I recommend anyone considering SSRIs to consider Silexan. See this write-up from Scott Alexander which covers the research. Someone I know has replaced their SSRI with Silexan. Several people I know have had good experiences. The main, and not always common, side effect is lavender flavored burps. Not everyone gets it. I don't, and it wasn't bad when I did. No-one I know has had a bad experience. Overall, the downside risk appears to be relatively low.
Silexan
For anxiety treatment only, if I understand it correctly.
There is no claim that it works as an antidepressant, as far as I know.
As I understand it, there are several studies showing that it works for depression. Of course, it may be the case that this is only for people for whom anxiety caused the depression.
E.g.,
https://pubmed.ncbi.nlm.nih.gov/26718792/
https://link.springer.com/article/10.1007/s00406-024-01783-2
Thanks for the references.
Yes, the first two of those do mention co-occurring anxiety in the title.
The third study suggests a possibility that it might just work as an effective anti-depressant as well. (I hope there will be further studies like that; yes, this might be a sufficient reason to try it for depression, even if one does not have anxiety. It might work, but it's clearly not a common knowledge yet.)
I still struggle with some of my old problems – particularly anxiety, loneliness and occasional depression
I still struggle with these, as well. Another LessWrong user (@Chipmonk) mentioned in a post the book Already Free: Buddhism Meets Psychotherapy on the Path of Liberation. After taking his recommendation and reading that book, it gave me a new perspective that I don't have to run away from these negative emotions. In fact, not only can I openly accept them, but when I chose to actively love them, it liberated my thought space and allowed me to non-judgmentally witness these emotions.
The book also helped me to finally understand and appreciate author Tara Brach's short story about Buddha and Mara.
I've used SSRIs for maybe 5 years, and I think they've been really useful, with no negative effects, and more or less unwavering efficacy. The only exception is that they've non-negligibly lowered my libido. But to be honest, I don't mind it that much.
Also, few times where I've had to not use them for a while (travelling and was very stupid not to bring enough), the withdrawal effects were quite strange and somewhat scary.
I also feel they had some very strange positive effects. Like I think they made my reaction time improve by quite a bit. Although it could be something random coinciding with starting SSRIs. Or just me being confused. I haven't tested it. On humanbenchmark I score around the same now as I did in high school. But I feel like I can catch falling things with much better regularity, and this was an almost immediate effect after starting.
Thanks for sharing <3
My main concern about trying SSRIs is that they'll make me stop noticing certain things that I care about, things that currently manifest as anxiety or so.
Opinions?
I've had SSRIs for 2 years. Then got off of them. They covered up a lot of stuff and I finally dealt with it once I got off of them. Now I'm back on them though, but on a half dose. It's easy enough to keep noticing the stuff I want to work on, while also giving me a bit of 'thicker skin'. What I'm trying to say with my experience is: although SSRIs can cover stuff up, the degree to which they do so might be dose dependent.
Hmm I don't recall no longer noticing things that I care about while on them. Of course, since I was less anxious, then having less anxiety also meant noticing less anxiety. But I think that either the anxiety just felt content-less and not associated with anything that I cared about, or to the extent that it was tracking things I cared about, I was able to track those even without it.
In 2014 I got on SSRIs the first time, and they were amazing. I wrote online about how I suddenly had energy to do things, could concentrate on stuff, and generally just felt better and happier.
I now got a message from someone who’d found my writings and was wondering what my experience with antidepressants was now, 10 years later.
I wrote this reply to them, and thought I might as well share it with others:
—
Hi, that was indeed me!
I was on SSRIs for about a year after writing that comment, after that it felt like they started losing some of their effect but I also thought I felt better for other reasons, so I stopped using them. Then I was off them for about a year or two and started feeling bad again, so I got back on them. They had similar effects so I kept using them for a year, until I again got to the “I think they’re losing some effect and I’m also feeling better for other reasons” stage, so I again stopped them.
Eventually my old problems started coming back again, but I also started making more progress on those problems with therapy. By this time I had the feeling that even though the SSRIs were great, to some extent they suppressed my problems rather than solving them.
For example, deep down my self-esteem was still based on getting others to like me to an unhealthy extent – of course everyone wants to be liked, but *most* of the things I was doing had some undercurrent of “how could I get others to like me more this way”. The SSRIs didn’t really change that, but they shifted me from being very pessimistic about that ever working, to feeling more hopeful that “okay I just need to do this thing and then more people will like me”, and then I had more energy to keep doing things again. But the things that I was doing, still had an unhealthy obsessiveness going on.
Since then therapy-type approaches have helped me fix more of that underlying issue. (I had one particularly big breakthrough in 2017, which I described here, and a later follow-up to it here.)
I still struggle with some of my old problems – particularly anxiety, loneliness and occasional depression – but quite a lot of them have gotten better to the extent of being non-existent, e.g. my self-esteem is much better and on more healthy ground these days.
On a few occasions when I’ve had particularly rough patches I’ve tried antidepressants again, most recently for a brief period last year, but they don’t seem to have the same effect anymore. Maybe I could have just increased the dose, but I was afraid that that’d make it harder to access the core of the problems therapeutically, if the SSRIs ended up burying it deeper.
I’m still very glad that I originally got on them though, since they viscerally showed me that life could be much better and gave me hope!
One thing worth noting is that at some point, the level of physical pleasure I experience from orgasms seemed to have dropped quite a bit. I’m not entirely sure when exactly that happened – I was single for a while, and then at one point when I got into a relationship again, I noticed that sex with my next partner didn’t feel as satisfying as it did with my previous one (and this never recovered), so the decline must have happened sometime between those two relationships.
I can’t know for sure that it was caused by the SSRIs, but a long-term loss of sexual pleasure is a known side effect and the timing would roughly match. Another side effect that I got, that persisted even after I stopped using them, is grinding teeth at night (but I got a mouth guard from a dentist that prevents the worst off it). Personally I feel like these side effects were worth it – I was really, really badly off when I got on the meds – but I could easily imagine someone feeling differently, if they weren’t equally miserable.