patience_limited's recent activity
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Comment on Any tips for stopping long term SSRIs? in ~health.mental
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Comment on Any tips for stopping long term SSRIs? in ~health.mental
patience_limited LinkDecades-long SSRI user here... I strongly suggest that you talk to your psychiatrist about tapering the Prozac dosage very, very slowly. Like no more than 10% per month decrease in dosage. You'll...Decades-long SSRI user here... I strongly suggest that you talk to your psychiatrist about tapering the Prozac dosage very, very slowly. Like no more than 10% per month decrease in dosage. You'll need a tablet cutter and a milligram scale...
I've been on cross-tapers where a new drug was ramped up over the course of a few weeks, and the old drug was decreased at the same rate... All the discontinuation symptoms (dizziness, brain fog, depression recurrence, electric shock sensations, tremors, headache, chills, muscle aches, etc.) plus the side effects of adapting to the new drug, for a couple of months.
Tapering off Zoloft without switching to a new SSRI felt like it took about 6 months to properly balance out the discontinuation effects.
YMMV, but it's also possible that the slow taper will let you arrive at a dosage that's effective for depression, but with less of the undesirable numbness. It's also possible that a different SSRI, or replacing both the Prozac and Wellbutrin with an SNRI, will have more mood brightening effect with less emotional blunting.
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Comment on I'm going on vacation in ~tildes
patience_limited LinkHope you have a wonderful time - enjoy living in a tin can, far across the world, Major Tom.Hope you have a wonderful time - enjoy living in a tin can, far across the world, Major Tom.
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Comment on What has changed as you've gotten older? in ~talk
patience_limited Link ParentThat's funny - I was commenting to my PT last week that in your 20's, you can blame aches and pains on the sport you spent hours playing during the weekend. At some point in your life as you get...That's funny - I was commenting to my PT last week that in your 20's, you can blame aches and pains on the sport you spent hours playing during the weekend. At some point in your life as you get older, all it takes is "I slept wrong."
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Comment on Tildes Survey #5: Pineapple on pizza? (Results) in ~talk
patience_limited LinkAccording to ancient (i.e. before I was born) Canadian tradition, I should enjoy the Hawaiian pizza which is my birthright. It's... fine. The pineapple is great, I just don't like ham on pizza.According to ancient (i.e. before I was born) Canadian tradition, I should enjoy the Hawaiian pizza which is my birthright. It's... fine. The pineapple is great, I just don't like ham on pizza.
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Comment on Square peg in a round hole: airpower against mobile targets and missiles in ~society
patience_limited LinkWell, thank you, for an interesting source on a topic I haven't yet rabbit-holed on, and a new book list to add to my Reading Mountain.Well, thank you, for an interesting source on a topic I haven't yet rabbit-holed on, and a new book list to add to my Reading Mountain.
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Comment on Once dismissed as weeds, native plants are now flying off the shelves in the US in ~enviro
patience_limited LinkI've let a sunny section of my front yard (on a downward slope that somewhat hides it from the street) turn into native wildflower meadow. The local conservation district holds annual sales of...I've let a sunny section of my front yard (on a downward slope that somewhat hides it from the street) turn into native wildflower meadow. The local conservation district holds annual sales of native flowering plant, shrub, and tree seedlings for reasonable prices, and I'm slowly replacing invasives. The local list [PDF warning] includes enough perennial bloom for a delightful three-season display - columbines, foxglove, irises, coreopsis, milkweeds, coneflowers, monarda, goldenrods, black-eyed Susans, asters, roses... It's not the best time for a picture, but I'm pretty happy with how it's turned out, and the bees and butterflies are singing through the "weeds". It's thriving without watering or care.
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Comment on What are you reading these days? in ~books
patience_limited Link ParentThe movie version of Cold Comfort Farm is very worthwhile as well, and it's an excellent realization of the book. The cast is amazing - Kate Beckinsale, Stephen Fry, Ian McKellen, Miriam...The movie version of Cold Comfort Farm is very worthwhile as well, and it's an excellent realization of the book. The cast is amazing - Kate Beckinsale, Stephen Fry, Ian McKellen, Miriam Margolies, Rufus Sewell...
All the comic turns and characterizations are spot-on, and the phrase "I saw something nasty in the woodshed" is hissed with all the dread you could desire.
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Comment on The US campaign to turn healthy people into Alzheimer’s patients in ~health.mental
patience_limited Link ParentTo make things even more complicated, the hottest places on Earth tend to have the highest relative food scarcity per person. Caloric restriction is known to contribute to longevity and cognitive...To make things even more complicated, the hottest places on Earth tend to have the highest relative food scarcity per person. Caloric restriction is known to contribute to longevity and cognitive health...
