.

[–] [email protected] 31 points 10 months ago (2 children)

That's a good metaphor! I'm not sure about the rock though, throwing a rock into a complicated machine doesn't seem like the best idea. I'd consider replacing it with oil, where it needs to cover the gears at the top first before it can drip down.

[–] ObviouslyNotBanana 20 points 10 months ago* (last edited 10 months ago) (1 children)

Yes! That's the point of the metaphor! The SSRI is the rock. We're not exactly sure how it's gonna land, or what it's total effects are on the machine, but it's the tool we have and it's the one we're using. I don't remember where I heard it, but I instantly understood why I became so paranoid all those years ago when I tried antidepressants.

edit: and that doesn't mean that a person shouldn't try using them. They can be incredibly effective. But they are what they are. Not a quick fix, and (to most people) not a long term solution.

[–] candybrie 12 points 10 months ago

Oil doesn't fix alignment of gears. Ideally, you need to precisely go in and realign the exact gear. But we don't have that power. So we're throwing rocks.

[–] Noedel 20 points 10 months ago (2 children)

"the rock may or may not cause the inability to cum and sleep"

[–] [email protected] 2 points 10 months ago* (last edited 10 months ago)

Friendly reminder that sexual side effects of SSRIs are incredibly common, some medications effect more than one in four, but it is something that’s typically wildly underreported unless the practitioner brings it up, specifically, first. Not just “any side effects”.

There are multiple treatment options for people who encounter those side effects. They can range from poor libido/drive, to inability to obtain an erection or adequate vaginal moisture, to delayed or absent orgasm. All are common and all are frustrating. All can occur alone or with one or more partners.

If it’s impacting treatment or quality of life or your ability to stay compliant with meds, it’s absolutely worth discussing with your provider. There are other medications or alternative schedules to taking SSRIs. There are other meds that can be prescribed alongside SSRIs to accommodate for the side effects.

Relevant article from Journal of Clinical Medicine: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6832699/

[–] [email protected] 1 points 10 months ago* (last edited 10 months ago) (1 children)

There's other antidepressants that don't do that. Mirtazapine for instance helps sleep, and has no real impact on sex. It'll make you hungry, though. Buproprion will mess with your sleep but not sex, but you'll have no appetite. They all have their own unique collection of side effects, well worth looking into other options if SSRI's aren't well tolerated

[–] Noedel 1 points 10 months ago

Thanks. I'm just making jokes. Fortunately most of my side effects went away, although I still have wild dreams.

[–] [email protected] 1 points 10 months ago (1 children)

I totally understand that this is a necessary process for anti depressants but damn it sounds scary as fuck. "Eat these brain chemicals and come back and see us in a couple weeks"

"How does it work?"

"Fuck if I know it's kind of like throwing a rock at an old machine. Just make sure you let me know if you experience any of the long extensive list of potential side effects!" Like damn im for sure not a doctor but that sounds like russian roulette with brain pellets to me. If Ecstasy (which was invented by a pharmacutical company to be medication) can permanantly fuck up your brain I would bet money that these pills certainly do the same. I bite my tongue anytime someone mentions they are considering it or talking to a doctor about it, their choice. But man it scares the fuck out of me. Ill just continue to sleep all the time and stay angry lol

[–] ObviouslyNotBanana 1 points 10 months ago

Sure, but that's a lot medicine. We know it works, just not why. We know why many things work and how, but far from all of them.

They're really not that scary, as long as you take your prescription as instructed and have regular contact with a physician.

[–] [email protected] 8 points 10 months ago* (last edited 10 months ago) (1 children)

Yes and no, also i am not a medical professional.

For classical antidepressants Chemicals tend to function pretty fast but the effect is designed to be subtle because you need to live a normal life, capable of dealing with and feeling both ups and downs. not be perpetually smiling or brain dead.

After some time “a few weeks” of taking a daily dose your body and mind adjust to the subtle changes causing a stable therapeutic effect. At least thats what I understand is the idea.

But lately there is also sm of a psychedelic renaissance of medicine and they work entirely different where a single dose within a therapeutic setting creates a longer lasting feeling of increased well being.

Nasal Ketamine seems to receive allot of attention, near instantly improving the condition. They tend to need 1 dose every 5 weeks so its less addictive then classic medicine. But i do admit it instant improvement for treatment resistant medications is a bold claim and still subject of more research.

[–] [email protected] 4 points 10 months ago

The side effects can last for weeks. It’s like a really shitty onboarding process. For some, the side effects are not bad. Personally I can say that the first 2 to 4 weeks are usually filled with nausea, extreme fatigue and exhaustion.

The way that these sorts of meds have been described to me is that “they give you a leg up”, meaning it gives you just enough of a “boost” that you might actually follow through on therapy and the strategies it offers.

It has been years now, and still no luck. I’d love to live a normal life, whatever the fuck that means lol

[–] [email protected] 1 points 10 months ago

It depends on what you mean by "start working." The first time I took a sertraline, I felt absolutely baked, but I feel like it took weeks for the desirable effects to take hold.

Then again, my doctor also told me that something like 60% of the effects are a placebo.

Regardless, yes, he would give me like a month of these individal samples at a time. I'm not sure how he swung that. It was like 2003 or 2004.