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  • EADD Moderators: Pissed_and_messed | Shinji Ikari

NHS antidepressant fixation

I remember when Lyrica (pregabalin) just came on the market. I was given, for anxiety, 2×75 mg for first 3 days and 2x150 mg from there on after. Came back within 2 weeks and told my doc that I am not going to take substance that can cause addiction and it causes dependence for sure. The doctor tried to brush it off and then started to explain how Lyrica has no abuse potential and thus brings no risk of addiction and if taken and stopped properly the withdrawals are non existant. I declined it cause I know how it made me feel so I can deduct how bad "the rebound syndrom" aka withdrawal could be. Fast forward to the expiry of patent and all of the sudden asking for pregabalin raises a red flag due to it's "well known abuse potential".

While patented drugs are safe and effective. When patent expires and generics flood the market all the skeletons come out of the closest. Psychiatry is still pseudoscience wearing the badge of the scientific (medical) world. It exploits pain that people feel, from one reason or another, and turns that pain into profit.

One day understanding and the instruments that can detect true diseases in this field may come but until then it is pseudoscience that is bringig pharmaceutical companies and their minions a fortune.

At least thats what I concluded from my experience...
 
I remember when Lyrica (pregabalin) just came on the market. I was given, for anxiety, 2×75 mg for first 3 days and 2x150 mg from there on after. Came back within 2 weeks and told my doc that I am not going to take substance that can cause addiction and it causes dependence for sure. The doctor tried to brush it off and then started to explain how Lyrica has no abuse potential and thus brings no risk of addiction and if taken and stopped properly the withdrawals are non existant. I declined it cause I know how it made me feel so I can deduct how bad "the rebound syndrom" aka withdrawal could be. Fast forward to the expiry of patent and all of the sudden asking for pregabalin raises a red flag due to it's "well known abuse potential".

While patented drugs are safe and effective. When patent expires and generics flood the market all the skeletons come out of the closest. Psychiatry is still pseudoscience wearing the badge of the scientific (medical) world. It exploits pain that people feel, from one reason or another, and turns that pain into profit.

One day understanding and the instruments that can detect true diseases in this field may come but until then it is pseudoscience that is bringig pharmaceutical companies and their minions a fortune.

At least thats what I concluded from my experience...
Do you have any idea the money these companies spend on research and development. Look all the good medicines that have come out.

Also a business is not a charity, they have to pay employees, and countless bills and millions, if not billions In insurance. Thank you ambulance chasers.

They need to recoup their money and make a profit. What if there were no real medicinal medicines? Also no pain killers and you have been seriously hurt?

However, from some of the posts, it seems like the UK politicians want to be lying, manipulative, corrupt, sacks of shit like the American politicians.
 
Do you have any idea the money these companies spend on research and development. Look all the good medicines that have come out.

Also a business is not a charity, they have to pay employees, and countless bills and millions, if not billions In insurance. Thank you ambulance chasers.

They need to recoup their money and make a profit. What if there were no real medicinal medicines? Also no pain killers and you have been seriously hurt?

However, from some of the posts, it seems like the UK politicians want to be lying, manipulative, corrupt, sacks of shit like the American politicians.
I am talking about psychiatry. Not evidence based medicine. Maybe you misunderstood me or maybe we disagree.
 
Just curious if you have an update on how it’s going getting off AD? Have you tried St John’s Wort when you need a mood lift?

Just so you know St John's Wort is basically a natural SNRI (or something very similar) and so is possibly as dependency causing as a pharma one. People do report withdrawal symptoms that sound similar. Its very cool though that nature produced this eons before pharma companies dreamed them up and meta analysis shows it having very similar efficacy to many anti depressants.
 
While patented drugs are safe and effective. When patent expires and generics flood the market all the skeletons come out of the closest. Psychiatry is still pseudoscience wearing the badge of the scientific (medical) world. It exploits pain that people feel, from one reason or another, and turns that pain into profit.

I wouldn't go as far as calling Psychiatrists quacks (at least in the UK where while they're well paid they're not working for a profit based company), they're much better versed in psychotropics than a GP. But you raise a very good point about the skeletons coming out of the closet once they're no longer highly lucrative to the Pharma who patented it.

My sister in law worked in animal testing on an SSRI for a pharma and not only would she not take them, she told me that while she couldn't tell me exact details due to a non disclosure agreement that the company had held back or massaged clinical trial data. Just like Boeing and their recent horrid safety culture I believe Pharma's are in the same position. They stand to make billions from a drug, but might have to invest a billion to get it to market. When you've invested that much money, and the clinical trials start showing problems, they are *highly* motivated to try and bury it and keep any dissenting voices silent. The closest I ever got was working in a £100M project, and the answer to problems was just to keep shoveling money at it and pretending it was all going fine to senior mgmt.

related side rant:

It also kind of reminds of the USSR's RBMK reactors. The scientists were in favour of VVER (a technology that has proven itself reliable and has advanced over several generations). The politicians of the time loved the RBMK, since it was dirt cheap to build, produced a ton of power, and anyway who needs a containment building, amirite?

