Psycho-Babble Medication Thread 1117445

Shown: posts 1 to 22 of 22. This is the beginning of the thread.

 

Vortioxetine (Brintellix-Trintellix)

Posted by undopaminergic on November 13, 2021, at 12:31:24

Hi all,

I've decided that vortioxetine is worth a try, despite the failure of lurasidone (Latuda) which shares some of the serotonin antagonism (5-HT7 to be specific). It could be that the serotonin 5-HT3 is key, and the only way to know is to try. Memantine is another antagonist at this receptor, and as some of you may recall, it made me manic; I thought it was the NMDA-glutamate antagonism, but I had horrible effects (worst dysphoria I've experienced) with methoxetamine, a powerful NMDA-antagonist. I have yet to try ketamine.

It does help some people with treatment resistant depression. Here is a sample from drugs.com: "I have been taking 20 mg for about 1 month. I feel awesome. I have taken everything you can imagine and no success.".

Most of the reports on this forum seem to have been negative; has anyone had any promising effects from it?

-undopaminergic

 

Re: Vortioxetine (Brintellix-Trintellix)

Posted by Lamdage22 on November 16, 2021, at 4:58:41

In reply to Vortioxetine (Brintellix-Trintellix), posted by undopaminergic on November 13, 2021, at 12:31:24

I quit it prematurely. I make do with what I have and don't want to screw that up. Cause med trials can do that. I wish you good luck anyway.

 

Re: Vortioxetine (Brintellix-Trintellix) » undopaminergic

Posted by SLS on November 17, 2021, at 9:55:34

In reply to Vortioxetine (Brintellix-Trintellix), posted by undopaminergic on November 13, 2021, at 12:31:24

> Hi all,

Hi, UD.

>
> I've decided that vortioxetine is worth a try, despite the failure of lurasidone (Latuda) which shares some of the serotonin antagonism (5-HT7 to be specific). It could be that the serotonin 5-HT3 is key, and the only way to know is to try. Memantine is another antagonist at this receptor, and as some of you may recall, it made me manic; I thought it was the NMDA-glutamate antagonism, but I had horrible effects (worst dysphoria I've experienced) with methoxetamine, a powerful NMDA-antagonist. I have yet to try ketamine.
>
> It does help some people with treatment resistant depression. Here is a sample from drugs.com: "I have been taking 20 mg for about 1 month. I feel awesome. I have taken everything you can imagine and no success.".
>
> Most of the reports on this forum seem to have been negative; has anyone had any promising effects from it?


Vortioxetine didn't help me at all. It didn't make the depression itself worse, but it left me in a profound state of brain-fog.

ALSO.

Immediately after I switched from vortioxetine to Effexor, my depression became dramatically worse, and I decided to commit suicide. This is as close as I ever came to doing it. I was at a friend's house, and, of course, I wasn't going to leave her with my dead body to deal with. I had NEVER had a negative reaction to Effexor during the five or more times that I had taken it. It sometimes helped. My best guess is that pre-treatment with vortioxetine set the brain up for this severe reaction to Effexor. If vortioxetine were a wonder-drug, I think we would all have known it by now.

My advice to you is that you try it vortioxetine if you have run out of options that have a low probability of working. You never know.


- Scott

 

Re: Vortioxetine (Brintellix-Trintellix) » SLS

Posted by undopaminergic on November 17, 2021, at 14:17:16

In reply to Re: Vortioxetine (Brintellix-Trintellix) » undopaminergic, posted by SLS on November 17, 2021, at 9:55:34

>
> Hi, UD.

Hi SLS.

>
> Vortioxetine didn't help me at all. It didn't make the depression itself worse, but it left me in a profound state of brain-fog.
>

Interestingly, I've seen several reports from people for whom it *treated* brain-fog. I have had chronic brain fog for years and still do.

