1 00:00:01,440 --> 00:00:07,720 Speaker 1: Welcome to Stuff You Should Know, a production of iHeartRadio. 2 00:00:11,160 --> 00:00:13,720 Speaker 2: Hey, and welcome to the podcast. I'm Josh, and there's 3 00:00:13,840 --> 00:00:16,919 Speaker 2: Chuck and Jerry's here too. Well. Actually, that's not true, 4 00:00:17,000 --> 00:00:19,320 Speaker 2: isn't it. It's a dirty, dirty lie. 5 00:00:19,280 --> 00:00:19,959 Speaker 1: You're talking about. 6 00:00:19,960 --> 00:00:25,320 Speaker 2: It's just me and Chuck. We're producing our own jam today. 7 00:00:25,360 --> 00:00:27,520 Speaker 2: I guess you could say, and this is stuff you 8 00:00:27,520 --> 00:00:27,960 Speaker 2: should know. 9 00:00:28,360 --> 00:00:31,640 Speaker 1: That's right, and the listener will never hear where we 10 00:00:31,760 --> 00:00:34,520 Speaker 1: edit out when Jerry burst into the room in two minutes. 11 00:00:36,080 --> 00:00:37,840 Speaker 1: We'll just cut that out nice and clean. 12 00:00:38,200 --> 00:00:40,280 Speaker 2: We should just leave it in once, just a really 13 00:00:40,440 --> 00:00:40,960 Speaker 2: kind shure. 14 00:00:41,200 --> 00:00:42,360 Speaker 1: Yeah, guys. 15 00:00:42,440 --> 00:00:46,559 Speaker 2: Uh, she's got like a little bit of miso in 16 00:00:46,560 --> 00:00:47,400 Speaker 2: the corner of her mouth. 17 00:00:47,479 --> 00:00:49,280 Speaker 1: Oh, always a little crusty miso. 18 00:00:50,280 --> 00:00:55,200 Speaker 2: So Chuck. Today, we are doing something in grand Stuff 19 00:00:55,240 --> 00:01:02,400 Speaker 2: you should Know Fashion. We're doing a tangential episode where 20 00:01:02,640 --> 00:01:06,160 Speaker 2: we haven't done like the core episode that it relates to. 21 00:01:06,920 --> 00:01:09,000 Speaker 1: Have We never done one on depression. 22 00:01:09,360 --> 00:01:13,000 Speaker 2: Actually, I could not believe. I looked on the stat 23 00:01:13,080 --> 00:01:17,080 Speaker 2: sheet maintained by Jill Hurley, which is infallible. I looked 24 00:01:17,120 --> 00:01:21,240 Speaker 2: all over the internet. I sat there and had a 25 00:01:21,240 --> 00:01:25,559 Speaker 2: conversation with myself. Nothing. It's not there. 26 00:01:26,959 --> 00:01:29,440 Speaker 1: Yeah. I mean that's so like us to hit stuff 27 00:01:29,440 --> 00:01:30,440 Speaker 1: like bipolar first. 28 00:01:31,360 --> 00:01:34,119 Speaker 2: Yeah. Yeah, we did do bipolar, we've done PTSD, we've 29 00:01:34,120 --> 00:01:39,440 Speaker 2: done ADHD obviously all that, but we'll definitely do depression 30 00:01:39,520 --> 00:01:40,119 Speaker 2: at some point. 31 00:01:41,200 --> 00:01:43,839 Speaker 1: Okay, I think it makes sense maybe to cover this first. 32 00:01:44,080 --> 00:01:45,120 Speaker 1: So how about that? 33 00:01:46,040 --> 00:01:47,480 Speaker 2: Sure? Think it to me? 34 00:01:47,680 --> 00:01:50,400 Speaker 1: Yeah, put that in your paulm and wash it down 35 00:01:50,400 --> 00:01:53,440 Speaker 1: with some water. How's that for a segue? 36 00:01:53,640 --> 00:01:55,600 Speaker 2: Oh that was a good one. That was great man. 37 00:01:56,120 --> 00:01:59,280 Speaker 2: So yeah, we're talking about antidepressants. That was a great one. 38 00:01:59,600 --> 00:01:59,880 Speaker 1: Thanks. 39 00:02:00,320 --> 00:02:03,080 Speaker 2: And to talk about antidepressants, we really do have to 40 00:02:03,120 --> 00:02:05,240 Speaker 2: kind of give at least the briefest overview of what 41 00:02:05,320 --> 00:02:06,040 Speaker 2: depression is. 42 00:02:06,160 --> 00:02:06,240 Speaker 1: Like. 43 00:02:08,120 --> 00:02:11,960 Speaker 2: It's kind of everywhere. I saw something like sixty million 44 00:02:12,240 --> 00:02:15,880 Speaker 2: adults in America and I think they define that over 45 00:02:15,960 --> 00:02:19,480 Speaker 2: age eighteen these days for this kind of stuff have 46 00:02:19,840 --> 00:02:27,760 Speaker 2: some sort of diagnosed depression. I think twenty million of 47 00:02:27,800 --> 00:02:33,120 Speaker 2: those have major depressive disorder, which also is called clinical 48 00:02:33,160 --> 00:02:37,440 Speaker 2: depression or unipolar depression, as opposed to say, like bipolar 49 00:02:37,480 --> 00:02:41,560 Speaker 2: where you have ups and downs, mania and depression unipolars 50 00:02:41,639 --> 00:02:45,880 Speaker 2: like just depression. And it apparently is picking up so 51 00:02:46,040 --> 00:02:49,440 Speaker 2: much that the World Health Organization is saying like, hey, guys, 52 00:02:49,800 --> 00:02:54,000 Speaker 2: by twenty thirty, that will be the leading disease essentially 53 00:02:54,080 --> 00:02:57,399 Speaker 2: in the entire world. Depression will be just the way 54 00:02:57,440 --> 00:03:00,160 Speaker 2: that things are going and everyone in the world. I 55 00:03:00,200 --> 00:03:03,800 Speaker 2: was like, yeah, you know, and it just kind of 56 00:03:03,880 --> 00:03:04,760 Speaker 2: is going from there. 57 00:03:05,200 --> 00:03:08,919 Speaker 1: Yeah, I mean, that's a good overview, you know, without 58 00:03:08,919 --> 00:03:13,079 Speaker 1: getting into the weeds as far as numbers go. Symptoms 59 00:03:14,040 --> 00:03:22,120 Speaker 1: as you might imagine are they're sad, disrupted sleep, feeling 60 00:03:22,320 --> 00:03:27,360 Speaker 1: like you're worthless. Sometimes it affects your concentration. Sometimes it 61 00:03:27,360 --> 00:03:32,080 Speaker 1: affects your ability to even experience pleasure at all. Even 62 00:03:32,120 --> 00:03:36,080 Speaker 1: you know, when you're you know, doing something that might 63 00:03:36,200 --> 00:03:40,040 Speaker 1: ordinarily be fun for you, it's not fun. It's not 64 00:03:41,240 --> 00:03:44,040 Speaker 1: being sad in a moment or being blue for a 65 00:03:44,040 --> 00:03:48,840 Speaker 1: little while. It is a persistent thing where it disrupts 66 00:03:48,880 --> 00:03:51,360 Speaker 1: your life. It interferes with your life. It can interfere 67 00:03:51,400 --> 00:03:55,040 Speaker 1: with your relationships and interfere with your relationship with yourself 68 00:03:55,080 --> 00:03:55,880 Speaker 1: in a big, big way. 69 00:03:56,480 --> 00:03:58,920 Speaker 2: Yeah, and for a lot of people, I think for 70 00:03:59,040 --> 00:04:04,520 Speaker 2: most people, statistically speaking, it's chronic or recurring. You don't 71 00:04:04,560 --> 00:04:07,600 Speaker 2: just have one episode. It can keep coming back and back, 72 00:04:08,760 --> 00:04:11,640 Speaker 2: and it's nothing new like depression is not new, although 73 00:04:11,680 --> 00:04:14,080 Speaker 2: it does it has really kind of picked up as 74 00:04:14,080 --> 00:04:17,440 Speaker 2: far as diagnoses and prescriptions go. But I mean, we 75 00:04:17,520 --> 00:04:20,719 Speaker 2: used to call it melancholy and they associated it with 76 00:04:20,839 --> 00:04:25,400 Speaker 2: black bile all the way back to Hippocrates. And depending 77 00:04:25,400 --> 00:04:28,360 Speaker 2: on what culture you were from, they would either say 78 00:04:29,240 --> 00:04:32,280 Speaker 2: tell you that you needed positive rewards. It's say you 79 00:04:32,360 --> 00:04:35,680 Speaker 2: lived in Persia in the ninth century, or if you 80 00:04:35,800 --> 00:04:38,760 Speaker 2: were in medieval Europe, they might burn you at the 81 00:04:38,800 --> 00:04:42,560 Speaker 2: stake or something like that. Luckily, we've come a long 82 00:04:42,600 --> 00:04:46,440 Speaker 2: way with treating depression. That's the that's I think we 83 00:04:46,440 --> 00:04:48,840 Speaker 2: should say here at the outset. That's the message we're 84 00:04:48,839 --> 00:04:52,400 Speaker 2: trying to say, like it is highly treatable. Like if 85 00:04:52,440 --> 00:04:55,200 Speaker 2: you have depression and you're you're not treating it, there's 86 00:04:55,760 --> 00:04:59,719 Speaker 2: definitely hope, So please don't feel like there's not. There's 87 00:04:59,760 --> 00:05:02,279 Speaker 2: plenty any of hope that if anything, hopefully. That's what 88 00:05:02,360 --> 00:05:06,720 Speaker 2: we get across this in this episode. But there used 89 00:05:06,760 --> 00:05:08,680 Speaker 2: to be they used to give people edemas, they used 90 00:05:08,720 --> 00:05:13,640 Speaker 2: to give people baths, positive thinking, diet, exercise, And what's interesting, 91 00:05:13,720 --> 00:05:16,760 Speaker 2: Chuck is some of those are still prescribed today. Depending 92 00:05:16,800 --> 00:05:18,080 Speaker 2: on the severity of your. 93 00:05:17,960 --> 00:05:22,240 Speaker 1: Depression, yeah, for sure, and those things very much help. 94 00:05:22,360 --> 00:05:24,359 Speaker 1: And I'm glad you said that what you said just 95 00:05:24,400 --> 00:05:27,640 Speaker 1: a second ago, because when I said, I sounded very 96 00:05:27,760 --> 00:05:31,039 Speaker 1: very down when I said that the symptoms are and 97 00:05:31,120 --> 00:05:34,200 Speaker 1: I pause and just said sad. There is a lot 98 00:05:34,200 --> 00:05:37,840 Speaker 1: of hope. But you know, I have everybody you know 99 00:05:38,480 --> 00:05:41,279 Speaker 1: has if they don't suffer from the depression. You have 100 00:05:41,360 --> 00:05:43,359 Speaker 1: people in your life and your family and your friends 101 00:05:44,040 --> 00:05:46,720 Speaker 1: that do it. And it makes me very sad because 102 00:05:46,800 --> 00:05:51,160 Speaker 1: these are, you know, great people who have a hill 103 00:05:51,240 --> 00:05:54,520 Speaker 1: they need to consistently hike up. And I imagine it 104 00:05:55,279 --> 00:05:59,760 Speaker 1: is something that drains your life force. And we're here 105 00:05:59,760 --> 00:06:01,640 Speaker 1: to talk talk about some of the ways that you 106 00:06:01,680 --> 00:06:02,279 Speaker 1: can change that. 107 00:06:03,000 --> 00:06:06,560 Speaker 2: Yeah, just as an aside, every time I think of 108 00:06:06,680 --> 00:06:11,800 Speaker 2: depression being like really accurately portrayed, I think of Kirsten 109 00:06:11,920 --> 00:06:15,880 Speaker 2: Dunst in Melancholia, the large von Trier movie. Yeah, Lars 110 00:06:15,960 --> 00:06:18,360 Speaker 2: von Trier, of all people, seems to have most accurately 111 00:06:18,839 --> 00:06:23,000 Speaker 2: portrayed clinical depression in that movie. It is a great movie, 112 00:06:23,000 --> 00:06:26,120 Speaker 2: but she just does an amazing job. Like there's a 113 00:06:26,120 --> 00:06:30,000 Speaker 2: part where she's just in physical pain, such physical pain 114 00:06:30,640 --> 00:06:34,200 Speaker 2: from being so depressed that like she can barely crawl 115 00:06:34,200 --> 00:06:35,360 Speaker 2: into a bath. 116 00:06:36,000 --> 00:06:37,160 Speaker 1: Yeah, it's really so. 117 00:06:37,120 --> 00:06:37,960 Speaker 2: It's hard to watch. 