It’s easy to sometimes feel as though we are being ignored. It’s even more true when you’ve got a mental illness. Depression fogs every emotion, not merely the “Good” ones. It grows, with very little help, from sadness and fatigue, until you don’t know how anyone gets through the day. And the anxieties kick in. It reaches a panicked pitch of loneliness and isolation. By choice or by force. When every time you start a new, “better” medication, you receive a warning from the doctor you’ve had memorized for years, Now, remember, it could take two or three months before you notice a change…” This is somehow seen as an acceptable way to treat people within an inch of suicide. It’s hard to imagine how we ended up here. Surely this wasn’t the goal when the first MAOIs were made available for prescription. MAOIs were developed in the 1950s, accidentally. The action was noticed in tests by the patients have a slight increase in energy, motivation, and activity than those on placebo. Tricyclics antidepressants were discovered in a similar manner in 1957 while attempting to create antipsychotic. It’s effects were thought to be almost entirely placebo at first. Imipramine was prescribed for years without any understanding of how it worked. It was hypothesized to work on norepinephrine, then later, serotonin. For 30 years, little changed. MAOIs had weird interactions with even common foods. Tricyclics are still considered among the most effective medications for depression, but they seem to have little effect on suicidal ideation, and can cause major issues in the case of overdose . In 1988, this all changed, when the first of a “novel class of antidepressants,” fluoxetine(commonly known by brand name Prozac) was released in the US. It was the first majorly successful SSRI, the class of medication that would hold America for thirty years to come. SSRIs are the most prescribed antidepressants ever. Dozens of slightly different SSRIs, and SNRIs have come and gone on the market. a few atypical medications have seen popularity in this time as well. Substituted amphetamines, GABA Inhibitors, Dopamine agonists, anticonvulsants, steroids, hormones, antipsychotics, stimulants, all have been used for depression, some in combination with an SSRI. Yet, even with secondary medications supplementing SSRIs, the success rate has been incredibly low. Around 30% of people have no reduction of symptoms, or only experience a partial relief. That’s right. Seventy percent of [...] https://kthejourney.selfhosting.rocks/2019/07/16/the-struggle-to-be-heard/

@jack My journey with ADs is pretty similar. The first one I took nearly killed me, so you can imagine how I felt about trying more after that. 2nd one was unending nausea and nerves, 3rd same thing, 4th killed my sex drive, stopping it brought it back immediately, 5th is the one I'm on now, and it's alright as long as I don't forget to take it. There is no science here, it's all guessing games. I think it's ridiculous this is as far as we've gotten with mental health pharmacology in 2019.

@zoetropeexplosn @Jack that’s what makes Ketamine truly novel in pharmacology. It’s the first drug we’ve ever witnessed cause neurogenesis. The actual growth of new neurons.

@jack @zoetropeexplosn @jack while I do agree that Ketamine seems promising, this is not true. Other antidepressants have been shown to promote neurogenesis: fluoxetine (Prozac, SSRI) (Ohira et al., 2013), venlafaxine (Effexor, SNRI) (Zhang et al., 2015) and even way before: reboxetine (NRI) and tranylcypromine (MAOI) (Malberg et al., 2000). Quite sure most SSRIs and SNRIs do promote neurogenesis.

Another point: neurogenesis is definitely implicated in the antidepressant effect but individual differences (genetics, epigenetics, biochemistry) play a major role in the effectiveness of a drug.. So for instance, fluoxetine works for me, might not work for somebody else. That could be the same for Ketamine. Definitely more research (and funding that research) is mandatory!