> ALSO.
>
> Immediately after I switched from vortioxetine to Effexor, my depression became dramatically worse, and I decided to commit suicide. This is as close as I ever came to doing it. I was at a friend's house, and, of course, I wasn't going to leave her with my dead body to deal with. I had NEVER had a negative reaction to Effexor during the five or more times that I had taken it. It sometimes helped. My best guess is that pre-treatment with vortioxetine set the brain up for this severe reaction to Effexor. If vortioxetine were a wonder-drug, I think we would all have known it by now.
>

It's obviously not a wonder drug for everyone; some say it's the worst drug they've been on. For others it does work wonders.

Nausea is a very common adverse effect of vortioxetine, so we can be pretty sure that many people quit it prematurely; for some of them it would have helped.

> My advice to you is that you try it vortioxetine if you have run out of options that have a low probability of working. You never know.
>

You know that you never know how a particular drug is going to affect a particular individual. The other options at this time are clomipramine, asenapine, or even venlafaxine. However, the wheels are already in motion as far as vortioxetine is concerned. I'm lucky if I get to try any of them!

-undopaminergic

 

Re: Vortioxetine (Brintellix-Trintellix)

Posted by SLS on November 18, 2021, at 2:45:06

In reply to Re: Vortioxetine (Brintellix-Trintellix) » SLS, posted by undopaminergic on November 17, 2021, at 14:17:16

Hi.

> > My advice to you is that you try it vortioxetine if you have run out of options that have a low probability of working. You never know.

>
> You know that you never know how a particular drug is going to affect a particular individual. The other options at this time are clomipramine, asenapine, or even venlafaxine. However, the wheels are already in motion as far as vortioxetine is concerned. I'm lucky if I get to try any of them!

That's a great perspective. Prior to the 1950s, there were no true antidepressants. Amphetamines and cocaine had been used in the past. Chlorpromazine (Thorazine), the first antipsychotic, was first introduced in 1952 in France. The first antidepressant approved for depression was iproniazid, a MAOI, in 1958. Imipramine, the first tricyclic, was introduced in 1959. MAOIs and TCAs. That was it. SSRIs didn't emerge in the United States until the approval of fluoxetine in 1987.


- Scott

 

Re: Vortioxetine (Brintellix-Trintellix) » SLS

Posted by undopaminergic on November 18, 2021, at 10:25:47

In reply to Re: Vortioxetine (Brintellix-Trintellix), posted by SLS on November 18, 2021, at 2:45:06

> Hi.

Hi.

> >
> > You know that you never know how a particular drug is going to affect a particular individual. The other options at this time are clomipramine, asenapine, or even venlafaxine. However, the wheels are already in motion as far as vortioxetine is concerned. I'm lucky if I get to try any of them!
> >
>
> That's a great perspective.

What are you referring to?

> Prior to the 1950s, there were no true antidepressants.

Well, the classification as antidepressant or something else is pretty arbitrary. For example, some primarily antihistaminic drugs have been classified as antidepressants.

> Amphetamines and cocaine had been used in the past. Chlorpromazine (Thorazine), the first antipsychotic, was first introduced in 1952 in France. The first antidepressant approved for depression was iproniazid, a MAOI, in 1958. Imipramine, the first tricyclic, was introduced in 1959. MAOIs and TCAs. That was it. SSRIs didn't emerge in the United States until the approval of fluoxetine in 1987.
>

Right. And they had chloral hydrate before barbiturates!

-undopaminergic

 

Re: Vortioxetine (Brintellix-Trintellix) » undopaminergic

Posted by SLS on November 18, 2021, at 12:21:53

In reply to Re: Vortioxetine (Brintellix-Trintellix) » SLS, posted by undopaminergic on November 18, 2021, at 10:25:47

> > That's a great perspective.

> What are you referring to?

> > Prior to the 1950s, there were no true antidepressants.

> Well, the classification as antidepressant or something else is pretty arbitrary. For example, some primarily antihistaminic drugs have been classified as antidepressants.

Arbitrary? In what way? I think the most histaminergic tricyclic is doxepin. Were the clinical trial directors providing the drug company with fraudulent information when the company reported sufficient efficacy for the FDA to approve it as an antidepressant? How many antipsychotics are histaminergic? Is the classification of quetiapine as an antipsychotic arbitrary? How many drugs, after their FDA approval for one indication, were found to be effective for another indication? Drugs are repurposed all of the time.