118 00:06:38,160 --> 00:06:41,599 Speaker 1: That was a one timer for me. Yeah, not the 119 00:06:41,680 --> 00:06:44,559 Speaker 1: kind of movie you watch over and over. But Lars 120 00:06:45,320 --> 00:06:47,479 Speaker 1: Lars von Trier can make a great, great plack and 121 00:06:47,480 --> 00:06:49,560 Speaker 1: I love Kirstend She's great for sure. 122 00:06:50,480 --> 00:06:53,600 Speaker 2: So we should say that you rarely will get an 123 00:06:53,680 --> 00:06:56,960 Speaker 2: enema when you present yourself to a physician and are 124 00:06:57,000 --> 00:07:03,640 Speaker 2: diagnosed with clinical DEPRESSI major depressive disorder. Instead, they will 125 00:07:03,760 --> 00:07:07,560 Speaker 2: prescribe you pills antidepressants. And the reason that they will 126 00:07:07,600 --> 00:07:10,360 Speaker 2: prescribe you any depressant is because, ever since the seventies, 127 00:07:10,800 --> 00:07:15,240 Speaker 2: people have kind of basically treated depression based on what's 128 00:07:15,240 --> 00:07:19,120 Speaker 2: called the biological model. And the biological model says that 129 00:07:19,600 --> 00:07:24,360 Speaker 2: you're depressed because there's an imbalance of neurotransmitters chemicals in 130 00:07:24,400 --> 00:07:28,920 Speaker 2: your brain, and usually they zero in on serotonin. They 131 00:07:28,960 --> 00:07:32,960 Speaker 2: say you are depressed because you have low levels of serotonin. 132 00:07:33,200 --> 00:07:37,520 Speaker 2: And that's been the dominant view for decades now. That's 133 00:07:37,560 --> 00:07:40,120 Speaker 2: how we treat depression as based on that presumption. 134 00:07:40,680 --> 00:07:43,960 Speaker 1: Yeah, and it's accepted, and it's not like it's accepted with, 135 00:07:44,080 --> 00:07:46,680 Speaker 1: you know, through gritted teeth. I think most people agree 136 00:07:46,720 --> 00:07:49,920 Speaker 1: That's what most people agree on, is they don't really 137 00:07:50,000 --> 00:07:54,200 Speaker 1: understand what might be the underlying issue or the mechanism 138 00:07:54,240 --> 00:07:58,560 Speaker 1: behind that is. We do know like a lot of 139 00:07:58,560 --> 00:08:03,280 Speaker 1: the things that may lead to depression. If you're a woman, 140 00:08:03,320 --> 00:08:06,800 Speaker 1: you're more likely to get would you call it MDD? 141 00:08:07,600 --> 00:08:09,880 Speaker 2: Yeah, major depressive disorder. 142 00:08:09,680 --> 00:08:13,559 Speaker 1: Yeah, major depressive disorder if you have suffered a loss 143 00:08:13,640 --> 00:08:16,960 Speaker 1: or unresolved grief, and these are things that can compound. 144 00:08:17,000 --> 00:08:19,840 Speaker 1: It's not like, again, that's different than being sad about 145 00:08:20,040 --> 00:08:22,240 Speaker 1: you know, losing a loved one or something like that, 146 00:08:23,240 --> 00:08:25,800 Speaker 1: but it can help contribute to MDD. Same as if 147 00:08:25,840 --> 00:08:28,640 Speaker 1: you suffer through a stress early in your life, that 148 00:08:28,680 --> 00:08:31,360 Speaker 1: can all contribute. So we know some of those things, 149 00:08:31,360 --> 00:08:35,600 Speaker 1: but we don't know that underlying mechanism that actually causes it. 150 00:08:35,679 --> 00:08:40,600 Speaker 1: And because that, we don't exactly know how antidepressants work. 151 00:08:41,559 --> 00:08:43,320 Speaker 1: We know that they do work, and we know what 152 00:08:43,360 --> 00:08:46,320 Speaker 1: they do, but if you really don't know the underlying cause, 153 00:08:47,040 --> 00:08:49,760 Speaker 1: you can't just say like, yeah, we have antidepressants completely 154 00:08:49,760 --> 00:08:51,480 Speaker 1: figured out because we know they work and we know 155 00:08:51,840 --> 00:08:52,560 Speaker 1: how they function. 156 00:08:53,160 --> 00:08:55,120 Speaker 2: Yeah. So much so we have so little of a 157 00:08:55,160 --> 00:09:02,880 Speaker 2: grasp on how people become depressed, especially like depressed. That 158 00:09:03,880 --> 00:09:07,960 Speaker 2: studies show that people with MDD don't have aren't likely 159 00:09:08,080 --> 00:09:12,160 Speaker 2: or to have lower levels of serotonin than other people, 160 00:09:13,640 --> 00:09:16,520 Speaker 2: and that just throws out basically the whole premise of 161 00:09:16,559 --> 00:09:20,800 Speaker 2: the biological model. And yet we know that antidepressants work, 162 00:09:20,840 --> 00:09:24,360 Speaker 2: They work better than placebo. They're definitely doing something, and 163 00:09:24,400 --> 00:09:27,480 Speaker 2: we know that by design what they're doing is going 164 00:09:27,520 --> 00:09:32,720 Speaker 2: in and messing with the concentration of neurotransmitters in your brain. 165 00:09:33,240 --> 00:09:35,560 Speaker 2: We know they're doing that. We just don't know how 166 00:09:35,679 --> 00:09:40,040 Speaker 2: that mechanism is treating the depression. We just know it works. 167 00:09:40,400 --> 00:09:45,840 Speaker 2: And I guess over the years psychologists or psychiatrists and 168 00:09:45,960 --> 00:09:48,559 Speaker 2: doctors have been like, let's just not ask questions. 169 00:09:48,880 --> 00:09:53,440 Speaker 1: Well, thankfully we know that's not one hundred percent true 170 00:09:53,440 --> 00:09:55,840 Speaker 1: because they are still studying and trying to figure this out. 171 00:09:56,160 --> 00:09:58,040 Speaker 1: There was a study that I guess you dug this 172 00:09:58,080 --> 00:10:01,560 Speaker 1: one up from last year from the University of Colorado, 173 00:10:01,760 --> 00:10:10,000 Speaker 1: Go Buffalo's that hypothesize that increasing well, increasing serotonin, we 174 00:10:10,040 --> 00:10:13,760 Speaker 1: know that alleviate symptoms, but it's not like it's just 175 00:10:14,240 --> 00:10:18,520 Speaker 1: rebalancing your brain and picking up a level that you 176 00:10:18,640 --> 00:10:22,040 Speaker 1: had that was low. They are saying from the study 177 00:10:22,440 --> 00:10:25,480 Speaker 1: that maybe it's helping to repair the neuroplasticity in the 178 00:10:25,520 --> 00:10:29,480 Speaker 1: brain and just sort of like their brain circuits that 179 00:10:29,559 --> 00:10:32,680 Speaker 1: become just sort of stuck and lodged in that depressed state, 180 00:10:32,760 --> 00:10:34,680 Speaker 1: and it helps to unstick those. 181 00:10:35,360 --> 00:10:38,360 Speaker 2: Yeah, that's a newish from what I can tell. Rival 182 00:10:38,480 --> 00:10:43,760 Speaker 2: theory to the biological model. Even though it's biological itself. 183 00:10:43,760 --> 00:10:47,880 Speaker 2: It's very very confusing stuff. But the idea remember you 184 00:10:47,920 --> 00:10:52,720 Speaker 2: said earlier that like you differentiate you know, MDD or 185 00:10:52,760 --> 00:10:57,320 Speaker 2: even just non major depression, but you know diagnosable depression 186 00:10:57,640 --> 00:11:02,480 Speaker 2: from just a passing feeling of the blues right for 187 00:11:02,520 --> 00:11:03,319 Speaker 2: like a day or so. 188 00:11:03,440 --> 00:11:05,480 Speaker 1: Yeah, or mood swings you might call it whatever. 189 00:11:05,720 --> 00:11:10,360 Speaker 2: Sure, So this theory basically says that thing that people 190 00:11:10,559 --> 00:11:13,760 Speaker 2: normally come out of people get stuck and it just 191 00:11:13,800 --> 00:11:15,960 Speaker 2: seems to get worse and worse and worse the longer 192 00:11:16,000 --> 00:11:19,440 Speaker 2: you're stuck in it, or the harder you're stuck in it. 193 00:11:19,840 --> 00:11:23,160 Speaker 2: So that's a I love that theory, and there's actually 194 00:11:23,200 --> 00:11:28,280 Speaker 2: support for it because some of the newer, more far 195 00:11:28,400 --> 00:11:33,640 Speaker 2: out treatments psychedelics in particularly like ketamine and psilocybin, they 196 00:11:33,679 --> 00:11:40,240 Speaker 2: have been basically irrefutably shown to treat major depressive disorder 197 00:11:40,559 --> 00:11:45,000 Speaker 2: really well. And we know that psilocybin, for example, goes 198 00:11:45,040 --> 00:11:49,200 Speaker 2: in and basically rewires your brain. So that would support 199 00:11:49,280 --> 00:11:51,959 Speaker 2: the idea that it's a change in neuroplasticity that you 200 00:11:52,080 --> 00:11:55,520 Speaker 2: need a pressance create that helps treat depression. 201 00:11:55,880 --> 00:11:58,840 Speaker 1: Yeah, for sure. And we also know you know you 202 00:11:58,920 --> 00:12:02,640 Speaker 1: mentioned serotonin and nora epernephrine and and you know, messing 203 00:12:02,720 --> 00:12:06,880 Speaker 1: or balancing out the brain chemistry. What's what's literally going 204 00:12:06,920 --> 00:12:09,760 Speaker 1: on and what they're designed to do. Antidepressants that is, 205 00:12:09,800 --> 00:12:11,720 Speaker 1: and we're going to talk about I guess all of 206 00:12:11,720 --> 00:12:16,000 Speaker 1: them probably right by god, we are, Uh. They interfere 207 00:12:16,080 --> 00:12:19,400 Speaker 1: what's what's called the synaptic transmission of these things of 208 00:12:19,480 --> 00:12:21,640 Speaker 1: serotonin and norepinephrine, dopamine. 209 00:12:22,160 --> 00:12:22,360 Speaker 2: Uh. 210 00:12:22,400 --> 00:12:27,040 Speaker 1: And that transmission is is the movement of neurotransmitters from 211 00:12:27,240 --> 00:12:30,679 Speaker 1: one neuron to another. They're they're they're leaping from one 212 00:12:30,720 --> 00:12:33,520 Speaker 1: to another, they're talking to each other, they're getting to 213 00:12:33,520 --> 00:12:38,000 Speaker 1: know one another. And it's that transmission that we know 214 00:12:38,240 --> 00:12:40,200 Speaker 1: is what antidepressants affect. 215 00:12:40,840 --> 00:12:44,080 Speaker 2: Right, That's where the money is. They go to the 216 00:12:44,400 --> 00:12:49,000 Speaker 2: horse's mouth, that's another word for the synapse. That's that's 217 00:12:49,000 --> 00:12:50,960 Speaker 2: what we're all just call it the horse's mouth. 218 00:12:50,880 --> 00:12:52,960 Speaker 1: That's right, with the ultimate goal for all of these 219 00:12:53,080 --> 00:12:58,960 Speaker 1: to increase levels of of those things usually I mean 220 00:12:59,080 --> 00:13:01,520 Speaker 1: some neuro epineph and as you'll see as we talk about, 221 00:13:01,880 --> 00:13:04,640 Speaker 1: but more along the lines of serotonin. 