Great video! I'm wondering about something you mentioned. You said that SSRIs act on the 5HT1A receptors to increase, but I thought their primary action was on the 5HT transporter? Thanks!
You’re correct- primary action is on the 5HT transporter! The theory from the paper is that because 5HT1A is the most common serotonin receptor in the brain, when SSRIs increase serotonin by blocking the transporter, it’s the 5HT1A receptor that most of that serotonin goes to.
This was SO helpful. Your way of explaining things makes it easy to follow and understand, while somehow making it entertaining too! Thank you so much!!
OMG this makes so much sense. SSRI cured my anxiety but stop me from making music. Then one day I tried psilocybin and feel like this thing works like SSRI but i can make better music. I think SSRI is wonderful if you have an office job, while create job you are better off with psilocybin
Great video but idk why you made it sound like ssris exclusively work on 5ht1a when they functionally work on 5ht2a as well, just not as intensely as psychedelics😊
Really great video ! In my opinion, it rehabilitates SSRIs. Moreover, this video helped me put into words a diffuse feeling about some heavy users of psychedelics (I'm thinking in particular of regular DMT users) who have always seemed to me particularly versed in bizarre stuff, even compared to other psychonauts. I'd love it if this picture could be completed with MAOIs and MDMA science !
Before jumping to a conclusion that SSRIs have been “rehabilitated”, I would suggest to look at the clinical effects of these substances: drowsiness and lethargy, emotional blunting, loss of libido, occasional agitation ('activation') and dysphoria. I don’t think it’s appropriate and beneficial to create artificial emotional blunting.
Wow! Thank you so much for helping me understand such a seemingly complicated labyrinth of knowledge. I'm so thankful for understanding serotonin (and psychedelics) with so much more precision and depth. Well done sir!!
As a psych nurse, these are very interesting. Even if most of the information isn't directly appliable at my job, I find having a very basic understanding, helps make the information that actually is important stick better.
Thank you, I’ve never heard of that article before. I like how you helped break it down for us. When it comes to those crazy amount of receptors, you may want to consider checking out Leo & Longevity’s channel. He has a playlist on Serotonin that goes more deeply into the neurotransmitter and receptors than anything anywhere else on the internet. Anyways, thanks again.
This really puts into perspective the danger of stopping SSRI treatment without tailoring down the dosage (as a patient may be inclined to do when confronted with the emotional dulling). I would imagine that in response to the artificially elevated levels of serotonin induced by the SSRIs, the 5-HT receptors (1A in particular being the most numerous) would down-regulate their expression to counteract the effect (curious if endogenous 5-HT biosynthesis would also down-regulate in response). So when someone stops taking their meds, and those inflated serotonin levels drop, they have even less capacity to passively cope than they would have had before taking the SSRI to begin with, potentially exacerbating a mental health crisis. Great vid! Going to have to go delve into that Carhart-Harris paper now!
Thanks so much for your service to spreading good information! Am very pleased I found your videos at this time in my life (switch careers to psych in 2020 and am in school to become a psych provider eventually). Appreciate the shoutout to the carhart-harris paper and will be diving into that. Looking forward to the antidepressant course as well. I wonder if you have any more repositories of good papers or reference lists that would help one dive deeper into this material and avoid at least some of the wading through super dense, hard to digest papers on pyschopharmacology?
Amazing video. Regarding the last part, Balance and Considerations, the Slate Star Codex articles "Why Were Early Psychedelicists So Weird" and "Mental Mountains" offer some fascinating insight into the potential of "becoming a crazy person" side effect of HT2A agonism.
Hey greg im a psychiatrist and both me and my patients enjoy your content. I would be very glad to enlist in the course but it seems to be closed on kickstarter. Is there any way i can still enlist? as i just now heard about it.
ahha! so that's how you look like! almost exactly as I thought! on serious note: I've been taking SSRIs for severe anxiety and they helped me tremendously BUT I wish I knew all this receptor type stuff before. I wish I had sth to stimulate the other receptors too in a legal and safe way ;p You are extremely helpful with your education! Thank you. Also, I've learned in the meantime that I'm autistic- and as much as I'm better with adopting to some stressors, many are not possible to cope with- becasue of innate way of how my brain processes stimuli. The thing is, autistic people, especially ones unaware that they are autistic, are super sensitive to how current human civilization works, and many psychiatrists/therapists likes to omit influence of the environment, even if it's adverse to the point of breaking a person :/ Just a digression, but sth to think about for psych students ;) (also, I take pregabalin as , at least my psych says it works in synergetic effect with my specific type of SSRI I take, seems to be true)
I don't like the Stoicism reference. Stoicism is a lot more active coping than passive. You are changing your outlook so that you do not feel stressed. Otherwise, nice video!
This. He should have used the term Indifference. Indifference is often confused with terms like stoicism, equanimity or composure which can be described as being at peace while deeply emotionally involved and active.
@@Benjamin20672those terms contradict each other though. You cannot have peace alongside passion. Passion invariably leads to conflict. What you reference isnt stoicism, it's actively detaching, dismissing, and disengaging from things you cannot control and upset you. That is not peace.
Appreciate the feedback! I'll look into it, and hopefully fix it for the next video. Any tips for something I can read/watch to better understand how I could go about fixing it? (I do think you're correct that I can just move further away from the mic in future recording, but now have a bunch of already recorded material I hope I can fix with just a few audio edits). Thanks!
Hey man, long time watcher first time commenter. Love your stuff. Regarding your new product, I am hoping it will be of help when I sit for my boards in the latter half of the year but even more so for general knowledge and real world practice. Not sure how PRITE compares to boards but would you say the boards goes into these kinds of details? I plan to back the kickstarter regardless, though am currently doing a rotation abroad and had a credit card SNAFU, will back you as soon as its resolved!
Appreciate the message! I'd say the board doesn't go into this level of detail on these things, which is to say you'll never be asked a specific question that a video like this covers... but I'd argue that when you have a good framework for organizing knowledge, you intuitively are able to get a lot more questions correct. On tests, I outperformed smarter people who were better studiers, because I focused more on understanding things and less on facts. The pass rate is quite high, and if you're not an incredibly anxious test taker, and put in a minimum amount of effort, statistically you will pass. I found most of "conventional" board studying to be meaningless collections of facts. I guess what I'm saying is.... you're probs going to pass... you might as well learn some things you enjoy along the way. WTF do I know though, I'm just a Farmer.
@@PsychoFarm Thanks man. I had figured as much. I've always done fairly well on PRITE and other standardized tests so I'll commit some meaningless facts to memory while looking over your stuff and call it a day.
Just a nitpick, but you show a chart suggesting that salvia is a 5htp2a agonist when it's instead a selective kappa-opioid receptor agonist. Happy to be wrong about that, but i think you meant to list only the "classic" psychedelics.
Interesting I’ll have to look into that. SWIM did salvia when he was 16 and was not mentally prepared for it and it broke his brain. I heard he’s now making psychotic RU-vid videos as if he’s a doctor or something.
Hey! Can you do a video of methylphenidate increasing ssris and is it safe ? I’m on Prozac and bifentin and I feel blah when I don’t take bifentin but feel amazing when I do. I’ve tried bifentin alone with no results. Only works with Prozac
You sound very book smart but at your age how much life experience do you have with the affects of these drugs on actual patients? From my experience with these meds and seeing first hand the affects on people I know these drugs do more damage than good. Jmo