Prazosin (Minipress) was approved for hypertension decades ago. In the last 10 years, it has been used to treat PTSD, especially nightmares. I don't think the FDA has approved prazosin for PTSD yet.

By the way, if you know anyone who is taking prazosin 3 mg at bedtime only for nightmares, and they suffer residual anxiety or depression during the day, prazosin can significantly relieve those symptoms by taking it 5-10 mg t.i.d. 30 mg/day is probably the sweet-spot, but a few researchers have gone as high as 40 mg/day.

I don't know why you challenge the FDA for its approval practices and established indications.

> > Amphetamines and cocaine had been used in the past. Chlorpromazine (Thorazine), the first antipsychotic, was first introduced in 1952 in France. The first antidepressant approved for depression was iproniazid, a MAOI, in 1958. Imipramine, the first tricyclic, was introduced in 1959. MAOIs and TCAs. That was it. SSRIs didn't emerge in the United States until the approval of fluoxetine in 1987.

> Right. And they had chloral hydrate before barbiturates!

Chloral hydrate is not pleasant. I have taken it.

Doxepin is a pretty crappy antidepressant. It had become used more often as a sleep-aid than an antidepressant. However, you never know how any many individuals will respond to an approved antidepressant - like doxepin. I don't happen to know how many respond to doxepin. Maybe no one, but that is not the issue you brought up.

I don't mind your scrutinization. It makes for good dialectic.


- Scott

 

Re: Vortioxetine (Brintellix-Trintellix) » SLS

Posted by undopaminergic on November 18, 2021, at 14:21:50

In reply to Re: Vortioxetine (Brintellix-Trintellix) » undopaminergic, posted by SLS on November 18, 2021, at 12:21:53

> > > That's a great perspective.
>
> > What are you referring to?

You did not comment. I was wondering what you thought was a great perspective.

> > > Prior to the 1950s, there were no true antidepressants.
>
> > Well, the classification as antidepressant or something else is pretty arbitrary. For example, some primarily antihistaminic drugs have been classified as antidepressants.
>
> Arbitrary? In what way?

It does not always follow pharmacological facts about a compound. It "just so happens" that it is classified as one thing and not another.

> I think the most histaminergic tricyclic is doxepin. Were the clinical trial directors providing the drug company with fraudulent information when the company reported sufficient efficacy for the FDA to approve it as an antidepressant?
>

I'm not saying there is anything fraudulent, just arbitrary. From a look at the pharmacological profile of doxepine, it is obviously more of an antihistamine than it is any kind of antidepressant, especially if you expect such a drug to have monoaminergic actions. Yet it came to be classified as an antidepressant. That is arbitrary. I'm not saying it cannot be employed as an antidepressant.

> How many antipsychotics are histaminergic?

I have the impression that most of them are *anti*histaminergic. That is not to say they shouldn't have been approved as antipsychotics. There seems to be only one property all antipsychotics have in common, and that is dopamine D2-receptor antagonism. In other words it's not all that arbitrary to classify dopamine antagonists as antipsychotic. There are even some antihistamines (eg. promethazine) that might have been better classified as antipsychotics.

> Is the classification of quetiapine as an antipsychotic arbitrary?

Frankly, yes. It's such a weak dopamine antagonist and it is not very effective as an antipsychotic. I have it prescribed as a hypnotic as needed myself. Clozapine may be ever weaker, but it has proven very effective.

> How many drugs, after their FDA approval for one indication, were found to be effective for another indication? Drugs are repurposed all of the time.
>

Sure, nothing wrong with that.

> Prazosin (Minipress) was approved for hypertension decades ago. In the last 10 years, it has been used to treat PTSD, especially nightmares. I don't think the FDA has approved prazosin for PTSD yet.
>

No problem.