222 00:13:05,360 --> 00:13:09,400 Speaker 2: Right. Here's the twist to all that. Though neurotransmitters do 223 00:13:09,640 --> 00:13:13,800 Speaker 2: all sorts of other things besides say, like regulate your mood. 224 00:13:14,520 --> 00:13:17,080 Speaker 2: I think serotonin does all sorts of crazy stuff like 225 00:13:17,960 --> 00:13:23,120 Speaker 2: it helps regulate sleep, digestion, nausea, blood clotting, bone growth, 226 00:13:23,200 --> 00:13:26,439 Speaker 2: It does everything right, So if you start messing with 227 00:13:26,480 --> 00:13:29,880 Speaker 2: the serotonin in your brain, it can also start to 228 00:13:29,960 --> 00:13:35,640 Speaker 2: mess with the other functions that serotonin does. Hence side effects, 229 00:13:35,880 --> 00:13:38,680 Speaker 2: and so those are something that we are still figuring 230 00:13:38,720 --> 00:13:41,600 Speaker 2: out too. But luckily that's another thing we're getting a 231 00:13:41,640 --> 00:13:43,479 Speaker 2: handle on, is the side effects. 232 00:13:44,880 --> 00:13:47,040 Speaker 1: That feels like a good break point. That's a big 233 00:13:47,040 --> 00:13:47,920 Speaker 1: old table setting. 234 00:13:48,559 --> 00:13:52,760 Speaker 2: Yeah, yeah, yeah. We've got a dessert knife and a 235 00:13:52,800 --> 00:13:53,440 Speaker 2: butter knife. 236 00:13:53,720 --> 00:13:55,160 Speaker 1: I don't know which is, witch pal, can you help 237 00:13:55,160 --> 00:13:55,400 Speaker 1: me out. 238 00:13:55,600 --> 00:13:58,360 Speaker 2: The dessert knife is a little smaller, fancy er. It's 239 00:13:58,400 --> 00:14:01,400 Speaker 2: got a kind of a sharp point and that you 240 00:14:01,440 --> 00:14:04,600 Speaker 2: could easily drive through the hand of the person sitting 241 00:14:04,600 --> 00:14:05,320 Speaker 2: next to you at the. 242 00:14:05,320 --> 00:14:07,080 Speaker 1: Table, Well, I no, I mean when I reach for 243 00:14:07,120 --> 00:14:09,160 Speaker 1: the wrong one, just give my hand a little smack. 244 00:14:09,440 --> 00:14:11,280 Speaker 2: I'll drive my dessert knife through your hand. 245 00:14:11,280 --> 00:14:14,280 Speaker 1: Have perfect? All right, Well, we'll be right back and 246 00:14:14,800 --> 00:14:17,600 Speaker 1: start off with the star of the show, the SSRI. 247 00:14:53,920 --> 00:14:56,520 Speaker 1: All right, so we promised to start off with SSRIs, 248 00:14:56,560 --> 00:14:58,280 Speaker 1: and we're starting off with that. We're kind of gonna 249 00:14:58,320 --> 00:15:02,720 Speaker 1: jump around, starting with the most frequently prescribed sort of 250 00:15:02,760 --> 00:15:06,360 Speaker 1: modern version of antidepressants, and then we'll jump back in 251 00:15:06,440 --> 00:15:10,440 Speaker 1: time and talk about drugs that you know, maybe your 252 00:15:10,480 --> 00:15:14,680 Speaker 1: parents took, who knows, but these came around in the 253 00:15:14,720 --> 00:15:18,640 Speaker 1: mid nineteen eighties. I think the very first one to 254 00:15:18,760 --> 00:15:23,680 Speaker 1: become to become available was fluoxetine in nineteen eighty eight. 255 00:15:25,480 --> 00:15:28,960 Speaker 1: And we're gonna, I guess we'll say both their regular 256 00:15:29,040 --> 00:15:32,240 Speaker 1: name and their trade name or trademark name, just so 257 00:15:32,280 --> 00:15:33,920 Speaker 1: everyone knows kind of what we're talking about. 258 00:15:34,080 --> 00:15:36,480 Speaker 2: Yeah, so the people who take them can like be like, yeah. 259 00:15:36,600 --> 00:15:45,479 Speaker 1: Yes, fluoxetine is prozac, paroxetine is paxel, sertraline is zoloft, 260 00:15:46,440 --> 00:15:53,120 Speaker 1: fluvoxamine is lubox. These are the challenge for me, I 261 00:15:53,160 --> 00:16:00,360 Speaker 1: appreciate Ititalopram is selexa and why don't you take that 262 00:16:00,440 --> 00:16:05,280 Speaker 1: lex lexapro for me? What is that escalopram escatala pram 263 00:16:05,280 --> 00:16:07,120 Speaker 1: Oh Okay, I just had a little yes at the 264 00:16:07,120 --> 00:16:07,640 Speaker 1: beginning of that. 265 00:16:07,920 --> 00:16:10,360 Speaker 2: You did fantastic. My favorite on all of them is 266 00:16:10,440 --> 00:16:12,400 Speaker 2: flu voxamine. 267 00:16:12,640 --> 00:16:13,680 Speaker 1: Yeah, that's a good word. 268 00:16:14,000 --> 00:16:16,840 Speaker 2: I like all those letters together like that. It's great. Yeah, 269 00:16:16,880 --> 00:16:19,280 Speaker 2: and I'm not saying the drug itself, just the GG. 270 00:16:20,040 --> 00:16:23,680 Speaker 1: Yeah. So these are the SSRIs that are going to block. 271 00:16:24,000 --> 00:16:26,400 Speaker 1: They're called re uptake inhibitors, and what that means is 272 00:16:26,400 --> 00:16:30,640 Speaker 1: they're going to block that that bus trip that serotonin 273 00:16:30,680 --> 00:16:34,160 Speaker 1: takes back to that original cell, the pre synaptic cell, 274 00:16:35,000 --> 00:16:38,240 Speaker 1: the one who sent that transmission, huh, and it leaves 275 00:16:38,320 --> 00:16:41,720 Speaker 1: it floating around in that space in between. I believe 276 00:16:41,800 --> 00:16:45,400 Speaker 1: that's probably you that said that's where all the action happens. Yes, 277 00:16:45,440 --> 00:16:48,000 Speaker 1: but that's in the what's called the synaptic cleft. So 278 00:16:48,080 --> 00:16:51,720 Speaker 1: it sends that that serotonin out and when it comes back, 279 00:16:51,800 --> 00:16:54,840 Speaker 1: instead of uptaking it or re uptaking it, it blocks 280 00:16:54,880 --> 00:16:57,560 Speaker 1: that from happening. So that just means there's more of 281 00:16:57,600 --> 00:16:58,320 Speaker 1: it where you need it. 282 00:16:58,600 --> 00:17:01,040 Speaker 2: They're just hanging out there like, where's my uber? 283 00:17:01,720 --> 00:17:01,960 Speaker 1: Yeah? 284 00:17:02,000 --> 00:17:06,560 Speaker 2: Exactly, So that was lame. I'm sorry, everybody. 285 00:17:06,800 --> 00:17:08,840 Speaker 1: Pretty good, it's an uber share. 286 00:17:09,240 --> 00:17:11,520 Speaker 2: There is so many other things I could have said, 287 00:17:11,560 --> 00:17:13,639 Speaker 2: and I just I don't know. I couldn't come up 288 00:17:13,680 --> 00:17:14,480 Speaker 2: with anything better. 289 00:17:14,760 --> 00:17:17,719 Speaker 1: You're trying to wedge ind jokes in an unfunny episode. 290 00:17:17,960 --> 00:17:19,600 Speaker 2: Okay, thank you for that. 291 00:17:19,600 --> 00:17:22,240 Speaker 1: That's what we try and do, wedgend jokes where they're 292 00:17:22,240 --> 00:17:22,840 Speaker 1: not appropriate. 293 00:17:24,000 --> 00:17:28,600 Speaker 2: So that's what that's specifically what you just said. Ssriyes too, 294 00:17:28,920 --> 00:17:30,640 Speaker 2: And they live up to their name essentially. 295 00:17:31,119 --> 00:17:33,199 Speaker 1: Yeah. I don't think I even read out what it 296 00:17:33,240 --> 00:17:36,359 Speaker 1: stands for. Selective serotonin reuptake inhibitor or I may have, 297 00:17:36,440 --> 00:17:37,720 Speaker 1: but there is I. 298 00:17:37,600 --> 00:17:41,119 Speaker 2: Think you did. But yes, So they specifically focus on 299 00:17:41,240 --> 00:17:45,159 Speaker 2: serotonin and they prevent its reuptake from the synapse that 300 00:17:45,320 --> 00:17:49,840 Speaker 2: senate or the neuron that scent it out right. So 301 00:17:50,000 --> 00:17:53,159 Speaker 2: the great thing about SSRIs is that they work really, really, 302 00:17:53,280 --> 00:17:58,040 Speaker 2: really well on most people with the fewest side effect 303 00:17:58,960 --> 00:18:03,199 Speaker 2: and it's in part because they selectively target serotonin. And 304 00:18:03,240 --> 00:18:06,719 Speaker 2: despite the fact that there's fewer side effects and fewer 305 00:18:06,760 --> 00:18:11,560 Speaker 2: people than other types of antidepressants, some people do not 306 00:18:11,720 --> 00:18:16,960 Speaker 2: respond particularly well to it. It depends on the brand. 307 00:18:17,720 --> 00:18:20,360 Speaker 2: Not necessarily the brand, but the type of drug. I mean, 308 00:18:20,440 --> 00:18:23,640 Speaker 2: all of the SSRIs aren't exactly the same. So if 309 00:18:23,680 --> 00:18:26,440 Speaker 2: one's not working for you, you can try another one, 310 00:18:26,440 --> 00:18:28,520 Speaker 2: and another one, another one, and if that doesn't work, 311 00:18:28,560 --> 00:18:31,840 Speaker 2: then you might move on to another class of antidepressants. 312 00:18:31,840 --> 00:18:36,119 Speaker 2: But from what I can tell, SSRIs are essentially still 313 00:18:36,160 --> 00:18:41,720 Speaker 2: today like basically the the flagship antidepressant, if there is 314 00:18:41,760 --> 00:18:42,280 Speaker 2: such a thing. 315 00:18:43,280 --> 00:18:46,720 Speaker 1: Yeah, I think you're right, And I think that when 316 00:18:46,720 --> 00:18:50,440 Speaker 1: it comes to getting that if you're on more than one, 317 00:18:50,520 --> 00:18:55,479 Speaker 1: either that cocktail right or that single ssri correct, that 318 00:18:55,600 --> 00:18:58,120 Speaker 1: is where your doctor comes into play. But that even 319 00:18:58,160 --> 00:19:00,400 Speaker 1: though I've never been through this, I've been a plenty 320 00:19:00,400 --> 00:19:02,880 Speaker 1: of people who have, I believe it's safe to say 321 00:19:02,920 --> 00:19:06,120 Speaker 1: that's also where you come into play though as advocating 322 00:19:06,200 --> 00:19:10,679 Speaker 1: for yourself in concert with your doctor. 323 00:19:10,880 --> 00:19:11,879 Speaker 2: Right for sure? 324 00:19:12,040 --> 00:19:13,040 Speaker 1: Is that a good way to say that? 325 00:19:13,240 --> 00:19:16,200 Speaker 2: It is? And patient education is a really important part 326 00:19:16,400 --> 00:19:19,920 Speaker 2: of treating depression. Like it's not one of those things 327 00:19:19,920 --> 00:19:21,920 Speaker 2: where you just turn up and say what you know here, 328 00:19:22,040 --> 00:19:24,240 Speaker 2: treat me like you're going to be armed with a 329 00:19:24,280 --> 00:19:26,880 Speaker 2: lot of stuff on how to help yourself too. And 330 00:19:26,960 --> 00:19:30,560 Speaker 2: I guarantee you they're going to say, exercise every day 331 00:19:30,600 --> 00:19:32,879 Speaker 2: for twenty thirty minutes a day will be one of 332 00:19:32,880 --> 00:19:36,560 Speaker 2: the things that they say because it works so well, 333 00:19:37,000 --> 00:19:40,119 Speaker 2: it's crazy what it does. Yeah, And that's part of 334 00:19:40,160 --> 00:19:43,840 Speaker 2: also treating things with any depressants is if you are 335 00:19:44,280 --> 00:19:48,760 Speaker 2: suffering from major depressive disorder, you probably can't get yourself 336 00:19:48,840 --> 00:19:54,399 Speaker 2: up in exercise, right, So on ndepressants increases the chances 337 00:19:54,400 --> 00:19:57,600 Speaker 2: that you can exercise, and then that just makes it 338 00:19:57,680 --> 00:19:58,680 Speaker 2: even more effective. 