re: Middle aged males on antidepressants?

Someone posted earlier SSRIs don’t outperform placebos well and they’re correct. This is especially true in people taking them at low doses as one thing we seem to know handily about how they work is that truly disrupting the removal of serotonin requires higher doses than most people ever reach. My personal opinion on them is they aren’t very effective. We as doctors would never accept it’s hit/miss rate in any other field.

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Someone posted earlier SSRIs don’t outperform placebos well and they’re correct

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Well either way, I feel better so for me it's worth it. And for my poor husband too. lol

He was also well respected by many. I am sure you and I have some laughable ideas. His basic premise is undeniable. To assume all mental health, or even a majority, is a result of a chemical imbalance is even more laughable. Now, considering the positive benefits of placebo, would you recommend Dallas Tiger take sugar pills? Again, that is not to say that medicine is not effective for many people but it is clearly not the only effective option.
To piggyback off of another poster. There is some interesting research being done on MDMA's effect on trauma therapy. It seems hopeful.

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. To assume all mental health, or even a majority, is a result of a chemical imbalance is even more laughable

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Why?

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Someone posted earlier SSRIs don’t outperform placebos well and they’re correct. This is especially true in people taking them at low doses as one thing we seem to know handily about how they work is that truly disrupting the removal of serotonin requires higher doses than most people ever reach. My personal opinion on them is they aren’t very effective. We as doctors would never accept it’s hit/miss rate in any other field.

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This is one thing I wish the general public was more aware of. I am currently in a counseling graduate program and it troubles me to know how many of the assumptions in the field of psychology are based off of potentially faulty science. Relatively, we know very very little about the brain and why it produces certain behaviors. It is probably why physio psychology interests me so much.

There’s also considerable evidence Amphetamine medication outperforms SSRIs for major depressive disorder. We know how Amphetamine compounds work. They flood the Dopamine Serotonin and Norepinephrine systems. This indicates at least a causation in depression and lack of these chemicals.

td01241

Regarding my pain. I forgot to mention that I got shingles on my right foot in January and it is seriously messed up my nervous system. What’s weird is when I feel a panic attack I feel the pain in my shoulder behind my shoulder blade from the wreck and my right foot feels like it’s on fire. I know it’s my amygdala that is worn out and very sensitive

Again, something is wrong with the signal to my brain that is telling my brain I’m in danger. I’m trying to shut that off.

My question is, do you think it’s better to go and treat the depression and anxiety which in return with settle down my nerves and pain? Or would it make more sense to try an SNRI or gabapentin to go after the nerve pain And thus the depression will get better?

I obviously cannot and will not diagnose you over a message board. That said, your initial treatment approach would likely be CBT, an SSRI, and either Lyrica or Gabapentin. Possibly a benzo short term to manage current and worsening anxiety from the initial SSRI side effects.

The trials that were conducted all used Adderall XR in low doses. 5mg, 10mg, and 15mg.