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[–] 80 points 3 days ago (20 children)

Unfortunately that's just how psychiatry is. You can get a metabolic test done that tells what meds your liver metabolizes better, but ultimately it's throwing darts and hoping something sticks.

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  • [–] 40 points 3 days ago* (last edited 2 days ago) (5 children)

    Hot tip, if any of your family members have similar mental heath conditions ask them what meds they're on. Worked out very well for my partner after trying several drugs she asked what her dad was on and tried that. It worked great

    Makes sense genetically

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  • [–] 2 points 2 days ago (3 children)

    You can just have this tested at most psychiatrists. Genesight is one version, there are a few. If your insurance covers it you basically just have to spit in a cup. If you don’t the cost is capped at $330 for genesight which is a lot. Their argument is that in that case it can still be worthwhile to avoid paying for meds that aren’t a good fit. That said this is a bit absurd as most first line psych meds are dirt cheap. Like fluoxetine is like $25 and you can often get it down to 0 with those prescription card things. If they start you on pristiq or fetzima then it’s way more, hundreds per month, but if your psychiatrist is starting you with those they’ve been corrupted by a pharmaceutical rep

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  • $330 for a genetic sequencing is fucking robbery. The cost to sequence is under $100, a major breakthrough in genetic testing dropped the cost to $80 per sequence. An extremely detailed research-grade sequencing is around $200. The U of Minnesota charges $250 for everything from sequencing to analysis for external screenings

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  • [–] -3 points 3 days ago (13 children)

    That's the best case scenario.

    The worst case scenario is that it's mostly placebo, and when it does work, it's just natural recovery; and, further, that the psychiatrists' prescription pattern is entirely based on "what's worked" in their personal history as prescriber which will, of course, be random.

    Anyway, long term studies on the effects of most psychotropic drugs indicate that they are much more likely to induce dependence than to actually "cure" you.

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  • [–] 21 points 3 days ago (3 children)

    The worst case scenario is that it's mostly placebo, and when it does work, it's just natural recovery

    I believed that for 30 years until I tried zoloft and experienced a sensation somewhat similar to that of psilocybin, which has also been linked to treating depression, and then I went "ohhh....." and stayed on it until the side effects wore off and yeah. It's not just placebo. I was wrong. I'm sorry to everyone on the internet I misled.

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  • [+] -7 points 3 days ago (2 children)
  • [–] 18 points 3 days ago (1 child)

    Sertraline is unlikely to reduce depressive symptoms within 6 weeks in primary care but we observed improvements in anxiety, quality of life, and self-rated mental health, which are likely to be clinically important. Our findings support the prescription of SSRI antidepressants in a wider group of participants than previously thought, including those with mild to moderate symptoms who do not meet diagnostic criteria for depression or generalised anxiety disorder.

    This... doesn't seem very meh?

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  • [–] 8 points 3 days ago

    That's actually pretty much spot on how it worked for me. My depression was cause of things in my life, and it didn't do much for that, but it did wonders for my anxiety, which made it easier for me to ask for help and fix my life. I used to be afraid of going into stores. I used to be afraid of pain, due to pain disorders I have. I couldn't have caffeine, or even chocolate, because even a little bit of stimulant made me too jittery and feel awful. I don't have so much fear anymore. I can eat chocolate again!

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  • [–] 11 points 3 days ago (3 children)

    Most of those meds aren't intended to cure you. You're supposed to take them in conjunction with therapy to develop healthy ways of managing the disorder.

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  • [–] 5 points 3 days ago (1 child)

    Medical treatment for bipolar and schizophrenia is considered lifelong.

    For depression, yes, there is one strand of thought it that pairs it with talk therapy, but often people are on the drugs for years.

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  • [–] 9 points 3 days ago* (last edited 3 days ago)

    Yes, much like diabetes someone with bipolar disorder or schizophrenia is going to be taking the medication their whole life. And much like diabetes, working with a medical professional will help them to identify lifestyle changes and coping strategies that allow them to eventually self-regulate their medical concerns, and they will only need occasional professional involvement.

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  • [–] 5 points 3 days ago (4 children)

    Maybe in some shitty countries, but over here we ain't prescribing shit without a decent evidence base because the medical regulator is actually competent.

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  • [–] -2 points 3 days ago (3 children)

    The studies for efficacy in the US are mostly short-term. Psychiatric outcomes in "shitty countries" uninfected with pro-medicine psychiatry are actually better.

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