339 00:19:59,080 --> 00:20:02,560 Speaker 1: Yeah. I if you suffer from depression and you feel 340 00:20:02,600 --> 00:20:06,760 Speaker 1: a little lost and you are a fan of comedy, 341 00:20:07,640 --> 00:20:10,840 Speaker 1: I can highly highly recommend the great comedian Gary Golman. 342 00:20:11,720 --> 00:20:14,040 Speaker 1: He's a comedian who has he's been around a long 343 00:20:14,080 --> 00:20:16,399 Speaker 1: long time and it's not like that's his act, but 344 00:20:16,880 --> 00:20:19,360 Speaker 1: he did have one tour in one sort of set 345 00:20:19,400 --> 00:20:21,760 Speaker 1: where he really really dug into this and one special 346 00:20:22,640 --> 00:20:25,320 Speaker 1: and then lately he wrote about it in his book, 347 00:20:25,359 --> 00:20:27,560 Speaker 1: which is great. I read the book. This is all 348 00:20:27,560 --> 00:20:29,960 Speaker 1: about his childhood growing up. But lately on Instagram he 349 00:20:30,040 --> 00:20:34,160 Speaker 1: has been posting just daily things he's kind of written 350 00:20:34,160 --> 00:20:36,280 Speaker 1: down on a paper that helped him when he was 351 00:20:36,320 --> 00:20:39,920 Speaker 1: at his darkest. And you take a walk things like that, 352 00:20:40,000 --> 00:20:44,639 Speaker 1: but drilled down and got more specific and advice on 353 00:20:45,200 --> 00:20:47,760 Speaker 1: if you're a friend of someone like what you can do, Like, 354 00:20:47,960 --> 00:20:50,719 Speaker 1: it's really really, really helpful. So Gary Goleman's awesome, and 355 00:20:50,760 --> 00:20:53,560 Speaker 1: I encourage you to check out that Instagram. As silly 356 00:20:53,600 --> 00:20:55,840 Speaker 1: as that sounds, it can really help. 357 00:20:56,800 --> 00:20:58,040 Speaker 2: It doesn't sound silly at all. 358 00:20:58,320 --> 00:21:00,680 Speaker 1: Well, anytime you're like, oh, go to a social media 359 00:21:00,720 --> 00:21:02,879 Speaker 1: thing and look at what this comedian said, but you 360 00:21:02,920 --> 00:21:03,520 Speaker 1: know what I mean. 361 00:21:04,680 --> 00:21:06,600 Speaker 2: No, I still don't think it was Kelly. I think 362 00:21:06,640 --> 00:21:08,080 Speaker 2: it was a great shout out for sure. 363 00:21:08,280 --> 00:21:08,480 Speaker 1: Good. 364 00:21:09,400 --> 00:21:12,040 Speaker 2: So a couple more things real quick on SSRIs before 365 00:21:12,080 --> 00:21:17,320 Speaker 2: we move on. They have fluoxetine in particular, Prozac has 366 00:21:17,359 --> 00:21:21,080 Speaker 2: a long half life. Yeah, so you can get away 367 00:21:21,080 --> 00:21:23,280 Speaker 2: with just one dose, which you're like, who cares one 368 00:21:23,320 --> 00:21:26,800 Speaker 2: a day? Yeah, but that actually decreases your chances of 369 00:21:26,840 --> 00:21:29,160 Speaker 2: missing a dose. So that's a good thing. And then 370 00:21:29,160 --> 00:21:31,000 Speaker 2: one of the other things too is when you go 371 00:21:31,480 --> 00:21:34,280 Speaker 2: to the doctor, especially if you're a kid, they start 372 00:21:34,320 --> 00:21:36,239 Speaker 2: treating you with any depressants, they're going to start out 373 00:21:36,320 --> 00:21:38,880 Speaker 2: really really low dose and just kind of slowly move 374 00:21:38,920 --> 00:21:41,240 Speaker 2: it up and as you get adjusted to it, it 375 00:21:41,280 --> 00:21:43,960 Speaker 2: cuts down on the chances of side effects, but there 376 00:21:43,960 --> 00:21:47,760 Speaker 2: can be side effects with SSRIs, from anxiety to sexual 377 00:21:47,840 --> 00:21:51,840 Speaker 2: dysfunction to vertigo. So I mean you need to go 378 00:21:51,960 --> 00:21:55,720 Speaker 2: into it understanding what you're facing. But a good psychiatrist 379 00:21:55,880 --> 00:21:57,800 Speaker 2: or doctor will be like, Okay, let's just do this 380 00:21:57,840 --> 00:22:00,600 Speaker 2: a little at a time to get you on your 381 00:22:00,600 --> 00:22:02,440 Speaker 2: feet as gently as possible. 382 00:22:02,760 --> 00:22:06,160 Speaker 1: Yeah, for sure. All right, So that's a quick overview 383 00:22:06,200 --> 00:22:08,400 Speaker 1: of the SSRIs and how they work. Now we're gonna 384 00:22:08,440 --> 00:22:12,440 Speaker 1: move on to we're gonna jump back in time, getting 385 00:22:12,440 --> 00:22:13,600 Speaker 1: the way back machine. That's fun. 386 00:22:13,920 --> 00:22:15,240 Speaker 2: Okay, let's do it. 387 00:22:21,960 --> 00:22:27,280 Speaker 1: To the nineteen fifties and sixties when tricyclic antidepressants made 388 00:22:27,320 --> 00:22:28,400 Speaker 1: their debut. 389 00:22:29,840 --> 00:22:32,840 Speaker 2: Yes, those were some of the first, but not the 390 00:22:32,840 --> 00:22:38,119 Speaker 2: first strangely, but these were really kind of early pioneering 391 00:22:39,200 --> 00:22:43,280 Speaker 2: antidepressants that they worked on serotonin. That was kind of 392 00:22:43,320 --> 00:22:48,199 Speaker 2: their goal. They were a reuptake inhibitor as well. The 393 00:22:48,359 --> 00:22:53,520 Speaker 2: problem with these things are is that they weren't selective. 394 00:22:54,080 --> 00:22:58,840 Speaker 2: That's why SSRIs are just so desirable. Tricyclic antidepressants are 395 00:22:58,880 --> 00:23:02,400 Speaker 2: just like, come me here a neurotransmitter and they kind 396 00:23:02,400 --> 00:23:05,639 Speaker 2: of dry homp the neurotransmitter, no matter what kind of 397 00:23:05,640 --> 00:23:09,280 Speaker 2: neurotransmitter it is, and prevent it from being taken back 398 00:23:09,359 --> 00:23:09,840 Speaker 2: up again. 399 00:23:10,720 --> 00:23:13,239 Speaker 1: All right, there's one way to put it. All right, 400 00:23:13,240 --> 00:23:15,680 Speaker 1: We're gonna name these and these again might be things 401 00:23:15,720 --> 00:23:19,320 Speaker 1: you saw if you're a gen xer, you might have 402 00:23:19,359 --> 00:23:23,840 Speaker 1: seen them in your in your grandparents medicine cabinet. 403 00:23:23,840 --> 00:23:26,879 Speaker 2: Even Yeah, you probably associate these names with the smell 404 00:23:26,880 --> 00:23:27,679 Speaker 2: of moth balls. 405 00:23:28,000 --> 00:23:31,720 Speaker 1: That's right, exactly. Let me see here. Here's the first one. 406 00:23:31,840 --> 00:23:36,800 Speaker 1: Nor nor try, nor tripetilen nor trip to Lene. 407 00:23:37,119 --> 00:23:38,680 Speaker 2: These are no SSRIs. 408 00:23:39,000 --> 00:23:40,959 Speaker 1: Jeez, I even practice these, nor trip to Lene. Why 409 00:23:40,960 --> 00:23:42,800 Speaker 1: am I getting all these? That's pamelaura. How about you 410 00:23:42,800 --> 00:23:43,560 Speaker 1: take the next one? 411 00:23:44,080 --> 00:23:44,800 Speaker 2: I I can't. 412 00:23:45,640 --> 00:23:46,399 Speaker 1: Yeah, sure you can. 413 00:23:47,640 --> 00:23:55,399 Speaker 2: Protelene that's the brand names even worse, ludio mil Yeah, 414 00:23:55,520 --> 00:23:58,680 Speaker 2: does a prey mean? That's nord Promean is the brand name? 415 00:23:59,440 --> 00:24:02,960 Speaker 2: Am a trip to lean a little bit job? Yeah, 416 00:24:03,040 --> 00:24:07,400 Speaker 2: clametpramine that does not roll off the tongue. That's anapernil, 417 00:24:07,680 --> 00:24:12,280 Speaker 2: and then emipremine, which is trophonil. I've never heard of 418 00:24:12,560 --> 00:24:18,200 Speaker 2: any of these, but they apparently work fairly well. It's 419 00:24:18,280 --> 00:24:22,359 Speaker 2: just the side effects that are really problematic. I mean, strangely, 420 00:24:22,400 --> 00:24:26,240 Speaker 2: they treat it just as well as Ssriyes, but again 421 00:24:27,000 --> 00:24:30,720 Speaker 2: they treat everything, all the neurotransmitters, and because as we've seen, 422 00:24:31,000 --> 00:24:35,760 Speaker 2: neurotransmitters perform more than one function in the body, they 423 00:24:35,800 --> 00:24:38,240 Speaker 2: have a whole host of side effects that you just 424 00:24:38,280 --> 00:24:38,960 Speaker 2: don't want it. 425 00:24:39,359 --> 00:24:42,200 Speaker 1: Yeah, I mean, yeah, we could go through them, but 426 00:24:42,240 --> 00:24:44,920 Speaker 1: it sounds like one of those commercials, but you're way 427 00:24:44,960 --> 00:24:48,400 Speaker 1: more likely to experience those with those than the ssries. 428 00:24:49,240 --> 00:24:55,640 Speaker 1: It's also they were the tricyclic were easier to overdose on. Yeah, 429 00:24:55,680 --> 00:24:57,120 Speaker 1: and you're just not going to see them a lot 430 00:24:57,160 --> 00:25:00,439 Speaker 1: for depression these days. They're still around. I think orpathic 431 00:25:00,480 --> 00:25:04,280 Speaker 1: pain is something they found use for. Yeah, and if 432 00:25:04,320 --> 00:25:07,720 Speaker 1: you you know, if you don't tolerate SSRIs, they might say, 433 00:25:07,760 --> 00:25:09,359 Speaker 1: you know, they might pitch you a drug from the 434 00:25:09,400 --> 00:25:10,760 Speaker 1: nineteen fifties. 435 00:25:10,800 --> 00:25:14,439 Speaker 2: Right that has I saw a black box warning that 436 00:25:14,520 --> 00:25:17,760 Speaker 2: the FDA slapped on it that's how we can cause 437 00:25:17,840 --> 00:25:22,119 Speaker 2: suicide And I was like, how how does that stuff happen? 438 00:25:23,080 --> 00:25:26,480 Speaker 2: And the way that I saw it explained is that 439 00:25:27,600 --> 00:25:32,280 Speaker 2: if you have like if you are if you're suicidal, 440 00:25:32,400 --> 00:25:35,600 Speaker 2: and you have depression, you're thinking of suicide, you may 441 00:25:35,640 --> 00:25:40,320 Speaker 2: be too immobilized to actually carry it out. A tricyclic 442 00:25:41,720 --> 00:25:44,720 Speaker 2: may lift the depression just enough for you to act. 443 00:25:45,440 --> 00:25:52,480 Speaker 2: And apparently there's a warning on the box that says that. So, yeah, 444 00:25:52,600 --> 00:25:57,639 Speaker 2: tricyclics don't sound particularly desirable. Yeah, but they probably saved 445 00:25:57,680 --> 00:25:59,920 Speaker 2: to quite a few people. Yeah, in the fifties and 446 00:26:00,080 --> 00:26:01,560 Speaker 2: sixties when they came out. 447 00:26:01,560 --> 00:26:03,520 Speaker 1: Yeah for sure. I mean that was a long time ago. 448 00:26:03,560 --> 00:26:06,440 Speaker 1: So this is early sort of you know, medicine at work. Yes, 449 00:26:06,800 --> 00:26:11,960 Speaker 1: we have snur eyes serotonin not just serotonin, but serotonin 450 00:26:12,000 --> 00:26:15,639 Speaker 1: and nor epinephrine re uptake inhibitors. They came around in 451 00:26:15,680 --> 00:26:18,399 Speaker 1: the mid nineties, so after the SSRI is a little 452 00:26:18,400 --> 00:26:20,919 Speaker 1: bit after and they do exactly what you would think. 