• trackball_fetish@lemmy.wtf
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    10 hours ago

    tricyclics as a first-line treatment

    What the hell did I just read?

    It’s not fear mongering. People need to be aware of the potential consequences prior to taking medication long term. Long-term usage causes (sometimes permanent) cognitive damage and withdrawal absolutely can cause psychosis, seizures and coma. Should you avoid medication if you need it? Absolutely not as the negatives are pale in comparison to the positives, but let’s not pretend that those side effects are extremely rare.

    • SoleInvictus@lemmy.blahaj.zone
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      10 hours ago

      I’d agree if you weren’t misquoting me and referring to another statement out of context.

      Do you have any specific criticism based on both what I actually wrote and actual medical science?

      Edit: I expect it’s how I mentioned tricyclics as a first-line treatment. Within anti depressants, SSRIs/SNRIs > tricyclic > MAOI due to side effect profiles, but all will often (but not always) be trialed before moving to benzodiazepine monotherapy or higher dose/frequency adjuvant therapy.

      Some studies suggest TCAs are more effective than SSRIs. MAOIs are absolutely more effective than both, but their side effect profiles and restrictions due to dietary/medication interactions can be brutal.

      The greatest evidence for this cognitive damage is a self-selected Internet survey: https://pmc.ncbi.nlm.nih.gov/articles/PMC10309976/

      We call that “pretty low quality” data in science and public health. Unsatisfied customers are more likely to write a review. lI’m not saying it’s not possible, but actual data is scant.