Sometimes one drug that shares most pharmacodynamic properties with another drug gets singled out and popularised for a particular purpose whereas the other drug does not. That is arbitrary.

> By the way, if you know anyone who is taking prazosin 3 mg at bedtime only for nightmares, and they suffer residual anxiety or depression during the day, prazosin can significantly relieve those symptoms by taking it 5-10 mg t.i.d. 30 mg/day is probably the sweet-spot, but a few researchers have gone as high as 40 mg/day.
>

OK. Personally I love to dream, and nightmares are some of the most interesting.

> I don't know why you challenge the FDA for its approval practices and established indications.
>

I never explicitly challenged the FDA. I just said that drug classification is often arbitrary. But that said, FDA approval of certain drugs for certain purposes often has more to do with the applicant's commercial interests. Ie. one company applies for approval of a certain indication for its drug that is pharmacologically equivalent to another company's drug for which the same indication is not sought. That is arbitrary.

> > Right. And they had chloral hydrate before barbiturates!
>
> Chloral hydrate is not pleasant. I have taken it.

You mean it lacks recreational potential in contrast to barbiturates and benzodiazepines?

> Doxepin is a pretty crappy antidepressant. It had become used more often as a sleep-aid than an antidepressant. However, you never know how any many individuals will respond to an approved antidepressant - like doxepin. I don't happen to know how many respond to doxepin. Maybe no one, but that is not the issue you brought up.
>

Actually it had a lot to do with that. I suggested the classification of doxepin is arbitrary. It not a very good antidepressant, even though it is classified as such. Note that arbitrary does not mean indefensible. It might even be reasonable from some point of view.

> I don't mind your scrutinization. It makes for good dialectic.
>

I made a comment in passing, without much, if any, intention to challenge you. But I'm glad you don't mind.

-undopaminergic

 

Re: Vortioxetine (Brintellix-Trintellix) » undopaminergic

Posted by SLS on November 20, 2021, at 10:15:36

In reply to Re: Vortioxetine (Brintellix-Trintellix) » SLS, posted by undopaminergic on November 18, 2021, at 14:21:50

Hi again.

> I never explicitly challenged the FDA. I just said that drug classification is often arbitrary. But that said, FDA approval of certain drugs for certain purposes often has more to do with the applicant's commercial interests. Ie. one company applies for approval of a certain indication for its drug that is pharmacologically equivalent to another company's drug for which the same indication is not sought.


> That is arbitrary.


In what way is it arbitrary? What are some examples that you feel most support your description?


> > > Right. And they had chloral hydrate before barbiturates!
> >
> > Chloral hydrate is not pleasant. I have taken it.
>
> You mean it lacks recreational potential in contrast to barbiturates and benzodiazepines?


No. It just feels almost like drinking alcohol. It felt yucky. Not pleasant for me.

I like zolpidem (Ambien). It is a potent sleep initiator with a short half-life - much like triazolam (Halcion), which is a benzodiazepine. The only major side effects for me were night-eating and some anterograde amnesia. Anterograde amnesia is more robust with triazolam than with zolpidem.
>
> > Doxepin is a pretty crappy antidepressant. It had become used more often as a sleep-aid than an antidepressant. However, you never know how any many individuals will respond to an approved antidepressant - like doxepin. I don't happen to know how many respond to doxepin. Maybe no one, but that is not the issue you brought up.

The issue you brought up is the classification of medications based upon nothing. Humans need to categorize things cognitively in order to make sense of world. The FDA uses evidence of efficacy as reported to determine specific indications for a chemical compound (drug). If other clinical properties are discovered and proven to be therapeutic, additional indications are affirmed and published by the FDA. How is that arbitrary?

> Actually it had a lot to do with that. I suggested the classification of doxepin is arbitrary.

Again, I don't understand what you mean by "arbitrary".


-------------------------------------------------

Arbitrary: Merriam-Webster

1. not planned or chosen for a particular reason An arbitrary number has been assigned to each district. : not based on reason or evidence I don't know why I chose that one; it was a completely arbitrary decision.