453 00:26:20,920 --> 00:26:24,320 Speaker 1: They've blocked the reptake of both of those in the 454 00:26:24,359 --> 00:26:24,840 Speaker 1: same way. 455 00:26:25,960 --> 00:26:30,840 Speaker 2: Yeah. And what's weird is snur eyes. You think it's better, right, Yeah, 456 00:26:31,000 --> 00:26:35,640 Speaker 2: despite selectively targeting two neurotransmitters, it's basically just as good 457 00:26:35,680 --> 00:26:40,760 Speaker 2: as the Ssriyes, yeah, I think they have about the 458 00:26:40,800 --> 00:26:43,280 Speaker 2: same number of side effects too. 459 00:26:43,840 --> 00:26:46,400 Speaker 1: Yeah, and those are there's only a couple of those 460 00:26:46,960 --> 00:26:52,959 Speaker 1: effectsor and simbalta, and in Symbalta's case, that's dueloxatine an 461 00:26:52,960 --> 00:26:56,840 Speaker 1: effectsor is vin lavaccine not. 462 00:26:57,280 --> 00:26:58,040 Speaker 2: The best name ever? 463 00:26:58,200 --> 00:27:03,919 Speaker 1: Vin laugh fixine Affle scene, What just happened? 464 00:27:04,320 --> 00:27:07,280 Speaker 2: That's great man, Ben Affleck scene is duncan. 465 00:27:07,760 --> 00:27:08,480 Speaker 1: Yeah, you're right. 466 00:27:08,640 --> 00:27:14,879 Speaker 2: There's another related class called nor adrenergic and specific serratonergic. 467 00:27:15,160 --> 00:27:20,320 Speaker 2: I'll bet the psychiatrists are just laughing, laughing or else 468 00:27:20,359 --> 00:27:22,879 Speaker 2: they turned this off a long time ago. Yeah, but 469 00:27:23,000 --> 00:27:28,520 Speaker 2: those type of antidipressants na SSA's lowercase A first, So 470 00:27:28,800 --> 00:27:31,360 Speaker 2: I'm pretty sure there's no other I guess you could 471 00:27:31,359 --> 00:27:35,200 Speaker 2: say not ssays. Surely people don't. 472 00:27:34,960 --> 00:27:36,440 Speaker 1: Say that NASAs. 473 00:27:37,119 --> 00:27:42,120 Speaker 2: Sure, that's even better. It's better than ben Laughic scene. 474 00:27:42,560 --> 00:27:44,720 Speaker 1: Yeah. Yeah, they came around in the what mid eighties? 475 00:27:45,280 --> 00:27:51,040 Speaker 2: Yeah, they the nassas have. They do the same thing, 476 00:27:51,200 --> 00:27:54,800 Speaker 2: but they have different side effects. It's just so bizarre. Yeah, 477 00:27:54,840 --> 00:27:58,680 Speaker 2: like you can experience weight gain insedation rather than say, 478 00:27:58,720 --> 00:28:03,280 Speaker 2: sexual dysfunction like on a SNRI. But they're all doing 479 00:28:03,320 --> 00:28:06,280 Speaker 2: the same thing. But again, none of them seem to 480 00:28:06,320 --> 00:28:09,760 Speaker 2: be any better than SSRIs and SSRs have the fewest 481 00:28:09,760 --> 00:28:13,280 Speaker 2: side effects. This episode is brought to you by SSRIs By. 482 00:28:15,560 --> 00:28:18,320 Speaker 1: The next thing we're going to talk about are MAOIs 483 00:28:18,720 --> 00:28:25,119 Speaker 1: or monoamine. Is that right, monoamines, monoamine, oxidase inhibitors. You 484 00:28:25,200 --> 00:28:27,800 Speaker 1: got all fancy and yeah, I don't think we've mentioned 485 00:28:27,880 --> 00:28:30,879 Speaker 1: yet that that's what that group is called. Serotonin, norepernephrin, 486 00:28:30,920 --> 00:28:36,560 Speaker 1: and dopamine are all monoamines because of the molecular structure 487 00:28:36,560 --> 00:28:37,360 Speaker 1: of those things. 488 00:28:37,640 --> 00:28:40,400 Speaker 2: Yes, so I've heard ma aoi is like basically my 489 00:28:40,440 --> 00:28:45,640 Speaker 2: whole life, haven't you. Uh Now, Okay, So they're this 490 00:28:45,880 --> 00:28:49,560 Speaker 2: like very like widespread class of drugs, but they have 491 00:28:49,640 --> 00:28:54,080 Speaker 2: a weird twist to them in that they prevent you 492 00:28:54,160 --> 00:28:58,280 Speaker 2: from breaking down something called tyramine, which is an amino acid. 493 00:28:58,800 --> 00:29:01,720 Speaker 2: And tyramine is great because it regulates blood pressure, but 494 00:29:01,800 --> 00:29:04,160 Speaker 2: you don't want too much tyramine. It gets out of 495 00:29:04,160 --> 00:29:06,479 Speaker 2: whack and your blood pressure gets out of whack. And 496 00:29:06,520 --> 00:29:09,760 Speaker 2: tyramine is present in a lot of different foods from 497 00:29:09,800 --> 00:29:14,239 Speaker 2: like soy sauce to fish to sausage, age, cheese, the 498 00:29:14,280 --> 00:29:17,680 Speaker 2: best cheese, and as a matter of fact, it's called 499 00:29:17,720 --> 00:29:22,960 Speaker 2: the cheese reaction where people get hypertensive from taking MAOIs 500 00:29:22,960 --> 00:29:27,600 Speaker 2: and accidentally eating the wrong food. So what the monoamines 501 00:29:27,640 --> 00:29:32,880 Speaker 2: get broken down by is monoamine oxidase MO, and an 502 00:29:33,000 --> 00:29:39,040 Speaker 2: ma AOI is a monoamine oxidase inhibitor, so it prevents 503 00:29:39,120 --> 00:29:44,560 Speaker 2: this thing from breaking down the monoamines. And that's why 504 00:29:44,600 --> 00:29:46,120 Speaker 2: you can't eat age cheese. 505 00:29:46,680 --> 00:29:48,800 Speaker 1: Do you think anyone ever goes in and they're like, 506 00:29:48,880 --> 00:29:51,160 Speaker 1: can I just do the SSRIs because everyone kind of 507 00:29:51,160 --> 00:29:55,640 Speaker 1: knows those, right, should we name check those? 508 00:29:57,320 --> 00:29:58,880 Speaker 2: I've never heard of any of them, but sure if 509 00:29:58,920 --> 00:29:59,280 Speaker 2: you want. 510 00:29:59,560 --> 00:30:00,640 Speaker 1: No, I don't feel they need to. 511 00:30:00,960 --> 00:30:03,080 Speaker 2: Well. I think what's also interesting is that it was 512 00:30:03,120 --> 00:30:04,320 Speaker 2: discovered by accident. 513 00:30:05,920 --> 00:30:09,680 Speaker 1: Oh yeh, that's right. This is one where I think 514 00:30:09,720 --> 00:30:12,280 Speaker 1: it was in the early nineteen fifties. They were testing 515 00:30:12,760 --> 00:30:16,240 Speaker 1: drugs for TB for tuberculosis, and it was one of 516 00:30:16,240 --> 00:30:19,560 Speaker 1: those deals where they said, Hey, these people over here 517 00:30:19,560 --> 00:30:22,320 Speaker 1: taking this thing, they're sleeping pretty good, they have a 518 00:30:22,320 --> 00:30:25,240 Speaker 1: good appetite, they're they're bouncing around the room, they seem 519 00:30:25,280 --> 00:30:29,000 Speaker 1: pretty happy, and so that's that's how it was born. 520 00:30:29,040 --> 00:30:31,120 Speaker 1: They found that I think that when they gave it 521 00:30:31,160 --> 00:30:34,680 Speaker 1: to patients with depression, that seventy percent of them showed 522 00:30:34,720 --> 00:30:36,800 Speaker 1: an improvement. So they said, I guess we've got a 523 00:30:36,880 --> 00:30:37,440 Speaker 1: new thing here. 524 00:30:37,760 --> 00:30:40,480 Speaker 2: Yeah, so I think they started in nineteen fifty eight 525 00:30:40,520 --> 00:30:45,280 Speaker 2: with marsalid, the first ever m AOI antidepressant. But again, 526 00:30:46,120 --> 00:30:50,400 Speaker 2: because you can't eat age cheese, people don't usually prescribed 527 00:30:50,480 --> 00:30:52,400 Speaker 2: as an antidepressant anymore. 528 00:30:52,760 --> 00:30:54,080 Speaker 1: I had that cheese duck. 529 00:30:54,960 --> 00:30:58,680 Speaker 2: Sure, I mean yeah, that don't make anybody depress not 530 00:30:58,720 --> 00:31:00,400 Speaker 2: being able to eat age. Jeez. 531 00:31:01,120 --> 00:31:04,040 Speaker 1: I guess now we can jump over to or should 532 00:31:04,080 --> 00:31:07,240 Speaker 1: we take a break or should we cover nutraceuticals? 533 00:31:07,760 --> 00:31:09,680 Speaker 2: I think it's I think it's break time. 534 00:31:10,040 --> 00:31:11,600 Speaker 1: All right, we'll take a break and then we'll come 535 00:31:11,640 --> 00:31:15,080 Speaker 1: back and talk about something that you can just get 536 00:31:15,080 --> 00:31:17,000 Speaker 1: over the counter. It's called a nutriceutical. 537 00:31:17,080 --> 00:31:54,760 Speaker 2: Right after this, okay, chuck, So we started to talking 538 00:31:54,760 --> 00:31:57,320 Speaker 2: about nutraceuticals, and that's just a fancy name for a 539 00:31:57,360 --> 00:32:01,160 Speaker 2: supplement that you could conceivably used to treat a malady. 540 00:32:01,200 --> 00:32:05,280 Speaker 2: And in this case, people have long been seeking supplements 541 00:32:05,320 --> 00:32:09,719 Speaker 2: to treat depression with whether it's clinical or you know, 542 00:32:09,960 --> 00:32:15,520 Speaker 2: diagnosable or passing depression. Who knows. People don't necessarily want 543 00:32:15,560 --> 00:32:18,880 Speaker 2: to take pharmaceuticals, and it's tough to blame them. So 544 00:32:19,400 --> 00:32:23,840 Speaker 2: they'll follow studies and they will read about new discoveries 545 00:32:23,920 --> 00:32:27,160 Speaker 2: with people poking around trying to figure out what causes depression, 546 00:32:27,960 --> 00:32:32,720 Speaker 2: and very often they'll turn up some specific amino acid 547 00:32:32,880 --> 00:32:35,920 Speaker 2: or something like that that they show that there's low 548 00:32:36,000 --> 00:32:38,600 Speaker 2: levels of that in the brain of people with depression, 549 00:32:38,600 --> 00:32:41,240 Speaker 2: and so they'll go off and test this amino acid 550 00:32:41,320 --> 00:32:44,360 Speaker 2: and they'll show like, yep, actually it improves symptoms, and 551 00:32:44,400 --> 00:32:46,720 Speaker 2: then people go out and buy tons of that supplement. 