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PolyDipsoManiac t1_jbv7j9i wrote

Reply to comment by tyler1128 in MDMA appears to confer resilience in a rodent model of chronic social defeat stress by chrisdh79

SSRIs are almost worthless and it’s an embarrassment that we’ve relied on them for so long.

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tyler1128 t1_jbv9a78 wrote

I don't disagree with the sentiment. They are not by any metric highly successful drugs nor is the side effect profile negligible. We also can't let personal experience cloud our analysis. They are not almost worthless in data. Here's a relatively modern meta-analysis: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5889788/. They are usually on the lower end of of the spectrum of the four main classifications that most anti-depressants fall into: MAOIs, tricyclics, SSRIs and SNRIs. They also are usually on the lower end of the spectrum in terms of tolerability. Tricyclics and irreversible MAOIs are generally more effective, but also more "dirty drugs" meaning a lower specificity in action. Some irreversible MAOIs are still used as drugs of last resort in treatment resistant depression, but they are fairly dangerous comparatively.

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MervinWervin t1_jbya9x4 wrote

>Some irreversible MAOIs are still used as drugs of last resort in treatment resistant depression, but they are fairly dangerous comparatively.

They're definitely more side-effect & interaction heavy but a lot of providers are unduly afraid of them. The dietary restrictions are pretty overblown unless you're chowing down on artisanal cheese or chugging soy sauce. A lot of the drug interactions aren't absolute either as long as you start very low and monitor closely when going up - I was able to safely take a low dose of adderall when plenty of providers would act like being in the same room as it while on MAOIs causes instant death.

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