Not only was it a flawed design but the scientists who raised objections were silenced. Positive void coefficient problem was well understood, but such literature was sidelined to a dusty library and never mentioned to reactor operators. When it came to building the RBMKs they were on tight construction deadlines and going over schedule was not tolerated. As a result the builders did whatever shoddy work they had to so as to complete on time.

As it happens there were finally lessons learned from Chernobyl and the RBMKs still in service (yes, I was surprised they still run to this day) have been pretty reasonable since a lot of design changes and better safety culture went into place. They still have no containment building though so.... 🧨
 
Just so you know St John's Wort is basically a natural SNRI (or something very similar) and so is possibly as dependency causing as a pharma one. People do report withdrawal symptoms that sound similar. Its very cool though that nature produced this eons before pharma companies dreamed them up and meta analysis shows it having very similar efficacy to many anti depressants.
My wife has been taking it and stopped due to almost exact adverse effects that SSRI/SNRIs induce (nausea, vomitting, diarrhea , headeche, vivid dreams, emotional blunting....).

In fact every drug that one can buy without prescription (and most prescription based) originates in one way or the other from "folk medicine". Most known example is acetylsalicylic acid (Aspirin) which is extracted from the bark of the willow tree.

But whole process is best summed up by opioids:

1.) First the pain relieving, sedative and other effects have been attributed to Papaver somniferum (opium poppy). The knowledge was passed generation after generation and became part of the native folk medicine.

2.) As the scientific enterprise was getting more refined during enlightenment phase alkaloids that made the plant such a good medicine were isolated. Morphine was first the first one, followed by codeine, thebaine, papaverine and noscapine. I'll stick to opiate/opiod alkaloids and further development of other drugs.

So morphine, codeine and thebaine are opiates - opioids that are extracted directly from a plant.

3) By studying those three alkaloids and tweaking the molecules first semi synthetic opioids were created. I will mention most basic and known ones:

-from opiate (and more broadly classed "opioid") morphine, semi synthetic opioid dia(cetyl)morphine (most famously known by Bayers brand name Heroin) was synthesised.

- from opiate (and more broadly classed "opioid") codeine, semi synthetic opioid hydrocodone was synthesised.

- from opiate (and more broadly classed "opioid") , semi synthetic opioid thebaine oxycodone was synthesised. Hydrocodone and buprenorphine can/are also synthesised from thebaine.

4) From further tweaking of opioid molecules and discovered metabolites host of other opioids we're synthesised like oxymorphone for an example.

5.) During research & development vast knowledge of opioids mode of action and how to create host of semi synthetic opioids was accumulated. From original point 1 (plant itself) to point 4 (understanding of how opioids work and can be created) the newest method of creating opioids was learned and fully synthetic opioids like pethidine/meperidine, methadone, fentanyl were introduced.

This is the rough process of how most of drugs were discovered and vast majority can be traced to plants.

This is the reason why I made the distinction between real science backed medicine...
Psychiatry is still pseudoscience wearing the badge of the scientific (medical) world.
...and psychiatry that is by the rigorous standards of science actually a pseudoscientific spin off thet doesnt even treat illness/disease but "disorders". If someone brought hypothesis to physicists or biologists for some new discovery but hypothesis was using method of detection that psychiatry is using when proving that they discovered "disorder" the paper would be laught of by physicist and biologists. But I have reserved my openes that psychiatry could become evidence based...
One day understanding and the instruments that can detect true diseases in this field may come
...but then it would again fall in the discipline of biology. We do not even know what is mind or consciousness if the strict evidence based scientific method is used - how could we then, with a straight face, say "we know how to cure it"?

But I digress. Just wanted to say that almost all medications that are commonly used come from plants and medicine that was practioned in Sumer, Egypt, Asia and South America long before the science as we know it today was available.

Sorry for the long post. I'm going to bet to get my beauty sleep.

Have fun and have a great Tuesday/Wednsday!

Edit: I am very tired and made too many mistakes while writing that I had to edit spelling and other mistakes in my post.
 
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I remember when Lyrica (pregabalin) just came on the market. I was given, for anxiety, 2×75 mg for first 3 days and 2x150 mg from there on after.
What the Fuck is that dose meant to do?

600mg of Pre-Gab is a good dose in one go imho & I have ZERO tolerance to those damn things.

