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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 17 of 17. This is the beginning of the thread.
Posted by linkadge on December 15, 2018, at 18:07:44
I read many articles on how specific antidepressants (i.e. scopolamine, ketamine, SSRIs) work better in women.
I wonder if any antidepressants (i.e. specific ones) work better in men?
Linkadge
Posted by SLS on December 15, 2018, at 20:14:13
In reply to Do any antidepressants work better in men?, posted by linkadge on December 15, 2018, at 18:07:44
> I read many articles on how specific antidepressants (i.e. scopolamine, ketamine, SSRIs) work better in women.
>
> I wonder if any antidepressants (i.e. specific ones) work better in men?
>
> LinkadgeTricyclic antidepressants are more effective in males.
- Scott
Posted by SLS on December 15, 2018, at 20:17:20
In reply to Re: Do any antidepressants work better in men?, posted by SLS on December 15, 2018, at 20:14:13
> > I read many articles on how specific antidepressants (i.e. scopolamine, ketamine, SSRIs) work better in women.
> >
> > I wonder if any antidepressants (i.e. specific ones) work better in men?
> >
> > Linkadge> Tricyclic antidepressants are more effective in males.
Interesting article:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5286730/
- Scott
Posted by rjlockhart37 on December 16, 2018, at 0:36:00
In reply to Re: Do any antidepressants work better in men?, posted by SLS on December 15, 2018, at 20:17:20
yeah i've wanted to start desipramine, i've been fluoxetine for years and yes it was a major help for the mood, it made me social and in better spirits, but still when i think of prozac i think of it's a chick med, not for guys
Posted by linkadge on December 16, 2018, at 13:43:01
In reply to Re: Do any antidepressants work better in men?, posted by rjlockhart37 on December 16, 2018, at 0:36:00
Most antidepressants feel 'feminizing' to me.
Linkadge
Posted by rjlockhart37 on December 16, 2018, at 20:05:14
In reply to Re: Do any antidepressants work better in men?, posted by rjlockhart37 on December 16, 2018, at 0:36:00
i'm not exactly sure where i read that, but this site study said TCAs are effective in men, SSRIs are better for female just like you said....ill have to google the keywords to find exactly were i found it
desipramine i've wanted to try or add, that or roboxetine
Posted by bleauberry on December 17, 2018, at 14:24:15
In reply to Do any antidepressants work better in men?, posted by linkadge on December 15, 2018, at 18:07:44
I have zero evidence to support my opinion, but I have not seen in my journeys any indication that antidepressants work different with men or women. Since the meds do interact with a change dozens of genes and genetic commands, I can see how a particular med might favor the male or female genetic make-up. But not as a general blanket style statement. Maybe one by one, minor differences if any.
What really needs to be acknowledged is that they need to work better for both male and female because a lot of patients are not doing well with them regardless of their gender.
Posted by linkadge on December 18, 2018, at 15:20:20
In reply to Re: Do any antidepressants work better in men?, posted by bleauberry on December 17, 2018, at 14:24:15
You're right that nothing is conclusive, but the notion that a medication could work better in one gender vs. another is not unreasonable.
I guess the reason I am mentioning it, is because I do read a number of studies where there is a higher response to certain antidepressants in women (for example, ketamine, scopolamine, certain SSRIs and MAOIs) than women, yet fewer studies showing the reverse.
Linkadge
Posted by SLS on December 19, 2018, at 10:10:11
In reply to Re: Do any antidepressants work better in men?, posted by linkadge on December 18, 2018, at 15:20:20
Estrogen and testosterone affect the development of the brain differently. The male brain and the female brain are indeed different.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4335177/
- Scott
Posted by Martinchen978 on December 19, 2018, at 13:41:33
In reply to Re: Do any antidepressants work better in men?, posted by SLS on December 19, 2018, at 10:10:11
Perhaps they work better in men because men wait longer until diagnosis and are more depressed than women when diagnosed... (the longer you wait, the more depressed you are!). And we all know that TCAs work better in more depressed patients!
Posted by Martinchen978 on December 19, 2018, at 13:42:40
In reply to Re: Do any antidepressants work better in men?, posted by Martinchen978 on December 19, 2018, at 13:41:33
> Perhaps they work better in men because men wait longer until diagnosis and are more depressed than women when diagnosed... (the longer you wait, the more depressed you are!). And we all know that TCAs work better in more depressed patients!
