Yeah, poop-out could be the culprit. However, this would also suggest that the positive effects were mainly placebo because, as you mention in your second comment, the most reasonable account of poop-out is that the placebo effect wears off.
I was correcting for placebo cause I wanted to try lots of different antidepressants and other drugs and see which “really” work. But I guess you’re right; the placebo effect is pretty amazing and one shouldn’t risk eliminating it by over-zealous self-experimentation.
I haven’t tried any other antidepressants since I fear the side-effects of SSRIs/SNRIs and MAOIs seem like too much of a hassle (although selegiline sounds pretty good). But I’m rationalizing. I definitely should try some new stuff.
In the past I was fairly happy during the summer or at least happier than in the winter so the weather has probably nothing to do with my current low. I also didn’t change the brand of my antidepressant.
You seem oddly trusting in self-experiment and advice from strangers; why are you seeking recommendations besides your psychiatrist’s? Cost?
Nah, it has nothing to do with money. My psychiatrist costs me basically nothing.
So, why do I prefer self-experimentation and seek out advice from strangers?
Well, I don’t think very highly of my psychiatrist or doctors in general to begin with (not especially eager for a long discussion about the reasons).
Furthermore, I learned a huge deal about my body through self-experimentation that I almost certainly couldn’t have learned otherwise.
Do you know more than I do about models of poop-out? That thing is annoying and I want to know about it.
You can get some interactions from trying too many antidepressants. For example, having been on SSRIs may make you build a tolerance to other SSRIs. This appears to be a big reason why psychiatrists like to stop early, along with side effects and convenience. Still there is some value in exploration.
For comparing antidepressants you probably want open-label tests, and comparing meds directly against each other rather than with placebo.
SSRIs are pretty damn tame; which side effects are you afraid of? Sexual side effects can be a major pain but they’ll go away when you go off the meds. Vanilla-ice-cream side effects (nausea, headache, somnolence, insomnia, diarrhea, constipation, dry mouth, sweating, weight gain) are common to the majority of meds, and they all go away except the weight gain. So you should at least try them unless you have some very unusual reason. If you’re worried about weight gain, try fluoxetine (which is the usual first resort, and combines well with bupropion) or sertraline.
MAOIs are freaky shit. I hear they’re very effective, but they have so many side effects and contraindications that they’re often not worth it.
TCAs have a reputation for being effective. Apparently the reason they fell out of style is that they don’t tolerate small lapses (unlike e.g. fluoxetine with its absurdly long half-life) and that a couple’s week worth is a fatal dose, which is very bad for suicidal patients.
“Throw lots of things at depression” is an area of expertise of psychiatrists, so consider trusting them more.
[…]argue that side effects enhance the placebo effects of antidepressants by confirming to patients that they are taking the active medication and thereby increasing their expectation of improvement.
Yeah, poop-out could be the culprit. However, this would also suggest that the positive effects were mainly placebo because, as you mention in your second comment, the most reasonable account of poop-out is that the placebo effect wears off.
I was correcting for placebo cause I wanted to try lots of different antidepressants and other drugs and see which “really” work. But I guess you’re right; the placebo effect is pretty amazing and one shouldn’t risk eliminating it by over-zealous self-experimentation.
I haven’t tried any other antidepressants since I fear the side-effects of SSRIs/SNRIs and MAOIs seem like too much of a hassle (although selegiline sounds pretty good). But I’m rationalizing. I definitely should try some new stuff.
In the past I was fairly happy during the summer or at least happier than in the winter so the weather has probably nothing to do with my current low. I also didn’t change the brand of my antidepressant.
Nah, it has nothing to do with money. My psychiatrist costs me basically nothing.
So, why do I prefer self-experimentation and seek out advice from strangers? Well, I don’t think very highly of my psychiatrist or doctors in general to begin with (not especially eager for a long discussion about the reasons).
Furthermore, I learned a huge deal about my body through self-experimentation that I almost certainly couldn’t have learned otherwise.
Do you know more than I do about models of poop-out? That thing is annoying and I want to know about it.
You can get some interactions from trying too many antidepressants. For example, having been on SSRIs may make you build a tolerance to other SSRIs. This appears to be a big reason why psychiatrists like to stop early, along with side effects and convenience. Still there is some value in exploration.
For comparing antidepressants you probably want open-label tests, and comparing meds directly against each other rather than with placebo.
SSRIs are pretty damn tame; which side effects are you afraid of? Sexual side effects can be a major pain but they’ll go away when you go off the meds. Vanilla-ice-cream side effects (nausea, headache, somnolence, insomnia, diarrhea, constipation, dry mouth, sweating, weight gain) are common to the majority of meds, and they all go away except the weight gain. So you should at least try them unless you have some very unusual reason. If you’re worried about weight gain, try fluoxetine (which is the usual first resort, and combines well with bupropion) or sertraline.
MAOIs are freaky shit. I hear they’re very effective, but they have so many side effects and contraindications that they’re often not worth it.
TCAs have a reputation for being effective. Apparently the reason they fell out of style is that they don’t tolerate small lapses (unlike e.g. fluoxetine with its absurdly long half-life) and that a couple’s week worth is a fatal dose, which is very bad for suicidal patients.
“Throw lots of things at depression” is an area of expertise of psychiatrists, so consider trusting them more.
There has been talk about side effects actually enhance the placebo effect.
From Efficacy and Effectiveness of Antidepressants: Current Status of Research: