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mental health mondays :: when drugs go retro

the new hotness?
one of the most common complaints about antidepressants is that they take so long to work. adjusting the taps in the bubble bath of your brain is something that takes several weeks- usually around four, but up to eight is not uncommon- during which time you might well be left feeling just as horrible as you were before, but with the added bonus of side effects: lethargy, somnolence and insomnia, nervousness, sweating, farting, nausea... what a time to be alive. in cases where the danger is acute to the patient or to others [those around the patient], doctors generally deal with this by sedating the sufferer within an inch of their life, so that they're much too calm to think about hurting anyone and so that reaching for the razor blade to slice your wrists is just way more effort than you're willing to put into anything.

our friends at science, however, appear to have found something that might address this. that's right, science has discovered a drug- something so new that they're not even willing to give it a name- that appears to fight depression in rats within twenty-four hours. my first reaction upon hearing that was that it was great news, even more so since it apparently achieves this miracle without creating a lot of side effects that are going to make you want to stop taking the drug, which is the problem with a lot of psychiatric medications to begin with. [that's not quite true. my first reaction was to feel sorry for all the depressed rats and to think about what a shitty, shitty job it must be to have to make them depressed in the first place. i'm picturing some forlorn phd student reading shopenhauer and holding the little wheel so that it will not budge, no matter how hard the rats try to run on it.]

but before we start to get all excited, i have a few questions. actually, i have a lot of questions, and none of them are getting answered because the drug is in such an early phase that the manufacturer isn't even telling us anything meaningful about it, since that would allow their competitors to develop something similar. for the moment, all they're willing to share is that, unlike "traditional" medications for depression that work by adjusting levels of serotonin in the brain, this drug works on a completely different neurotransmitter: gaba.

that sounds awesome, but what the manufacturer [and everyone who published what looks like the company's press release with minimal adjustments] doesn't mention is that there are literally dozens of drugs that manipulate gaba already on the market and that many of them are older than the serotonin reuptake inhibitors that this new drug would supposedly be replacing. barbiturates work on gaba. so do benzodiazepines. for that matter, substances that affect gaba are found in certain species of mushrooms [ibotenic acid], common plants [skullcap] and seawater [bromide]. so saying that the drug works by targeting gaba rather than serotonin says absolutely nothing about what makes it new, different, or more effective.

because gaba-modulators are so widespread in pharmacology and the world, it's difficult to generalise about them. if we look at the one category that's generally used for mental health applications- the benzos- then it's worth noting that they're both fast and effective already and while they do have some side effects, the real problem is that they're addictive and can be harsh on your liver. those are really the important things that need to be tested before this gets anywhere near your mouth and stomach.

so yes, this looks like it could be promising. but it also looks like it could be the start of an insidious marketing campaign to get people excited about the properties of a new drug that might just be a new twist on something we've had access to for a long time...

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