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MixedNuts comments on Have you changed your mind lately? On what? - Less Wrong Discussion

25 Post author: Emile 04 June 2012 07:54PM

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Comment author: MixedNuts 07 June 2012 03:44:53PM 2 points [-]

My first tought was poop-out, but that doesn't happen with bupropion, only with SSRIs, right? You shouldn't stop and start again the same antidepressant (and, to a lesser extent, antidepressants in the same family, or that target the same neurotransmitter), this will build resistance.

With SSRIs, poop-out tends to be resistance at any dose, not tolerance. I've had poop-out from placebo (WTF?) and larger doses don't work there either.

A week is a bit short for a test, but bupropion is unusually fast so that's a decent test. Why are you trying to correct for the placebo effect at all? Improvement from placebo is real and desirable, and there's probably a feedback loop between placebo- and drug-related improvement that helps even further.

How many antidepressants have you tried? You might just be on the wrong one. How large is your dose? If you're at 300mg/day trying going up to 450 is possible, though I'm not very optimistic. Does your depression have a seasonal pattern at all, and if so could the weather be responsible for the mood drop? You seem oddly trusting in self-experiment and advice from strangers; why are you seeking recommendations besides your psychiatrist's? Cost?

Disclaimer: I'm a nutjob who reads Crazy Meds and Neuroskeptic, not a psychiatrist.

Comment author: MixedNuts 09 June 2012 02:52:12PM 0 points [-]

More ideas:

There's some evidence that poop-out can affect any antidepressant, perhaps any med. The dominant theory is "When a med doesn't work, it can work at first due to placebo effect, but then be conditioned out of working".

Have you been taking the exact same form of bupropion? Different brands of the same med can work differently for some people. Also, if you're taking sustained/extended-release pills, this will have affected your experiments.