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[–] 43 points 2 days ago*

I know this is a joke but don’t combine any of these meds. You might add Wellbutrin to lexapro or Zoloft, but you would never take them together, and your body metabolizes Effexor into the medication in pristiq so they wouldn’t combine those either.

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  • [–] 80 points 2 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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  • [–] 39 points 2 days ago* (last edited 1 day 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 1 day 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 2 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 2 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 2 days ago (2 children)
  • [–] 18 points 2 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 2 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 2 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 2 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 2 days ago* (last edited 2 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 2 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 2 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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  • [–] 19 points 1 day ago

    My son has a complicated set of prescriptions that restored him to euthymia after two years of hideous depression. I am so grateful for his cocktail.

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  • [–] 25 points 2 days ago (1 child)

    Depression is the logical outcome of the system we live under.

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  • [–] 28 points 2 days ago* (last edited 2 days ago)

    Medications are only there to enrich your doctor! The medical industry only exists to extract profit! You don't need drugs - it's natural to be depressed, just look at how bad the world is! ADHD is a superpower! Autism is caused by vaccines!

    - Things said by idiots.

    (edit: Or just the misguided. Disillusion with the medical industry and all its myriad problems is understandable, but that doesn't make it a conspiracy nor does it mean the people who dedicate their lives to it are all profit-driven goblins that don't care about you. Overprescription is a hugely complex and heavily propagandized topic, but tarring all mental health professionals with this brush and discouraging people from getting what little professional help is available is indefensible)

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  • [–] 20 points 1 day ago (7 children)

    Nowhere near as real as doctors genuinely believing pseudoscientific bullshit and having it thrive way past the point of disproven efficiency.

    Looking at you, homeopathy and psychoanalysis.

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  • [–] 8 points 1 day ago (6 children)

    Wait, are we really putting psychoanalysis on the same bucket as homeopathy now?

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  • [–] 7 points 1 day ago* (last edited 1 day ago) (5 children)

    Pretty much. It's built on unverifiable claims, even Freud's own case studies ended wrecks, and it!s used today to support shit "diagnoses" like "this kid is autistic because his mother loved him too much". And there's all the bullshit coming from the forced proximity with the analyst, like false memories. It is, in many ways, a pseudoscience.

    As for what can be determined through actual science, there were huge cross-studies that could not find any benefit to psychoanalytic therapy for treatment of most psychological problems.

    Psychoanalysis is not an equivalent term to psychology. It's only a branch of it, one that shits on experimentation and proof because all the proof you need are in the ravings of an old weirdo from a century ago.

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  • [–] 4 points 1 day ago (4 children)

    They cover Freud in psychiatry like you cover Satie in music, Picasso in art and Brecht in writing classes. That doesn't mean that the latest TV shows like Heated Rivalry are cubist versions of Mother Courage set to Gymnopedes. And how much Freud have you actually read and studied at a postgraduate level? Why do you mentioned Freud and not Lacan?

    Politely, I think your opinion is under-informed.

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  • [–] 10 points 1 day ago (3 children)

    They also teach obsolete models of the atom in science so students understand where we're coming from, but they don't still use them.

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  • [–] 2 points 1 day ago* (last edited 23 hours ago) (2 children)

    Not in postgraduate. Which the last comment made pretty clear that, at high levels, Freud is not seen as a complete fraud (mostly).

    I have mixed feelings about Lacan, although that's not my real academic position.

    None in postgraduate is looking at old models [of anything] as absolute truths.

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  • [–] 4 points 1 day ago (1 child)

    I think i see the two senses of where the miscommunication occurred.

    You can put psychoanalysis in the same bucket at homeopathy in that it doesn't work when studied by clinical trials, and mainstream practitioners don't use it.

    On the other hand, Freud was not trying to be fraudulent, and did contribute tremendously to the field of psychology, unlike homeopathy's fraudulent relationship to medicine.

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  • [–] 11 points 1 day ago

    These are all generic drugs. No one is winning cruises for writing scripts on the $4 list.

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  • [–] 10 points 1 day ago

    Ahh yes, better living through modern chemistry.

    And medicine as a skill/occupation, if you've been around it, isn't something you "do". But rather something you practice. I never one "did" medicine to or on any patient I dealt with in 20 years of being an EMT or Medic. I practiced medicine within my scope of practice, (there's that word again), just like any doctor or nurse.

    And when you administer a medication/prescribe to a patient, that's called a "trial". Why is it called a "trial"? Be you have no idea what it's going to do to a patient. You simply go on past collective and professional experiences. And then you hand them a pill and wait to see what it does. It's going either cure them, do nothing, or it kills them. The 3 True Outcomes.

    The first and last options means that you don't need to deal with the patient again. It's the middle option, "does nothing" that is a huge problem. That's when you pull out that bingo card in the cartoon and start trying to get your bingo some other way. And sometimes you even need to hit the blackout to get a bingo. And that's how you get the cartoon.

    I will leave with this wise thought I got at an EMS symposium many years ago. The keynote speaker told us "That no matter how much we think we know about medicine and believe how advanced we've become in caring for people, it all still boils down to keeping the patient amused and letting nature take it's course".

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  • [–] 22 points 1 day ago (3 children)

    this is anti-treatment propaganda.

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  • [–] 2 points 1 day ago (1 child)

    I disagree.

    This is question everything recommendation. Doctors are just people too. They can make mistakes, be out of date, or be corrupt.

    But corrupt is very unlikely.

    Do research. Read studies. Question. Challenge. And get the best result for yourself in the process.

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    [–] 8 points 1 day ago

    This comic brought to you by the Church of Scientology.

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  • [–] 3 points 2 days ago

    Rearrange that and I would've gotten 2 bingos if we're counting all the meds I've been prescribed in my life

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  • [–] 3 points 2 days ago

    Sorry can't hear you over the sound of my Paxil

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  • [–] 2 points 1 day ago

    Obligatory - Fuck effexor!

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  • Hey look! He can take her on a cruise too!

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  • [–] 1 point 2 days ago

    So the plot of

    Tap for spoilerSpiderhead

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