[tcj_phx]

Thanks for sharing your mom's experience with big pharma's then-new wonder-drug.

> Somehow, I doubt there is much motivation to look for economically inconvenient and unnerving side-effects in some demographics,

Robert Whitaker examined the pharmaceutical industry's ideological capture of conventional psychiatry in his third book, Psychiatry Under the Influence.

https://robertwhitakerbooks.com/psychiatry-under-the-influen...

I've written for the Mad in America Foundation's webzine. My latest piece was titled Theodoric of Arizona: State-Sanctioned Pharma-Based Pseudo-Doctor: https://www.madinamerica.com/2024/07/theodoric-arizona/

This was inspired by the old SNL skit, Theodoric of York, Medieval Barber. The article is structured around my proposal of a Theodoric’s Principle of Medical Advancement, to explain why medical progress is so glacial.

[burnt-resistor]

Yup. There's too much institutional inertia to adopt evidence-based approaches.

I've tried 19 antidepressants over about 15 years. Stuck with mirtazapene-induced obesity that doesn't qualify for GLP-1 coverage, so I can either be fat, broke, or crushingly catatonic.

[tcj_phx]

"Institutional inertia" is a great term, thanks.

> I've tried 19 antidepressants over about 15 years. Stuck with mirtazapene [...]

Have you tried any anti-serotonin interventions? (chatbot in comment link below)

Mirtazapene is a "tetracyclic antidepressant". I think the development of antidepressants went MAOI -> Tricyclic -> tetracyclic -> SSRI. My chatbot transcript said the SSRI's are marginal drugs, but "SSRIs are much safer in overdose" than the earlier drugs.

My understanding is that the MAOIs were reasonably-effective at bringing people out of an acute depression, but they interacted with high-tyramine foods (fine cheese, etc) to cause high blood pressure. Reversible MAOIs are less problematic than the non-reversible ones. Methylene Blue [MB] is the most ubiquitous of the reversible MAOIs. I felt a definite warming effect with my first MB microdose (a fraction of a milligram), but I've never noticed anything from larger doses.

My comments on this thread might be helpful: https://news.ycombinator.com/item?id=46000812