2x150mg once every 24 hours ain't gonna touch the sides.
 
What the Fuck is that dose meant to do?

600mg of Pre-Gab is a good dose in one go imho & I have ZERO tolerance to those damn things.

2x150mg once every 24 hours ain't gonna touch the sides.
If youre taking it for the first time and have never taken gabapentin 150mg if more than enough to experience alcohol like intoxication. Obviously I took 600mg to test what will higher dose do and results were obvious. But give GABAeric drugs naive person 150mg of pregabalin and I can assure you that most of them will be "pregabalin drunk". General population is not banging dope and drinking benzos with whiskey to counteract decades long tolerance. And there are people with naturally high tolerance (or are absorbing lesss of some drug) that will not feel certain drugs like an average person. People that drink will have higher tolerance to gabaerics let alone polydrug (ab)users. Or maybe I'm just weak when it comes to pregabalin. It could be that also.

I have derailed a thread in EADD. I'll give myself a warning. Sorry people - NHS antidepressant fixation is where the thread should be. 🙂
 
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Pregabs are one of those things where peoples reactions vary incredibly massively.

Personally my favourite way of using it is as part of a combo, so I'll usually have 100-150mg and combine with benzos, kratom, or alcohol, preferably whisky.

I dosed 100mg 3 times about 4 hours apart the other day and when I took just a moderate dose of a benzo later on I was absolutely smashed. In a way I hadnt felt for a long time. And in a nice way.

Layering up the pregabs re-doses over the course of the day does seem to work well.

I dont like large doses at any one time. Never going anywhere near 400mg again, I think I tried it once and I hated it. Felt like a bad trip! I dont know how on earth people do huge multi gram doses of this stuff!

Some people say it combines nice with opis, but it didnt work out nicely for me last couple of times I tried. It kind of killed the buzz of both things.
 
I have some confusion about pregab because modulating the whole nervous system it seems like it has something to do with serotonin but I've yet to hear people having issues combining with tram or molly. HAs anyone heard about that kind of incidents?

me and my friend were using pregab a lot with tram and separately with molly, never any issues. It is funny to think about.
 
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If someone asked me what kind of drug pregabalin is? I would respond "I can not tell but it's more like a mix of drugs than one substance.". Effects of 600mg dose for me is like "combination of alcohol and benzo with a of a low dose dissociative, emphathogen and psychedelic". It's definitely a weird one. So much going on there and yet I wouldn't call the high a dirty one. At one point I was prescribed 50mg methadone + 6mg clonazepam + 450mg pregabalin +72mg methylphenidate. At the time I actually used pregabalin per need for sleep and methylphenidate not every day. With my previous, now more than 20 years ago stimulant addiction and countless psychedelic trips (mostly LSD and mashrooms) I wasnt inexperienced in (poly)drug use but pregabalin if taken infrequently due to rapid tolerance formation if taken daily is a polydrug experience even if taken without any other drug.

***In my case pregabalin works great if I get anxiety fron stimulants, goes great with benzos and can be great with small dose of opioids. But if dose of opioids isn't adjusted then pregabalin can actually make the whole experience too heavy and ruin it. Sleep on pregabalin (I suffer from horrible insomnia) is magnificent and it acts as per need antidepressant when I wake up. Truly a tough drug and experience to pinpoint.

***IMPORTANT: For the lurkers and even tolerant persons - doses I wrote are result from tolerance acquired from many years on high doses of benzodiazepines, opioids and stimulants. PLEASE DO NOT USE THIS POST AS A GUIDE CAUSE YOU WILL OD AND DIE. As Zopiclone bandit wrote YMMV and I truly hope that your body is not as used as mine cause it is surely not something to be aiming for. I wish that 20mg of methadone was still something that could get me floored. Use caution and HR principles if you have made the decision to take any of the substances mentioned!
 
I dont like large doses at any one time. Never going anywhere near 400mg again, I think I tried it once and I hated it. Felt like a bad trip! I dont know how on earth people do huge multi gram doses of this stuff!
First time I ever tried them was 600mg of Gabapentin & I HATED it, I got Visual effects off it that made a persons mouth look like a hole torn in a Pancake, I said from my first time it was on the level of Pure DXM powder.

The 2nd time I did it was Pre-Gab & I did 600mg again (1200mg / 1.2 grams of Gabapentin) & was fucking Smashed but in a good way, I fell in love with it. If you are Dope sick it helps so much, well in my experience I found it to be better than anything I have ever tried to get the sickness off, well apart from a good shot of Heroin in the vein of course.

Both Pre-Gab & Gabapentin goes very well with high level CBD Weed & of course high grade Hash as it is more CBD.
Mixing either of them with Alcohol isn't a good idea, well if you enjoy pissing yourself, falling into a wall & walking like you have suffered from Polio as a child.
 