All because of manly pride ;-)
Posted by Martinchen978 on December 19, 2018, at 13:44:25
In reply to Re: Do any antidepressants work better in men?, posted by Martinchen978 on December 19, 2018, at 13:42:40
> > Perhaps they work better in men because men wait longer until diagnosis and are more depressed than women when diagnosed... (the longer you wait, the more depressed you are!). And we all know that TCAs work better in more depressed patients!
>
>
> All because of manly pride ;-)"C*m hoc ergo propter hoc"... or "Correlation does not imply causation"...
Posted by linkadge on December 19, 2018, at 16:10:58
In reply to Re: Do any antidepressants work better in men?, posted by SLS on December 19, 2018, at 10:10:11
Yes. I agree. The male an female brain are indeed different (on average, of course). Therefore (gender identity issues asside) I am interested in acutal reseach that may help me get better.
Linkadge
Posted by linkadge on December 19, 2018, at 16:14:38
In reply to Re: Do any antidepressants work better in men?, posted by Martinchen978 on December 19, 2018, at 13:44:25
>Perhaps they work better in men because men wait longer until diagnosis and are more depressed than women when diagnosed.
Possibly, but usually groups are randomized to control for depression severity (i.e. both groups contain, on average, patients with the same average depression severity.
I agree with SLS though, that there is ample evidence that there are real differences in biology. Both male and female sex hormones are neuroactive and impact brain development in different ways. Taking testosterone vs. estrogen have distinct behavioral effects.
Linkadge
Posted by Martinchen978 on December 19, 2018, at 16:16:48
In reply to Re: Do any antidepressants work better in men?, posted by linkadge on December 19, 2018, at 16:10:58
> Yes. I agree. The male an female brain are indeed different (on average, of course). Therefore (gender identity issues asside) I am interested in acutal reseach that may help me get better.
>
> Linkadge
>
>
>
>Yes, but those "gender identity issues" may obscure any studies / results, unless you have a really high quality study that accounts for those social differences...
Posted by Martinchen978 on December 19, 2018, at 16:34:47
In reply to Re: Do any antidepressants work better in men? » Martinchen978, posted by linkadge on December 19, 2018, at 16:14:38
> >Perhaps they work better in men because men wait longer until diagnosis and are more depressed than women when diagnosed.
>
> Possibly, but usually groups are randomized to control for depression severity (i.e. both groups contain, on average, patients with the same average depression severity.
>
> I agree with SLS though, that there is ample evidence that there are real differences in biology. Both male and female sex hormones are neuroactive and impact brain development in different ways. Taking testosterone vs. estrogen have distinct behavioral effects.
>
> Linkadge
>
>
>
>Yes, but on the other hand: men tend to downplay / trivialize their symptoms, although they may have really severe depression. Male pride again! Women are more health-conscious and tend to visit their doctors earlier and with milder symptoms ==> randomized control might be poor / faulty.
If a man visits a doctor and says: "I think I have depression, can't sleep, lots of ruminating, no appetite, no motivation..." and a women does the same: DO THEY HAVE THE SAME SEVERITY OF SYMPTOMS?" ;-)
That's why men die by suicide explicitly more often than women:
https://afsp.org/about-suicide/suicide-statistics/
https://en.wikipedia.org/wiki/Gender_differences_in_suicideI also agree that there are real differences in biology and that different antidepressants have distinct behavioral effects on different genders, but it will be quite difficult to find really good studies... ;)
Posted by linkadge on December 20, 2018, at 16:29:38
In reply to Re: Do any antidepressants work better in men?, posted by Martinchen978 on December 19, 2018, at 16:16:48
>Yes, but those "gender identity issues" may >obscure any studies / results, unless you have a >really high quality study that accounts for those >social differences...
Meh, I beg to disagree. There are enough men who identify as men (the majority of men who identify as men) that I don't think transgender individuals would severely skew a possible biological gender based marker, should one exist.
I have zero issue with those who identify as such, I just think that the incidence is low enough that one could still detect gender based differences, should they exist.
For example, there are gender based differences in physical strength, even without controlling for gender identity.
Linkadge
This is the end of the thread.
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