2. done without concern for what is fair or right Although arbitrary arrests are illegal, they continue to occur in many parts of the country.

-------------------------------------------------

- Scott

 

Re: Vortioxetine (Brintellix-Trintellix)

Posted by undopaminergic on November 20, 2021, at 11:48:31

In reply to Re: Vortioxetine (Brintellix-Trintellix) » undopaminergic, posted by SLS on November 20, 2021, at 10:15:36

> Hi again.
>

Hi there.

> > > > Right. And they had chloral hydrate before barbiturates!
> > >
> > > Chloral hydrate is not pleasant. I have taken it.
> >
> > You mean it lacks recreational potential in contrast to barbiturates and benzodiazepines?
>
>
> No. It just feels almost like drinking alcohol. It felt yucky. Not pleasant for me.
>

Many people enjoy drinking alcohol. Do you think some may find chloral hydrate likewise pleasant?

> I like zolpidem (Ambien). It is a potent sleep initiator with a short half-life - much like triazolam (Halcion), which is a benzodiazepine. The only major side effects for me were night-eating and some anterograde amnesia. Anterograde amnesia is more robust with triazolam than with zolpidem.
>

I liked zolpidem as well. I've never tried triazolam, but I've used another short-acting benzodiazepine for sleep (initiation), namely midazolam (Dormicum), which appears to be available in the US only as injection (Versed?).

Later, I seemed to become resistant to sleep aids, at least zolpidem and temazepam.

Antihistamines don't work as hypnotics for me, as they don't make me sleepy, but they do make me tired and/or apathetic, so I guess they help me fall asleep sooner after all -- it just takes an annoyingly long time, in contrast to how midazolam and zolpidem used to work for me.

>
> The issue you brought up is the classification of medications based upon nothing.

Ah, I see. That ("based on nothing") was never my intention.

>
> Arbitrary: Merriam-Webster
>
> 1. not planned or chosen for a particular reason An arbitrary number has been assigned to each district. : not based on reason or evidence I don't know why I chose that one; it was a completely arbitrary decision.
>
> 2. done without concern for what is fair or right Although arbitrary arrests are illegal, they continue to occur in many parts of the country.
>

I think I was thinking along the lines of definition 2. Not "fair", not "right", not "legitimate", not "kosher".

You seem to be disagreeing based on your definition of "arbitrary". You thought I meant something else than what I intended. Maybe "arbitrary" isn't the best choice of word -- what would *you* call it?

-undopaminergic

 

Re: Vortioxetine (Brintellix-Trintellix) » undopaminergic

Posted by SLS on November 20, 2021, at 12:52:19

In reply to Re: Vortioxetine (Brintellix-Trintellix), posted by undopaminergic on November 20, 2021, at 11:48:31

> Right. And they had chloral hydrate before barbiturates!

> > Chloral hydrate is not pleasant. I have taken it.

> You mean it lacks recreational potential in contrast to barbiturates and benzodiazepines?

> > No. It just feels almost like drinking alcohol. It felt yucky. Not pleasant for me.

> Many people enjoy drinking alcohol. Do you think some may find chloral hydrate likewise pleasant?

I don't know what percentage of people taking chloral hydrate, if any, find it likewise as pleasant as alcohol to dose themselves with. Do you happen to know? Did you find it pleasant when you took it? What was the amount and frequency of your chloral hydrate dosing to receive the maximal pleasant psychotropic effects?

> > I like zolpidem (Ambien). It is a potent sleep initiator with a short half-life - much like triazolam (Halcion), which is a benzodiazepine. The only major side effects for me were night-eating and some anterograde amnesia. Anterograde amnesia is more robust with triazolam than with zolpidem.

> I liked zolpidem as well. I've never tried triazolam, but I've used another short-acting benzodiazepine for sleep (initiation), namely midazolam (Dormicum), which appears to be available in the US only as injection (Versed?).

> > The issue you brought up is the classification of medications based upon nothing.

> Ah, I see. That ("based on nothing") was never my intention.