552 00:32:47,000 --> 00:32:48,960 Speaker 2: But the problem is in the United States, if it's 553 00:32:48,960 --> 00:32:53,560 Speaker 2: a supplement, it's essentially totally unregulated, so there's no one 554 00:32:53,760 --> 00:32:55,920 Speaker 2: checking out, like to make sure that the dose is 555 00:32:55,920 --> 00:32:58,840 Speaker 2: the same pill to pill, that they actually have what 556 00:32:58,880 --> 00:33:01,320 Speaker 2: they say they have in them, that they don't have 557 00:33:02,080 --> 00:33:05,640 Speaker 2: old newspapers ground up with it. Like it's just the 558 00:33:05,680 --> 00:33:08,040 Speaker 2: wild West when it comes to supplements, which makes it 559 00:33:08,160 --> 00:33:12,200 Speaker 2: really a tricky thing to treat your depression with. Even 560 00:33:12,240 --> 00:33:15,600 Speaker 2: though I totally understand how somebody would not want to 561 00:33:16,200 --> 00:33:18,120 Speaker 2: take pharmaceuticals if they don't. 562 00:33:17,840 --> 00:33:20,560 Speaker 1: Have to, yeah, for sure. And you know, this is 563 00:33:20,560 --> 00:33:22,520 Speaker 1: a real shame because a lot of these studies on 564 00:33:22,680 --> 00:33:25,800 Speaker 1: these have come back with some results that are that 565 00:33:25,840 --> 00:33:28,760 Speaker 1: look pretty good. Some of them show you know, can 566 00:33:28,840 --> 00:33:30,600 Speaker 1: kind of be over the all over the place. Again, 567 00:33:30,640 --> 00:33:33,640 Speaker 1: maybe because it's not regulated is the reason. Because some 568 00:33:34,080 --> 00:33:38,280 Speaker 1: studies show that results can can treat MDD pretty effectively. 569 00:33:38,720 --> 00:33:43,400 Speaker 1: Others show it's not any better than at placebo. They 570 00:33:43,440 --> 00:33:45,760 Speaker 1: can also have side effects, so it's not like, oh, 571 00:33:45,800 --> 00:33:48,080 Speaker 1: it's just a supplement, so I don't you know, I 572 00:33:48,080 --> 00:33:50,320 Speaker 1: don't hear the commercial listing, you know, a laundry list 573 00:33:50,320 --> 00:33:52,600 Speaker 1: of things that could go wrong then and I can 574 00:33:52,640 --> 00:33:54,760 Speaker 1: buy it just over the counter, then there can be 575 00:33:54,760 --> 00:33:57,360 Speaker 1: any side effects, right, But that's not true at all. 576 00:33:57,440 --> 00:34:00,600 Speaker 1: There are side effects to supplements as well, and it 577 00:34:00,640 --> 00:34:03,880 Speaker 1: can you know, there have been plenty of situations where 578 00:34:04,640 --> 00:34:07,800 Speaker 1: there's a supplement that becomes kind of the the all 579 00:34:07,840 --> 00:34:11,680 Speaker 1: the rage, yeah, and people just start like Saint John's 580 00:34:11,680 --> 00:34:13,520 Speaker 1: work used to be when people were just like, hey, 581 00:34:13,520 --> 00:34:15,879 Speaker 1: Saint John's Work's the best, we just should take tons 582 00:34:15,920 --> 00:34:18,719 Speaker 1: of it. And that can result in its own set 583 00:34:18,760 --> 00:34:19,280 Speaker 1: of issues. 584 00:34:19,560 --> 00:34:22,319 Speaker 2: I remember that that was our parents taking Saint John's wart. 585 00:34:22,560 --> 00:34:24,160 Speaker 2: Wasn't that Uh? 586 00:34:24,280 --> 00:34:28,600 Speaker 1: Yeah? I remember my parents even at one point signed 587 00:34:28,640 --> 00:34:33,000 Speaker 1: up for one of the uh supplement you know, pyramid schemes. 588 00:34:33,040 --> 00:34:36,359 Speaker 1: I guess no, really sort of like the Avon Lady. 589 00:34:36,400 --> 00:34:39,200 Speaker 1: But it's supplements that I remember a short time. I mean, 590 00:34:39,200 --> 00:34:41,719 Speaker 1: they were always trying to hustle some side gig because 591 00:34:41,719 --> 00:34:44,600 Speaker 1: they were teachers. But I specifically remember when I was 592 00:34:44,600 --> 00:34:46,799 Speaker 1: a kid that we just had like a house full 593 00:34:46,840 --> 00:34:49,160 Speaker 1: of this stuff for a while. And I can't remember 594 00:34:49,200 --> 00:34:53,200 Speaker 1: which system or brand this was, but if someone wrote 595 00:34:53,200 --> 00:34:55,359 Speaker 1: in and told me, I would be like, oh, yep, 596 00:34:55,400 --> 00:34:56,320 Speaker 1: that's the one. 597 00:34:56,960 --> 00:34:59,200 Speaker 2: Yeah. I can't bring it to mind either, but I'll 598 00:34:59,239 --> 00:35:03,120 Speaker 2: bet I know what you're talking about. Yeah. So, yeah, 599 00:35:03,120 --> 00:35:05,240 Speaker 2: Saint John's Ward. It was all the rage in the eighties, 600 00:35:05,560 --> 00:35:07,319 Speaker 2: and I think one of the other things that lent 601 00:35:07,360 --> 00:35:09,480 Speaker 2: it a lot of credibility is people have been using 602 00:35:09,480 --> 00:35:13,759 Speaker 2: Saint John's Wart to improve mood for probably thousands and 603 00:35:13,800 --> 00:35:15,360 Speaker 2: thousands of years, if not longer. 604 00:35:15,719 --> 00:35:15,959 Speaker 1: Yeah. 605 00:35:17,000 --> 00:35:20,240 Speaker 2: The problem is is all that time through history, people 606 00:35:20,239 --> 00:35:24,920 Speaker 2: weren't also taking like birth control pills or pharmaceutical antidepressants, 607 00:35:24,960 --> 00:35:28,319 Speaker 2: both of which Saint John's Wart reduces the effectiveness of. 608 00:35:29,000 --> 00:35:31,400 Speaker 2: You don't really want to reduce the effectiveness of your 609 00:35:31,440 --> 00:35:34,080 Speaker 2: birth control pills if you're trying not to get pregnant 610 00:35:34,360 --> 00:35:37,760 Speaker 2: at that time. It also breaks down It also prevents 611 00:35:37,760 --> 00:35:41,080 Speaker 2: the breakdown of antihistamines. It does all sorts of unwanted stuff, 612 00:35:41,320 --> 00:35:45,520 Speaker 2: And that's just such a great stellar lesson in the 613 00:35:45,600 --> 00:35:49,640 Speaker 2: problems with using a supplement to treat something like major 614 00:35:49,719 --> 00:35:53,960 Speaker 2: depressive disorder. But it's also a lesson in just how 615 00:35:54,120 --> 00:35:58,800 Speaker 2: far we need to go to look into non pharmaceutical 616 00:35:58,840 --> 00:36:01,400 Speaker 2: treatments for stuff and actually study them and figure out 617 00:36:01,480 --> 00:36:05,120 Speaker 2: exactly how to do it and start producing that treatment 618 00:36:05,160 --> 00:36:08,640 Speaker 2: as well, because you know, I think most people do 619 00:36:08,719 --> 00:36:13,560 Speaker 2: prefer something that you could conceivably consider more natural than 620 00:36:13,600 --> 00:36:14,680 Speaker 2: a pharmaceutical. 621 00:36:15,239 --> 00:36:15,920 Speaker 1: No, for sure. 622 00:36:16,120 --> 00:36:19,840 Speaker 2: The problem with that, though, is that it's we're not 623 00:36:20,040 --> 00:36:22,360 Speaker 2: set up the United States at least isn't set up 624 00:36:22,400 --> 00:36:24,839 Speaker 2: to make a trillion dollars off of Saint John's ward. 625 00:36:25,239 --> 00:36:28,320 Speaker 2: It's tough to do that that as opposed to creating 626 00:36:28,320 --> 00:36:32,320 Speaker 2: a new proprietary compound that that treats depression. 627 00:36:33,000 --> 00:36:36,360 Speaker 1: Yeah, for sure. So I mean that leads very nicely 628 00:36:36,400 --> 00:36:40,280 Speaker 1: into psychedelics. We promised talk of those earlier with ketamine 629 00:36:40,360 --> 00:36:44,279 Speaker 1: and psilocybin, and here we are they at least for 630 00:36:44,800 --> 00:36:48,200 Speaker 1: ketamine that is one that is way out in front 631 00:36:48,239 --> 00:36:50,640 Speaker 1: of psilocybin. As far as like official studies in the 632 00:36:50,640 --> 00:36:53,160 Speaker 1: government kind of getting behind some of this stuff. 633 00:36:53,320 --> 00:36:54,120 Speaker 2: Yeah, they love K. 634 00:36:54,440 --> 00:36:57,799 Speaker 1: Yeah, they love that K. They're being tested ketamine that 635 00:36:57,920 --> 00:36:59,960 Speaker 1: is as a breakthrough treatment and breakthrough as a lay 636 00:37:00,480 --> 00:37:04,200 Speaker 1: or a designation rather that the FDA says, hey, where 637 00:37:04,200 --> 00:37:06,680 Speaker 1: you can fast track this through the approval process because 638 00:37:06,680 --> 00:37:10,759 Speaker 1: we think it has so much potential and these still though, 639 00:37:10,880 --> 00:37:13,120 Speaker 1: even though like ketamine has shown a lot of promise, 640 00:37:13,440 --> 00:37:15,880 Speaker 1: it's still looked at and studied as a last resort 641 00:37:16,239 --> 00:37:18,600 Speaker 1: if you're resistant to other more traditional treatments. 642 00:37:18,960 --> 00:37:21,640 Speaker 2: Yeah, so the government was all about, I should say, 643 00:37:21,680 --> 00:37:27,760 Speaker 2: the FDA back in twenty nineteen, they prescribed or they approved, sorry, 644 00:37:28,160 --> 00:37:33,279 Speaker 2: a prescription version of ketamine called esketamine. And apparently that 645 00:37:33,440 --> 00:37:39,080 Speaker 2: to ketamine i've seen compared to CBD to THC, right, 646 00:37:39,600 --> 00:37:41,399 Speaker 2: there were a couple double colons in there. 647 00:37:41,440 --> 00:37:44,680 Speaker 1: If you don't a water down version. 648 00:37:44,719 --> 00:37:48,200 Speaker 2: Exactly that like say a geriatric person might take. 649 00:37:48,719 --> 00:37:52,920 Speaker 1: Yeah, exactly. They started to develop ketamine in the nineteen 650 00:37:53,040 --> 00:37:58,919 Speaker 1: sixties in Belgium, and you know they've been like you said, 651 00:37:59,160 --> 00:38:02,399 Speaker 1: I think arty in two thousand it's when they really 652 00:38:02,440 --> 00:38:04,239 Speaker 1: started kind of looking into stuff. So it had a 653 00:38:04,320 --> 00:38:08,440 Speaker 1: big jump on psilocybin. That's one that's just now starting 654 00:38:08,440 --> 00:38:11,640 Speaker 1: to kind of people are starting to say, hey, you know, 655 00:38:12,640 --> 00:38:16,480 Speaker 1: you know, magic mushrooms I now has a bad connotation 656 00:38:16,560 --> 00:38:18,960 Speaker 1: for a lot of people. So let's call it psilocybin, 657 00:38:19,120 --> 00:38:20,759 Speaker 1: you know the medical or you know the I guess 658 00:38:20,800 --> 00:38:23,680 Speaker 1: biological name, and let's let's study this stuff. 659 00:38:24,520 --> 00:38:29,759 Speaker 2: Yeah, so psilocybin is just gangbusters at treating depression. Ketamine 660 00:38:29,800 --> 00:38:32,440 Speaker 2: is too. We should say also that psychiatrists are like, 661 00:38:32,440 --> 00:38:35,400 Speaker 2: we need a more potent version of ketamine, so please 662 00:38:35,640 --> 00:38:39,239 Speaker 2: approve that FDA. They're not, as far as I know, 663 00:38:40,200 --> 00:38:43,239 Speaker 2: on the way to do that, but who knows. But 664 00:38:43,280 --> 00:38:49,400 Speaker 2: psilocybin in particular, there's just study after study after study 665 00:38:49,440 --> 00:38:53,279 Speaker 2: that's like, this stuff really works, and it works in 666 00:38:54,000 --> 00:38:55,719 Speaker 2: like you don't have to stay on it. You don't 667 00:38:55,719 --> 00:38:57,400 Speaker 2: have to take mushrooms every day for the rest of 668 00:38:57,440 --> 00:39:00,960 Speaker 2: your life, which you know, but there's only take them 669 00:39:00,960 --> 00:39:03,920 Speaker 2: a couple of times, and it can have effects that 670 00:39:04,040 --> 00:39:06,600 Speaker 2: last up to a year. There was a I think 671 00:39:06,600 --> 00:39:10,319 Speaker 2: a Johns Hopkins study from twenty twenty two where they 672 00:39:10,360 --> 00:39:14,880 Speaker 2: gave two doses of psilocybin to patients two weeks apart, 673 00:39:16,080 --> 00:39:19,319 Speaker 2: and so they gave each patient a dose of psilocybin 674 00:39:19,400 --> 00:39:21,719 Speaker 2: two weeks apart. They didn't just wait two weeks to 675 00:39:21,760 --> 00:39:24,440 Speaker 2: go to the next patient, I guess, is what I'm saying. Yeah, 676 00:39:24,520 --> 00:39:28,239 Speaker 2: so they found that this the effects could last like 677 00:39:28,280 --> 00:39:32,560 Speaker 2: a year after a year from the second dose they 678 00:39:33,280 --> 00:39:37,000 Speaker 2: and the effects were like just mind blowing too as 679 00:39:37,040 --> 00:39:42,640 Speaker 2: far as the I guess quantifying the symptoms of depression, right. 