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Comment on The everything, everywhere, all at once corruption story in ~society
patience_limited Link ParentI'm sorry - I'm acquainted with way too many highly competent public health, science, parks, and other career public service people who've been devastated by this administration. Frankly, I've...I'm sorry - I'm acquainted with way too many highly competent public health, science, parks, and other career public service people who've been devastated by this administration.
Frankly, I've caught myself fantasizing about public floggings for the corrupt. And realizing at the same time, in good Buddhist fashion, that focusing on them is corrupting me.
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Comment on The everything, everywhere, all at once corruption story in ~society
patience_limited (edited )LinkIt's not just Trump, there's a whole coterie of corrupt sycophants, enablers, and appointees. Take, for instance, our Secretary of Transportation Sean Duffy (another former "reality" TV star) and...It's not just Trump, there's a whole coterie of corrupt sycophants, enablers, and appointees. Take, for instance, our Secretary of Transportation Sean Duffy (another former "reality" TV star) and his family tour of America. Or Scott Bessent, our erstwhile Treasury Secretary, who gutted the Corporate Transparency Act and apparently had an interest in soybean farming while negotiating soybean trade deals.
The list goes on and on - kakistocracy is not too strong a word.
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Comment on The US campaign to turn healthy people into Alzheimer’s patients in ~health.mental
patience_limited Link ParentApologies - I wasn't trying to argue with your point about the HSP hypothesis, it was more about generalizing any specific population's risk profile without looking at potential confounders....Apologies - I wasn't trying to argue with your point about the HSP hypothesis, it was more about generalizing any specific population's risk profile without looking at potential confounders. Public health research review habits...
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Comment on How I feel about LLM (AI) writing in ~tech
patience_limited Link ParentThank you - I appreciate the forbearance! With all that's being said about the increase in intemperate arguments, it's still important to me that Tildes isn't an in-your-face social media app with...Thank you - I appreciate the forbearance! With all that's being said about the increase in intemperate arguments, it's still important to me that Tildes isn't an in-your-face social media app with constant notifications badgering for responses.
There are many people here whom I'd be delighted to interact with in face-to-face conversation, you among them. But in the electronically mediated world, we have to be very conscious about when and how to respond. It's normal to maintain a level of interpersonal guardedness that can feel oppressive and exhausting, due to the lack of the physical signals that we've evolved to perceive for emotional/physical safety and conflict avoidance.
I have an imposed awareness of the limitations on my time and emotional energy, as well as my ability to contribute positively with knowledge, experience, and empathy. As /u/286437714 said, there are just too many events in the world that are worthy of incandescent rage. Our ability to gather and share valid information about them, coordinate on responses, and act meaningfully is being intentionally exhausted, eroded, and drowned out through slop, greenwashing, propaganda, ragebait, and a hundred other infowar strategies.
It's hard to pull back and stay out when I see a segment of Tildes users who are habitually promoting the latest alt-right inflected lines of online argument, but I think it's effective to deny them the attention they seem to be seeking. I know things have gone way past "don't feed the trolls", especially when they've learned to be more subtle in sealioning and demanding "evidence". I still believe noping-out is a good habit from the days of healthier forums.
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Comment on The US campaign to turn healthy people into Alzheimer’s patients in ~health.mental
patience_limited Link ParentI'm not a great example because I can't tolerate the traditional cold water plunge to bounce back into the heat. It's how I found out the hard way that I've got cold-induced urticaria... That...I'm not a great example because I can't tolerate the traditional cold water plunge to bounce back into the heat. It's how I found out the hard way that I've got cold-induced urticaria... That being said, I normally take 3 or 4 5-minute breaks in open air during the course of a 90-minute session, which seems to be about average for the others in the sauna. I have days when I can't bear to leave, and days when I didn't get my hydration right, or otherwise just don't want the warmth as much.
I do love heat and my spouse doesn't - he usually prefers temperatures about 20 °F cooler than I do, and he's constantly in and out of the 180 °F sauna. I wouldn't worry about how long you can tolerate it - just enjoy it while it's enjoyable, exit and recover while it's not, and see how your body behaves. Don't let those mean Scandis bully you!
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Comment on The US campaign to turn healthy people into Alzheimer’s patients in ~health.mental
patience_limited Link ParentFinland has relatively high rates of alcoholism and depression, which are both Alzheimer's risks. The population is somewhat genetically homogenous as well, which might have concentrated...Finland has relatively high rates of alcoholism and depression, which are both Alzheimer's risks. The population is somewhat genetically homogenous as well, which might have concentrated predisposing genetic risk factors. Finally, it's a relatively prosperous nation where many people live to the age range in which Alzheimer's can be a cause of death, and they dont die so frequently of other preventable causes.
