this post was submitted on 16 Mar 2025
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Mental Health

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I found this chart on reddit some time ago, I thought to repost it here as well

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[–] peoplebeproblems@midwest.social 1 points 2 minutes ago

Is this chart actually used in prescribing patients? I find that concerning. I have abnormal metabolism on several of my CYP enzymes, plus I have other medications that are ligands of them as well.

For instance, there are people who have multiple gene copies of rapid metabolizing enzymes. They may not get any side effects, but may also not get any benefit.

An intermediate metabolizer may get a better response at lower doses and not have to worry about side effects at all.

Compared with someone who has two inactive copies of the primary metabolic enzyme, they may end up with significant side effects and no benefit at low doses.

The only way to know your metabolism is genetic testing. (Which they have studies for, and some insurances cover).

[–] ptc075@lemmy.zip 3 points 40 minutes ago

Man, I wish we had these charts for all classes of medicines.

[–] 1984@lemmy.today 1 points 18 minutes ago

So... If you wanted to reduce population growth, you would make everyone depressed?

Seems like its working.

[–] cyborganism@lemmy.ca 5 points 1 hour ago (1 children)

Can confirm, bupropion causes insomnia.

I sometimes have to take nighttime benadryl to help me sleep.

[–] jkYkM7a@lemmy.ml 1 points 20 minutes ago

Been on it consistently for over a decade now and have always been funky with sleep. I started back in undergrad when the pressure of life left me spiralling out of control, and have since always thought I was just a weird sleeper.

I have insomnia semi often, usually anxiety-induced, but I've never thought that it could be the bupropion directly.

Very curious, and good to know.

[–] RobotToaster@mander.xyz 11 points 2 hours ago* (last edited 2 hours ago)

Seems to be missing the entire MAOI class (moclobemide, selegiline, phenelzine, tranylcypromine, isocarboxazid), and most tricyclics (clomipramine, imipramine, nortriptyline)

[–] TwoBeeSan@lemmy.world 7 points 2 hours ago

Had a doctor tell me I should never feel the antidepressant. Should be a background thing. Thought that was good advice.

Setraline leveled me the fuck out.

[–] Caesium@lemmy.world 3 points 1 hour ago (1 children)

Yeah Mirtazapine fucked me up in the weight department

[–] Kcg@lemmy.ml 2 points 1 hour ago

Same here. Soon as I stopped, the weight stopped!

[–] OliebollenXXL@feddit.org 3 points 2 hours ago

Now I know y I dont have that much of a Craving for Sex anymore. Thought I just got old.

[–] makeshiftreaper@lemmy.world 10 points 3 hours ago

An off label use for Trazadone is as a sleep aid. At doses under 150 mg it doesn't really work as an antidepressant but will make you drowsy. I've been prescribed it before as the first step before Ambien

[–] Senseless@feddit.org 3 points 2 hours ago (1 children)

Tried a bunch of them, none really worked except for Venlafaxine. Had sexual dysfunktion which was an unacceptable side effect for me so I also quit them. This sucks.

[–] weariedfae@sh.itjust.works 1 points 4 minutes ago

Hey twinsies!

[–] sexy_peach@feddit.org 2 points 2 hours ago

Antidepressants get such a bad rep, they're truly amazing

[–] paranoia@feddit.dk 5 points 3 hours ago (3 children)

So I have never had depression but I am aware that Sertraline is probably the most common. Is there some higher rate of effectiveness it has over the less alternatives with less side effects? Is it just that it's cheaper?

[–] Nougat@fedia.io 4 points 2 hours ago

The issue with mental health and medications is that different root causes can create different symptoms in different people, and different medications have different effects in different people. The understanding of what those root causes even are is very limited, let alone trying to figure out what the root causes are in a specific person.

We know that certain medications have certain effects on symptoms, generally speaking, but identifying which one, at which dose, suits that specific person with a collection of reported symptoms that look like depression or anxiety or whatever, often in combination, is trial and error.

Of course, in the US, where healthcare is "fuck you, I got mine," cost does also play a role. Shouldn't, but does. Another thing to take into account is what other medications you're taking, and whether they interact poorly with one another.

Sertraline is the generic for Zoloft, and it's been FDA-approved since 1991. That's a good long time, and if you're going to prescribe an SSRI, it makes sense to give more weight to something that has a long history, for the sake of both effectiveness and side effects.

[–] RobotToaster@mander.xyz 2 points 2 hours ago

There's some conventional thinking that it's slightly more "activating" and has fewer side effects than the other cheap SRIs, escitalopram being still under patent.

[–] MyDogLovesMe@lemmy.world 3 points 3 hours ago (2 children)

Research, and more anecdotal than I can count, including a number of my own, shows psilicybin (I use ground magic mushrooms) at slightly-less-than ‘feel high’ doses 4 days a week (aka micro or threshold dose) equals, or surpasses efficacy of any of that list.

No side effects.

Shit works, and you don’t have to “get high” and lose your moral compass, etc.

If you abuse psilicybin, it just stops working. You really can’t get addicted to it at all. Also there is NO ‘lethal dose’. You can’t die from it.

Fuck Rx!

[–] paranoia@feddit.dk 1 points 52 minutes ago

In general I feel the same about an occasional dose of ketamine. Any time I feel a general malaise, ketamine blasts all the cobwebs out and gives me a new lease of life for quite a long time.

[–] Kyrgizion@lemmy.world 3 points 3 hours ago

I would but it's illegal here and in the same category as heroin or coke for some idiotic reason.

[–] pntha@lemmy.world 3 points 3 hours ago

i take agomelatine and have tried SSRIs and i will never go back after agomelatine.