Some people say it combines nice with opis, but it didnt work out nicely for me last couple of times I tried. It kind of killed the buzz of both things
I found it to be ok, they are a Gift from "God" if you are Dope sick I Promise you that much.

What kind of Opiate had you taken when you mixed them together?
 
@LoginNotSecure

Can I ask, how much training does a 'normal' GP (LOL) usually get in mental health?

Do you think that it's ethical that GP's can prescribe seriously strong and potentially negatively lifechanging drugs (such as SSRI's) on the back of that amount of training? Especially given the tiny amount of time allocated for a GP appointnment?

No diss, genuinely interested
 
@LoginNotSecure

Can I ask, how much training does a 'normal' GP (LOL) usually get in mental health?

Do you think that it's ethical that GP's can prescribe seriously strong and potentially negatively lifechanging drugs (such as SSRI's) on the back of that amount of training? Especially given the tiny amount of time allocated for a GP appointnment?

No diss, genuinely interested
Training is continuous and part of your ongoing employment. It’s severally lacking in several areas (mental health, palliative, Alzheimer’s etc) but don’t forget, you are the first port of call, you assess what you can with what you’ve been taught/experienced, and make a choice based on that.

You always have someone you can call/refer too, but referring to specific areas is always the better option. However, if someone presents saying they’re going to top themselves, you have to make a snap decision. Do you give them something to help the immediate while waiting for a referral to the right team to intervene and take over..? If you don’t and they unalive themselves, it’s on you.

My personal views are since England began it’s muddying of the waters, wait times that were already excessively long, are now beyond attainable.

Even private care has wait times, and that was the main caveat people went private, to beat the wait times.

Add in the medication shortages, backlog of patients, Drs leaving due to shit pay and long hours, I’m surprised more and more that hospitals and trusts haven’t yet collapsed.

The end is nigh. When it does, I’m off to Italy. Buying something where I can spend the rest of my days fannying about making furniture and quirky things with wood. 🪵

Also, don’t forget. Your appointment is 10 minutes, don’t be fobbed off and out the door (even though you’re treated like cattle in a revolving door) if you want to ask questions, do so. Write them down if you’re prone to forgetting or get flustered easily.

Ask for a second opinion, ask for a third. Ask for a referral to the specialist. Don’t be afraid to sound out your issues or concerns. You are the “customer” as it were, if nobody got sick, there’d be no need for Drs after all.
 
I found it to be ok, they are a Gift from "God" if you are Dope sick I Promise you that much.

What kind of Opiate had you taken when you mixed them together?
It was DHC and / or codeine the last couple of times. Introducing pregabs just killed the buzz completely for me. It doesn't seem to mix well for me, although I know a lot of people enjoy adding pregabs to their opis.
 
First time I ever tried them was 600mg of Gabapentin & I HATED it, I got Visual effects off it that made a persons mouth look like a hole torn in a Pancake, I said from my first time it was on the level of Pure DXM powder.

The 2nd time I did it was Pre-Gab & I did 600mg again (1200mg / 1.2 grams of Gabapentin) & was fucking Smashed but in a good way, I fell in love with it. If you are Dope sick it helps so much, well in my experience I found it to be better than anything I have ever tried to get the sickness off, well apart from a good shot of Heroin in the vein of course.

Both Pre-Gab & Gabapentin goes very well with high level CBD Weed & of course high grade Hash as it is more CBD.
Mixing either of them with Alcohol isn't a good idea, well if you enjoy pissing yourself, falling into a wall & walking like you have suffered from Polio as a child.
Yeah I can imagine that it would go very nicely with weed. Unfortunately I've not had the opportunity to try that combo yet.

With taking realtively low doses of pregabs, it it possible to drink alcohol without becoming a walking casualty, and I can be fully functional out and about at gigs and things like that. Although I'm usually just chilling at home when I do that combo.

I'm only drinking very rarely these days though, and feeling better for it. I turned the corner a while ago on an excessive and very expensive habit that started during 4 months of furlough due to the covid lockdown.
 
Training is continuous and part of your ongoing employment. It’s severally lacking in several areas (mental health, palliative, Alzheimer’s etc) but don’t forget, you are the first port of call, you assess what you can with what you’ve been taught/experienced, and make a choice based on that.
Thanks - I suspected that GP's would have a minimum annual CPD requirement, thank fuck for that eh

Can you tell me though - during the initial years of training, how long is spent spcifically on mental health (I know it's not much...)

Alos, regarding CPD, is there any actual requirement that some of this is on mental health? Or is just up to the individual to decide what gaps in knowledge etc they wish to addres via CPD?
 
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