680 00:39:42,920 --> 00:39:45,919 Speaker 1: Yeah, do you know how what the dose was before 681 00:39:45,960 --> 00:39:46,800 Speaker 1: I give this number. 682 00:39:47,960 --> 00:39:51,520 Speaker 2: I think it was like melt your face half a bag, 683 00:39:52,719 --> 00:39:53,800 Speaker 2: two handfuls. 684 00:39:54,320 --> 00:39:57,239 Speaker 1: I'm very curious, but this is a I think it 685 00:39:57,280 --> 00:39:59,359 Speaker 1: was a depression rating scale they were using, where twenty 686 00:39:59,400 --> 00:40:02,320 Speaker 1: four was to be and seven or below was no depression. 687 00:40:03,000 --> 00:40:06,799 Speaker 1: And before they had the psilocybin, they scored twenty two, 688 00:40:06,920 --> 00:40:10,640 Speaker 1: an average of twenty two point eight out of twenty 689 00:40:10,640 --> 00:40:14,480 Speaker 1: four as far as being severely depressed, and then afterward 690 00:40:14,800 --> 00:40:16,840 Speaker 1: it went all the way down to seven point seven, 691 00:40:17,239 --> 00:40:19,960 Speaker 1: which is just a scoche above no depression. 692 00:40:20,200 --> 00:40:22,799 Speaker 2: Yeah, and that seven point seven was that follow up 693 00:40:22,840 --> 00:40:23,600 Speaker 2: a year later. 694 00:40:23,960 --> 00:40:25,160 Speaker 1: Yeah, that's remarkable. 695 00:40:25,320 --> 00:40:28,719 Speaker 2: Yeah, so that was twenty twenty two. I wonder if 696 00:40:28,760 --> 00:40:32,360 Speaker 2: they check in with these people now, what the scores 697 00:40:32,440 --> 00:40:34,200 Speaker 2: will be, you know, is it do you have to 698 00:40:34,200 --> 00:40:38,600 Speaker 2: take psilocybin every two years twice over two weeks and 699 00:40:38,920 --> 00:40:44,040 Speaker 2: maintain control over depression. That's it's pretty amazing. There's another 700 00:40:44,120 --> 00:40:48,000 Speaker 2: study from twenty twenty four that found that psilocybin is 701 00:40:48,040 --> 00:40:53,040 Speaker 2: at least as effective at treating MDD as SSRI is 702 00:40:53,320 --> 00:40:54,200 Speaker 2: probably more. 703 00:40:54,760 --> 00:40:56,839 Speaker 1: Yeah, and I think they had did try to follow 704 00:40:56,880 --> 00:40:59,120 Speaker 1: up those people, but they got no self service out 705 00:40:59,120 --> 00:41:00,160 Speaker 1: there on Joshua Tree. 706 00:41:03,000 --> 00:41:06,640 Speaker 2: So just real quick, there's we because we'll probably go 707 00:41:06,680 --> 00:41:08,759 Speaker 2: over this a little bit in the depression episode. But 708 00:41:08,920 --> 00:41:11,439 Speaker 2: if you go in for treatment of depression, they're going 709 00:41:11,520 --> 00:41:16,040 Speaker 2: to treat you in three different phases, two possibly, but 710 00:41:16,680 --> 00:41:19,960 Speaker 2: probably three. The first is acute where you show up 711 00:41:20,000 --> 00:41:22,760 Speaker 2: and you're like, I can't take this anymore. I need treatment. 712 00:41:23,040 --> 00:41:25,920 Speaker 2: They're going to get you on ss or yeah, probably 713 00:41:25,960 --> 00:41:28,600 Speaker 2: an SSR. They're going to get you on some antidepressant 714 00:41:28,920 --> 00:41:31,279 Speaker 2: to start. They're going to try to work their way 715 00:41:31,400 --> 00:41:34,399 Speaker 2: up while also balancing getting you feeling better as soon 716 00:41:34,440 --> 00:41:39,760 Speaker 2: as possible, and time was they would try an antidepressant 717 00:41:40,120 --> 00:41:43,200 Speaker 2: for like four to six weeks. That was what was 718 00:41:43,280 --> 00:41:46,400 Speaker 2: generally prescribed, like that's what all psychiatrists did. And if 719 00:41:46,440 --> 00:41:49,040 Speaker 2: after four to six weeks there wasn't more than a 720 00:41:49,120 --> 00:41:52,120 Speaker 2: twenty five percent reduction and symptoms, they would say, this 721 00:41:52,200 --> 00:41:54,840 Speaker 2: isn't working for you, let's try another one. But I 722 00:41:54,880 --> 00:41:58,640 Speaker 2: guess something happened to the psychiatry zeitgeist, and now they're 723 00:41:58,640 --> 00:42:01,640 Speaker 2: waiting as long as six months to give it a chance, 724 00:42:02,800 --> 00:42:04,960 Speaker 2: which has got to be tough when you're suffering from 725 00:42:05,040 --> 00:42:09,560 Speaker 2: major depressive disorder. But that's the acute phase and once 726 00:42:09,600 --> 00:42:13,799 Speaker 2: they get a once they find an antidepressant that can 727 00:42:13,840 --> 00:42:18,560 Speaker 2: manage your symptoms, you'll move into what's called the continuation phase. 728 00:42:19,000 --> 00:42:23,080 Speaker 1: That's right, and that's after remission has begun, and that 729 00:42:23,200 --> 00:42:26,799 Speaker 1: is when they're trying to you know, knock down or 730 00:42:26,920 --> 00:42:31,200 Speaker 1: outright eliminate the symptoms that are still sticking around and 731 00:42:31,320 --> 00:42:34,759 Speaker 1: get you back to where you were before your MDD episode. 732 00:42:36,520 --> 00:42:39,120 Speaker 1: After six months of that, if there's no relapse, then 733 00:42:39,719 --> 00:42:42,240 Speaker 1: they may wean you down or completely off of something. 734 00:42:43,960 --> 00:42:46,360 Speaker 1: You know, it just sort of depends. Like again, like 735 00:42:46,480 --> 00:42:49,720 Speaker 1: talk talk a lot to your doctor through all this stuff, 736 00:42:49,840 --> 00:42:52,719 Speaker 1: so you really have a good handle on what's going on. 737 00:42:53,520 --> 00:42:58,080 Speaker 2: So I think I said most people will suffer multipolar, 738 00:42:58,160 --> 00:43:02,839 Speaker 2: chronic or recurring episodes of major depressive disorder once they 739 00:43:02,880 --> 00:43:05,840 Speaker 2: have one. Yeah, something like fifty to eighty five percent 740 00:43:05,960 --> 00:43:10,359 Speaker 2: of people who have one will have another episode. So 741 00:43:10,400 --> 00:43:14,160 Speaker 2: there's it's probable that your continuation phase will eventually turn 742 00:43:14,200 --> 00:43:17,719 Speaker 2: into a maintenance phase where they'll just keep an eye 743 00:43:17,800 --> 00:43:21,880 Speaker 2: on you. You'll probably keep up with say therapy or psychoanalysis 744 00:43:22,000 --> 00:43:27,040 Speaker 2: or something like that, and if your episode starts to 745 00:43:27,040 --> 00:43:30,839 Speaker 2: come back, they'll put you on the antidepressant that worked before. Yeah, 746 00:43:30,840 --> 00:43:34,319 Speaker 2: And this can go anywhere from a year to indefinite. 747 00:43:35,760 --> 00:43:38,120 Speaker 2: Just the point is to stay on top of your 748 00:43:38,120 --> 00:43:41,440 Speaker 2: symptoms so that you don't have another episode or if 749 00:43:41,520 --> 00:43:43,319 Speaker 2: one starts to come along, the nipp it in the 750 00:43:43,320 --> 00:43:44,680 Speaker 2: butt very quickly. 751 00:43:44,760 --> 00:43:47,600 Speaker 1: Yeah, for sure, Which kind of all leads to the 752 00:43:47,680 --> 00:43:52,360 Speaker 1: question are these being prescribed too much? That's you know, 753 00:43:52,400 --> 00:43:55,160 Speaker 1: you can't hardly bring this up without hearing somebody say, yeah, 754 00:43:55,200 --> 00:43:57,520 Speaker 1: they're just doctors are just willing nelly prescribing this stuff 755 00:43:57,520 --> 00:44:00,880 Speaker 1: to everybody, like young children all the way to senior citizens, 756 00:44:00,880 --> 00:44:02,960 Speaker 1: Like they'll just throw anyone on that. And that's just 757 00:44:02,960 --> 00:44:06,040 Speaker 1: a very sort of dumb down way to look at this. 758 00:44:07,120 --> 00:44:11,400 Speaker 1: There are critics who you know, have valid points about stuff, 759 00:44:11,440 --> 00:44:14,319 Speaker 1: but you have to look at real numbers as far 760 00:44:14,360 --> 00:44:18,400 Speaker 1: as like an increase in prescriptions. If you look at 761 00:44:18,400 --> 00:44:22,000 Speaker 1: the numbers, part of it is that they are they 762 00:44:22,040 --> 00:44:25,720 Speaker 1: are staying on something for longer. So if they're keeping 763 00:44:25,719 --> 00:44:28,520 Speaker 1: you on something for six months rather than just switching 764 00:44:28,520 --> 00:44:31,080 Speaker 1: something out at six weeks, then the numbers for that 765 00:44:31,440 --> 00:44:34,040 Speaker 1: prescription are going to be higher over a six month period. 766 00:44:34,320 --> 00:44:37,480 Speaker 1: So there's just a lot more nuance in those numbers. 767 00:44:37,520 --> 00:44:39,719 Speaker 1: As far as there's been a big increase, like a 768 00:44:39,760 --> 00:44:42,120 Speaker 1: sweeping statement, like there's been a big increase in the 769 00:44:42,200 --> 00:44:43,239 Speaker 1: number of prescriptions. 770 00:44:43,719 --> 00:44:47,120 Speaker 2: Right, Plus, if you're just counting prescriptions of antidepressants, you 771 00:44:47,200 --> 00:44:50,799 Speaker 2: might miss that, say, the tricyclic antidepressants are now being 772 00:44:50,840 --> 00:44:54,600 Speaker 2: prescribed for neuropathic pain, right, so that would get lumped 773 00:44:54,600 --> 00:44:58,120 Speaker 2: into that as well. And yet you can totally get 774 00:44:58,200 --> 00:45:00,680 Speaker 2: the viewpoint of people who are like, yeah, that probably 775 00:45:00,719 --> 00:45:03,440 Speaker 2: accounts for some of it. But dude, I saw a 776 00:45:03,480 --> 00:45:07,520 Speaker 2: statistic that in the United States people ages twelve to 777 00:45:07,600 --> 00:45:12,480 Speaker 2: twenty five between twenty sixteen and twenty twenty two, monthly 778 00:45:12,560 --> 00:45:15,800 Speaker 2: prescriptions that antidepressants went up sixty six percent. 