> > Arbitrary: Merriam-Webster
> >
> > 1. not planned or chosen for a particular reason An arbitrary number has been assigned to each district. : not based on reason or evidence I don't know why I chose that one; it was a completely arbitrary decision.
> >
> > 2. done without concern for what is fair or right Although arbitrary arrests are illegal, they continue to occur in many parts of the country.
> >
>
> I think I was thinking along the lines of definition 2. Not "fair", not "right", not "legitimate", not "kosher".

Can you provide me with a few examples of the arbitrary classification of drugs by the FDA?


> You seem to be disagreeing based on your definition of "arbitrary". You thought I meant something else than what I intended. Maybe "arbitrary" isn't the best choice of word -- what would *you* call it?

Undopaminergic:

When was the last time you recognized that you had lost an argument?


- Scott

 

Re: Vortioxetine (Brintellix-Trintellix) » SLS

Posted by undopaminergic on November 20, 2021, at 13:33:15

In reply to Re: Vortioxetine (Brintellix-Trintellix) » undopaminergic, posted by SLS on November 20, 2021, at 12:52:19

> > Right. And they had chloral hydrate before barbiturates!
>
> > > Chloral hydrate is not pleasant. I have taken it.
>
> > You mean it lacks recreational potential in contrast to barbiturates and benzodiazepines?
>
> > > No. It just feels almost like drinking alcohol. It felt yucky. Not pleasant for me.
>
> > Many people enjoy drinking alcohol. Do you think some may find chloral hydrate likewise pleasant?
>
> I don't know what percentage of people taking chloral hydrate, if any, find it likewise as pleasant as alcohol to dose themselves with. Do you happen to know? Did you find it pleasant when you took it? What was the amount and frequency of your chloral hydrate dosing to receive the maximal pleasant psychotropic effects?
>

I never tried chloral hydrate. I *used* to enjoy drinking certain preparations of alcohol, especially liqueur.

>
> > > The issue you brought up is the classification of medications based upon nothing.
>
> > Ah, I see. That ("based on nothing") was never my intention.
>
> > > Arbitrary: Merriam-Webster
> > >
> > > 1. not planned or chosen for a particular reason An arbitrary number has been assigned to each district. : not based on reason or evidence I don't know why I chose that one; it was a completely arbitrary decision.
> > >
> > > 2. done without concern for what is fair or right Although arbitrary arrests are illegal, they continue to occur in many parts of the country.
> > >
> >
> > I think I was thinking along the lines of definition 2. Not "fair", not "right", not "legitimate", not "kosher".
>
> Can you provide me with a few examples of the arbitrary classification of drugs by the FDA?
>

Doxepin is one that I feel wasn't classified "right", ie. based on "legit" pharmacological facts. It's more an antihistamine that can be of some use to treat depression than it is an antidepressant that can be used as an antihistamine. I don't blame the FDA specifically; the drug company was at least as much to blame.

> > You seem to be disagreeing based on your definition of "arbitrary". You thought I meant something else than what I intended. Maybe "arbitrary" isn't the best choice of word -- what would *you* call it?
>
> Undopaminergic:
>
> When was the last time you recognized that you had lost an argument?

Frankly, I have no idea.

However, there *is* no argument, just misunderstanding. I used the word "arbitrary" to mean something else than what it means to you. There seems to be no disagreement about the facts.

If it makes you feel better, we can agree to consider you the winner. It's just no competition to me. It's not important, I just made a comment in passing, not expecting I'd be opening a can of worms. Can we move on now?

-undopaminergic

 

Re: Vortioxetine (Brintellix-Trintellix) » undopaminergic

Posted by SLS on November 20, 2021, at 16:49:06

In reply to Re: Vortioxetine (Brintellix-Trintellix) » SLS, posted by undopaminergic on November 20, 2021, at 13:33:15

> > Undopaminergic:
> >
> > When was the last time you recognized that you had lost an argument?


> Frankly, I have no idea.

> However, there *is* no argument, just misunderstanding. I used the word "arbitrary" to mean something else than what it means to you. There seems to be no disagreement about the facts.
>
> If it makes you feel better, we can agree to consider you the winner.