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Comment on The US campaign to turn healthy people into Alzheimer’s patients in ~health.mental
patience_limited (edited )Link ParentIn the past year, I'd read the book Doctored: Fraud, Arrogance, and Tragedy in the Quest to Cure Alzheimer’s. It's a compilation of articles by Charles Piller, an investigative journalist for...In the past year, I'd read the book Doctored: Fraud, Arrogance, and Tragedy in the Quest to Cure Alzheimer’s. It's a compilation of articles by Charles Piller, an investigative journalist for Science magazine. There's a cumulatively damning story about gross research misconduct, outright scams, malpractice, lack of institutional controls, pharmaceutical industry greed, regulatory capture, and wilful blindness in pursuing the amyloid hypothesis to the exclusion of all other possible Alzheimer's mechanisms. There've been lives lost and damaged, billions of dollars and a couple of decades wasted. The foundational papers "proving" that beta-amyloid accumulation causes Alzheimer's are among the clear fakes.
I'm not 100% certain that amyloid buildup is harmless, but it's very likely a symptom and not a cause; removing amyloid does not produce clinically significant improvement in the course of the disease in humans.
Which just made the OP story all the more infuriating. Not just that pharma is greedily trying to expand the customer base unnecessarily, but the industry is doing it with high-risk, potentially fatal treatments that work poorly if at all.
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Comment on The US campaign to turn healthy people into Alzheimer’s patients in ~health.mental
patience_limited Link ParentSo I've gotten into Nordic saunas, too - it's an easy way to get some of the benefits of cardiovascular exercise without the joint pounding, raises body temperature enough to reduce infectious...So I've gotten into Nordic saunas, too - it's an easy way to get some of the benefits of cardiovascular exercise without the joint pounding, raises body temperature enough to reduce infectious disease risk, and you've just provided evidence of yet another benefit. Plus a sauna just feels ecstatically good when it's January, -20 °C outside, and the sun has been invisible for months.
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Comment on How I feel about LLM (AI) writing in ~tech
patience_limited Link ParentExtra hug from someone else who often has to "nope" out of the discourse.Extra hug from someone else who often has to "nope" out of the discourse.
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Comment on The US campaign to turn healthy people into Alzheimer’s patients in ~health.mental
patience_limited LinkThis story makes a compelling case that pharma profits by overdiagnosis, with a current 600,000 early Alzheimer's patients receiving anti-amyloid drugs set to become 47 million "pre-clinical"...This story makes a compelling case that pharma profits by overdiagnosis, with a current 600,000 early Alzheimer's patients receiving anti-amyloid drugs set to become 47 million "pre-clinical" healthy people who receive dangerous treatments because they test positive for amyloid buildup that is less than 20% likely to cause clinical symptoms.
This article is U.S.-centric, and American systemic incentives for care of elderly people through Medicare are closely aligned with drugmakers' priorities. However, it's my impression that other countries with national health systems are vulnerable to the same manipulative marketing for "preventative" Alzheimer's testing and treatment.
The "amyloid hypothesis" for Alzheimer's and related dementias has been called into question due to research misconduct, narrowly based research, and drug company biases. As the article illustrates, the risk/benefit ratio for the eye-wateringly expensive amyloid-busting drugs is very questionable.
There's growing evidence that herpesviruses, autoimmunity, and nutritional deficiency contribute to the development of symptomatic Alzheimer's dementia.
Disclosure: I have a personal stake in Alzheimer's research and prevention. I have rheumatoid arthritis, which used to carry a 40% increased risk of early dementia. I'm on a TNF-alpha inhibitor, and current research says this means I now have a 20% reduced risk of Alzheimer's compared to the general population. I've gotten my shingles vaccination. I've also started taking 1 mg lithium orotate daily, in part because I'm in a region with naturally low lithium content in water and soils. So yes, I'm biased against the single-cause amyloid hypothesis.
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The US campaign to turn healthy people into Alzheimer’s patients
27 votes
The point is to titrate the dosage slowly enough to avoid discontinuation symptoms and at the same time get a feel for whether it's still effective at the new dose with less of the bothersome side effects. If you've been on an SSRI for a long time, it's been remodeling your neurotransmitter receptor abundance, and that doesn't stabilize quickly. If it takes 6 - 8 weeks for an SSRI to reach full effect, it seems reasonable to take half that amount of time to adjust to a new dose. I'm not saying you couldn't try bigger steps, but I found that decreasing by 25% a month was too much.
Edit: I'm on a very small dose of vortioxetine (5 mg) these days, but I definitely notice it within 12 hours if I accidentally miss a pill. People's experiences with these medications are ridiculously variable; my experience was bad enough that my recommendation bends heavily in the direction of caution. It sounds like you're not doing too badly so far, but I got the worst of the discontinuation syndrome starting at about 10 days to two weeks. You could always resume a lower dose if it's too bothersome, and see how that fits.
Second edit: I knew I'd come across recent research that suggested a "hyperbolic" strategy for tapering antidepressants, which may require months to years. Good summary here.