779 00:45:17,200 --> 00:45:21,040 Speaker 1: Yeah, I mean twenty sixteen to twenty twenty two is 780 00:45:21,080 --> 00:45:23,200 Speaker 1: also a period of a lot of upheaval in the 781 00:45:23,280 --> 00:45:27,160 Speaker 1: United States and starting in twenty twenty with COVID around 782 00:45:27,200 --> 00:45:30,800 Speaker 1: the world, so all of that stuff comes into play 783 00:45:30,840 --> 00:45:31,200 Speaker 1: for sure. 784 00:45:31,440 --> 00:45:33,960 Speaker 2: Yeah. I think from twenty twenty to twenty twenty two, 785 00:45:33,960 --> 00:45:37,120 Speaker 2: if you just look in that window, especially for I 786 00:45:37,160 --> 00:45:40,239 Speaker 2: think girls and women age twelve to twenty five, it 787 00:45:40,320 --> 00:45:43,479 Speaker 2: went up like one hundred and fifty percent in those 788 00:45:43,520 --> 00:45:44,080 Speaker 2: two years. 789 00:45:44,320 --> 00:45:46,960 Speaker 1: Kids pulled out of school in their entire social structure 790 00:45:47,040 --> 00:45:47,799 Speaker 1: sometimes yep. 791 00:45:48,280 --> 00:45:55,000 Speaker 2: Yeah, yeah, So it's also possible that the stigma has 792 00:45:55,080 --> 00:45:59,360 Speaker 2: been reduced, thank you gen Z around seeking treatment for 793 00:45:59,440 --> 00:46:02,280 Speaker 2: mental health, talking about your mental health, so more people 794 00:46:02,640 --> 00:46:05,480 Speaker 2: could be seeking help, which could lead to a higher 795 00:46:05,560 --> 00:46:08,480 Speaker 2: increase in diagnoses, which would of course lead to an 796 00:46:08,520 --> 00:46:11,960 Speaker 2: increase in prescriptions. At the same time, some people are like, 797 00:46:12,080 --> 00:46:16,320 Speaker 2: we're just a lot of this is just pathologizing human sadness, 798 00:46:16,680 --> 00:46:20,640 Speaker 2: and we need to especially so everybody agrees basically that 799 00:46:20,960 --> 00:46:25,920 Speaker 2: if you have a low level diagnosable depression that's not MDD, 800 00:46:27,040 --> 00:46:29,719 Speaker 2: then you should not start out with any depressants. You 801 00:46:29,760 --> 00:46:33,080 Speaker 2: should start out with lifestyle changes like changes in your diet, 802 00:46:33,280 --> 00:46:37,640 Speaker 2: exercise again, getting good sleep, just stuff you can do 803 00:46:37,719 --> 00:46:42,080 Speaker 2: without pharmaceuticals. Everyone agrees except I'm sure for the pharmaceutical 804 00:46:42,120 --> 00:46:45,160 Speaker 2: companies that you should not start with that for like 805 00:46:45,280 --> 00:46:46,400 Speaker 2: low level depression. 806 00:46:47,120 --> 00:46:50,200 Speaker 1: Yeah. I was curious too about kids about I wondered 807 00:46:50,200 --> 00:46:52,960 Speaker 1: if there was just a minimum age, and from what 808 00:46:53,040 --> 00:46:56,759 Speaker 1: I found, each drug is FDA approved starting at a 809 00:46:56,760 --> 00:46:57,359 Speaker 1: certain age. 810 00:46:57,920 --> 00:46:59,160 Speaker 2: What's the youngest you found? 811 00:47:00,360 --> 00:47:02,560 Speaker 1: The youngest I found was seven years old. 812 00:47:02,840 --> 00:47:03,800 Speaker 2: I would have guessed five. 813 00:47:04,760 --> 00:47:07,479 Speaker 1: Yeah, I mean that may be, but I just found seven. 814 00:47:08,360 --> 00:47:11,239 Speaker 2: So there's just a couple of other things we want 815 00:47:11,280 --> 00:47:13,600 Speaker 2: to cover real quick that fall under the umbrella of 816 00:47:14,000 --> 00:47:18,960 Speaker 2: antidepressants making depression worse, right, because you would probably be 817 00:47:18,960 --> 00:47:21,600 Speaker 2: bewildered if you were taking any deepressants and you're like, 818 00:47:21,640 --> 00:47:24,600 Speaker 2: I actually feel way worse than I did before. And 819 00:47:24,680 --> 00:47:28,560 Speaker 2: there's a whole kind of little suite of possible reasons 820 00:47:28,600 --> 00:47:29,800 Speaker 2: for why that might happen. 821 00:47:30,320 --> 00:47:33,280 Speaker 1: Yeah, I mean, you may be just may be simple misdiagnosis. 822 00:47:34,440 --> 00:47:38,040 Speaker 1: It could be bipolar disorder. It could be BPD, which 823 00:47:38,040 --> 00:47:42,160 Speaker 1: we've talked about borderline personality disorder h but those are 824 00:47:42,200 --> 00:47:45,879 Speaker 1: not the same things. So you just might be misdiagnosed. 825 00:47:45,960 --> 00:47:49,040 Speaker 2: Yeah, you might have a chump for a doctor. Yeah, 826 00:47:49,120 --> 00:47:53,520 Speaker 2: genetics is also one apparently that also determines whether you 827 00:47:53,719 --> 00:47:57,120 Speaker 2: have whether a risk factor like you said earlier, like 828 00:47:57,200 --> 00:48:02,000 Speaker 2: grief or something like that pushes you into major depressive disorder. 829 00:48:02,600 --> 00:48:05,759 Speaker 2: There's a gene, the SLC sixty four a, the serotonin 830 00:48:05,760 --> 00:48:09,520 Speaker 2: transporter gene. I think there's a variation in that where 831 00:48:09,600 --> 00:48:13,879 Speaker 2: you can actually get feel worse after taking an adepressants 832 00:48:13,920 --> 00:48:15,040 Speaker 2: because of that gene. 833 00:48:15,440 --> 00:48:18,960 Speaker 1: Yeah, your metabolism might affect it if some people just 834 00:48:19,000 --> 00:48:23,240 Speaker 1: don't clear drugs out of their system as quickly. Yeah, 835 00:48:23,320 --> 00:48:27,640 Speaker 1: so if it's taking longer than usual then it usually 836 00:48:27,719 --> 00:48:30,360 Speaker 1: a dose adjustment can help with that, but that could 837 00:48:30,440 --> 00:48:31,799 Speaker 1: imbalance things even more. 838 00:48:32,360 --> 00:48:35,960 Speaker 2: Yeah, and then being under twenty five before your brain 839 00:48:36,000 --> 00:48:41,000 Speaker 2: is fully developed, that's one. There's something called acathesia, which 840 00:48:41,600 --> 00:48:45,440 Speaker 2: it's basically just an internal restlessness that keeps you from sleeping, 841 00:48:45,520 --> 00:48:49,160 Speaker 2: makes you anxious, and then those will make your depression 842 00:48:49,200 --> 00:48:52,680 Speaker 2: symptoms worse. And then just being on too many drugs, right. 843 00:48:53,360 --> 00:48:57,600 Speaker 1: Yeah. Polypharmacy pretty good band name, but not a great 844 00:48:57,600 --> 00:49:01,520 Speaker 1: thing to live with, because, you know things, interacting with 845 00:49:01,600 --> 00:49:04,719 Speaker 1: other drugs is a real thing, and if you're on 846 00:49:04,760 --> 00:49:07,359 Speaker 1: a lot of them, then it's some kind sometimes can 847 00:49:07,400 --> 00:49:10,319 Speaker 1: be hard to even tell what might be affecting what 848 00:49:10,560 --> 00:49:11,920 Speaker 1: you had to get at a certain point. 849 00:49:11,920 --> 00:49:16,799 Speaker 2: Right, exactly. So that's it for antidepressants, right, you got 850 00:49:16,840 --> 00:49:17,399 Speaker 2: anything else? 851 00:49:17,760 --> 00:49:18,520 Speaker 1: Got nothing else? 852 00:49:18,880 --> 00:49:23,000 Speaker 2: Okay, Well, go forth and seek treatment. If you have depression, 853 00:49:23,400 --> 00:49:26,560 Speaker 2: especially if you think you have major depressive disorder, go 854 00:49:26,560 --> 00:49:29,560 Speaker 2: get help. Things can get a lot better. And since 855 00:49:29,600 --> 00:49:32,120 Speaker 2: I said things can get a lot better, everybody, it's 856 00:49:32,120 --> 00:49:32,880 Speaker 2: time for a listener. 857 00:49:32,920 --> 00:49:36,960 Speaker 1: Mayw This is one of a couple I'm going to 858 00:49:37,040 --> 00:49:40,080 Speaker 1: read in the next few episodes about the inner monologue episode. 859 00:49:40,080 --> 00:49:43,640 Speaker 1: We heard a lot from people about that. Yeah, and 860 00:49:44,000 --> 00:49:48,080 Speaker 1: specifically in this case, my inner monologue when I'm falling 861 00:49:48,120 --> 00:49:52,000 Speaker 1: asleep getting really weird. Hey, guys, Chuck mentioned before falling 862 00:49:52,040 --> 00:49:53,759 Speaker 1: asleep with his thoughts start to get weird, and that's 863 00:49:53,760 --> 00:49:56,279 Speaker 1: how he knows he's falling asleep right away. A newt 864 00:49:56,320 --> 00:49:58,600 Speaker 1: he was talking about. And the reason I read this 865 00:49:58,640 --> 00:50:01,400 Speaker 1: one because I had and dozens of people that have 866 00:50:01,480 --> 00:50:03,799 Speaker 1: the same thing. Right, It's because it's very common, but 867 00:50:03,880 --> 00:50:07,120 Speaker 1: this person names it. There's a term called hypnagogic imagery, 868 00:50:08,600 --> 00:50:10,320 Speaker 1: which I think we've talked about that in something It 869 00:50:10,400 --> 00:50:13,839 Speaker 1: might have been lucid dreaming, which I learned about from 870 00:50:13,920 --> 00:50:16,440 Speaker 1: Jeff Warren's awesome book of the head Trip. It's basically 871 00:50:16,480 --> 00:50:18,600 Speaker 1: the stage before falling asleep, when our brains start to 872 00:50:18,640 --> 00:50:22,080 Speaker 1: produce hallucination like images. This happens to me, though I'm 873 00:50:22,120 --> 00:50:24,399 Speaker 1: not consciously aware of it on nights when I fall 874 00:50:24,400 --> 00:50:28,279 Speaker 1: asleep quickly. Often I'll drift into the hypnagogic stage and 875 00:50:28,280 --> 00:50:31,160 Speaker 1: then catch myself and think that was weird, which is 876 00:50:31,160 --> 00:50:33,640 Speaker 1: what happens to me, and then drift back in. Chuck 877 00:50:33,680 --> 00:50:37,239 Speaker 1: described his experience as a series of nonsensical thoughts, so 878 00:50:37,280 --> 00:50:41,799 Speaker 1: I wonder if his is truly verbal versus visual. I 879 00:50:41,800 --> 00:50:43,239 Speaker 1: would love to hear more. I think mine are a 880 00:50:43,239 --> 00:50:45,520 Speaker 1: little bit of both. Jill and that is Jill in Connecticut. 881 00:50:45,880 --> 00:50:48,400 Speaker 2: Thanks Jill, that was a great one. We'd love naming 882 00:50:48,480 --> 00:50:51,360 Speaker 2: stuff that we experience and didn't know there was a 883 00:50:51,440 --> 00:50:56,120 Speaker 2: name for right right, So okay, Well, if you want 884 00:50:56,120 --> 00:50:58,719 Speaker 2: to be like Jill, send us an email. Send it 885 00:50:58,760 --> 00:51:05,040 Speaker 2: off to stuff podcast at iHeartRadio dot com. 886 00:51:05,200 --> 00:51:08,080 Speaker 1: Stuff you Should Know is a production of iHeartRadio. For 887 00:51:08,160 --> 00:51:12,359 Speaker 1: more podcasts my heart Radio, visit the iHeartRadio app, Apple Podcasts, 888 00:51:12,480 --> 00:51:14,320 Speaker 1: or wherever you listen to your favorite shows,