Phew...

You had me scared there for a moment. I thought I had lost one. It would have been my first.

> It's just no competition to me. It's not important, I just made a comment in passing, not expecting I'd be opening a can of worms. Can we move on now?

Does it really matter in what manner you made a comment - passing or not? You made a statement proposing that the classification of drugs is arbitrary. I think this claim of yours is important to look at closely. I have not seen evidence that the FDA chronically classifies the drugs it approves arbitrarily and without deliberation. Perhaps this opinion of yours is more salient to me than it is to you.

What was *your* conceptualization of the word "arbitrary" when you used it (in your own words)?

Can you cite a few instances where the classification of a drug was arbitrary, and by whom? The FDA? Do you think this agency is capricious when it decides what indications to approve a drug for?

The FDA doesn't classify drugs. It only lists the indications for which it determines a drug is effective to treat. Using a drug for any reason other than the indications approved by the FDA is considered "off-label". This is an issue that has obvious importance.

I found an article that I think helps clarify the reasons for why I place so much importance on examining your thesis. My comments here are not made in passing - obviously.

http://jaapl.org/content/early/2020/11/24/JAAPL.200049-20


- Scott

 

Re: Vortioxetine (Brintellix-Trintellix)

Posted by sigismund on November 21, 2021, at 11:06:30

In reply to Re: Vortioxetine (Brintellix-Trintellix) » undopaminergic, posted by SLS on November 20, 2021, at 12:52:19

For me there's no comparison. Alcohol is fun for a bit. Chloral is yucky.

 

Re: Vortioxetine (Brintellix-Trintellix) » SLS

Posted by undopaminergic on November 21, 2021, at 13:31:11

In reply to Re: Vortioxetine (Brintellix-Trintellix) » undopaminergic, posted by SLS on November 20, 2021, at 16:49:06

> > > Undopaminergic:
> > >
> > > When was the last time you recognized that you had lost an argument?
>
>
> > Frankly, I have no idea.
>
> > However, there *is* no argument, just misunderstanding. I used the word "arbitrary" to mean something else than what it means to you. There seems to be no disagreement about the facts.
> >
> > If it makes you feel better, we can agree to consider you the winner.
>
> Phew...
>
> You had me scared there for a moment. I thought I had lost one. It would have been my first.
>

Are you serious?

> > It's just no competition to me. It's not important, I just made a comment in passing, not expecting I'd be opening a can of worms. Can we move on now?
>
> Does it really matter in what manner you made a comment - passing or not?

It matters to me, but maybe not to you.

> You made a statement proposing that the classification of drugs is arbitrary. I think this claim of yours is important to look at closely. I have not seen evidence that the FDA chronically classifies the drugs it approves arbitrarily and without deliberation. Perhaps this opinion of yours is more salient to me than it is to you.
>

It is, apparently.

> What was *your* conceptualization of the word "arbitrary" when you used it (in your own words)?
>

I elaborated on it a bit in my previous reply. Maybe "not proper", or "for second-rate reasons".

> Can you cite a few instances where the classification of a drug was arbitrary, and by whom? The FDA? Do you think this agency is capricious when it decides what indications to approve a drug for?
>

I mentioned doxepin. There was also a SSRI that was approved for the indication of premenstrual syndrome, whereas other SSRIs probably are as effective but have not received the same approval.

> The FDA doesn't classify drugs. It only lists the indications for which it determines a drug is effective to treat. Using a drug for any reason other than the indications approved by the FDA is considered "off-label". This is an issue that has obvious importance.
>

Yes.

> I found an article that I think helps clarify the reasons for why I place so much importance on examining your thesis. My comments here are not made in passing - obviously.
>
> http://jaapl.org/content/early/2020/11/24/JAAPL.200049-20

In my opinion, the official indications are pretty much irrelevant. What matters is what is known (or at least presumed for good reason) to work.

-undopaminergic

 

Re: Vortioxetine (Brintellix-Trintellix) » undopaminergic

Posted by SLS on November 23, 2021, at 12:10:50

In reply to Re: Vortioxetine (Brintellix-Trintellix) » SLS, posted by undopaminergic on November 21, 2021, at 13:31:11

You won, UD.

Dammit.

I guess there's a first time for everything...


- Scott

 

Re: Vortioxetine (Brintellix-Trintellix) » undopaminergic

Posted by SLS on November 23, 2021, at 12:12:07

In reply to Re: Vortioxetine (Brintellix-Trintellix) » SLS, posted by undopaminergic on November 21, 2021, at 13:31:11

You won, UD.

Dammit.

I guess there's a first time for everything...

...my losing, that is.


- Scott

 

Re: Vortioxetine (Brintellix-Trintellix) » SLS

Posted by undopaminergic on November 23, 2021, at 12:22:10

In reply to Re: Vortioxetine (Brintellix-Trintellix) » undopaminergic, posted by SLS on November 23, 2021, at 12:12:07

> You won, UD.
>
> Dammit.
>
> I guess there's a first time for everything...
>
> ...my losing, that is.
>
>
> - Scott

OK. But why do you think I won?

-undopaminergic

 

Re: Vortioxetine (Brintellix-Trintellix) » undopaminergic

Posted by SLS on November 23, 2021, at 21:43:06

In reply to Re: Vortioxetine (Brintellix-Trintellix) » SLS, posted by undopaminergic on November 23, 2021, at 12:22:10

> > You won, UD.
> >
> > Dammit.
> >
> > I guess there's a first time for everything...
> >
> > ...my losing, that is.
> >
> >
> > - Scott
>
> OK. But why do you think I won?
>
> -undopaminergic

I think because you wanted it more than I did.

I never had the impression that the FDA, nor anyone else, categorized drugs arbitrarily and without some rationale involving critical thinking. Arbitrary is like flipping a coin.

"Coin tossing is a simple and unbiased way of settling a dispute or deciding between two or more arbitrary options"

https://en.wikipedia.org/wiki/Coin_flipping

Please let me lose with some dignity.


- Scott

 

Re: Vortioxetine (Brintellix-Trintellix) » SLS

Posted by undopaminergic on November 24, 2021, at 7:36:07

In reply to Re: Vortioxetine (Brintellix-Trintellix) » undopaminergic, posted by SLS on November 23, 2021, at 21:43:06

> > > You won, UD.
> > >
> > > Dammit.
> > >
> > > I guess there's a first time for everything...
> > >
> > > ...my losing, that is.
> > >
> > >
> > > - Scott
> >
> > OK. But why do you think I won?
> >
> > -undopaminergic
>
>
>
> I think because you wanted it more than I did.

I wasn't very invested in it. As I said, I made a comment in passing.

> I never had the impression that the FDA, nor anyone else, categorized drugs arbitrarily and without some rationale involving critical thinking. Arbitrary is like flipping a coin.
>

Well, that was never what I meant.

> Please let me lose with some dignity.

OK, but I still don't understand why you think you lost.

-undopaminergic

 

Re: Vortioxetine (Brintellix-Trintellix) » undopaminergic

Posted by beckett2 on November 28, 2021, at 20:32:56

In reply to Vortioxetine (Brintellix-Trintellix), posted by undopaminergic on November 13, 2021, at 12:31:24

Hey, I've taken it for a few years and I like it well enough. The biggest benefit was greater clarity of thought. Like the cliché, the mental fog cleared.

Some years in, it's ok. I'm at 20 mg. It's not a cure-all for my depression. Apathy has returned, but not the terror or existential horrors of anxiety and gad. So that's good :-)

 

Re: Vortioxetine (Brintellix-Trintellix)

Posted by Lamdage22 on November 30, 2021, at 3:07:33

In reply to Re: Vortioxetine (Brintellix-Trintellix) » undopaminergic, posted by beckett2 on November 28, 2021, at 20:32:56

Meds seldomly are a cure-all. There is also the psychological side. And biology is not just meds either.


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