I have seen and treated a large number of people with SSRIs, and the majority are incredibly thankful. I spoke to a patient yesterday who told me his Sertraline saved his life following a suicide attempt a few months ago. I saw a patient last year who fantasized constantly about murdering his colleagues at work. Fluoxetine cured him completely and he was incredibly grateful to not be tortured by those thoughts anymore. Some have had sexual side effects, but in my experience switching SSRIs often cures these. They aren't perfect drugs, but on balance they help a lot of people.

I do not think engaging with the above sort of network is a good idea, I suspect a large amount of these people suffer from psycho-social causes of libido/orgasm loss and being part of an echo chamber telling you that change is permanent will only reinforce that idea if indeed it is a psychosocial change.

I practice in the UK so things may be different here. I've never heard of a patient with persisting sexual symptoms following an SSRI switch. Certainly hear about a lot more psychosomatic conditions in the US than we seem to see here. I think a lot of this is downstream from the US fee-paying healthcare model where the implication is that doctors want to make money.

As a side note, and I find myself saying this a lot on HN, but most of you are not doctors. There are a huge amount of unknown unknowns in medical practice that the layperson is unaware of. I wouldn't even think about commenting on any technical subject with the amount of confidence most commenters here give with single-digit sample sizes, or using self-reinforcing internet forums as evidence. Frankly what we say in the consultation room and what patients walk away with is often different. All doctors know SSRI's have side effects and in my experience all counsel on these. There's probably something for us to improve there with communication, but after you explain side effects and give a leaflet explaining those again, and the patient still claims you didn't tell them about a side effect, I feel like there's not much more we can do.

Also, NewScientist is a poorly written pop-sci publication. It has constant inaccuracies and misinterpretations of the evidence. I cancelled my sub years ago when they were bought by the Daily Mail.

There is some utter pseudoscience in this thread and some completely misunderstandings of how medical practice works. The body is infinitely complex on a biochemical level and we have a very limited understanding of the interplay between all systems. Just because the serotonin theory has been disproven by one systematic review does not mean SSRIs are a bad treatment or do not work, it just means we do not fully understand their mechanism of action. These are not the same thing.

I suspect some SWE's or similar in this thread are used to having the complete understanding of a system and the levers involved, this is simply not the case for the human body.

Comments URL: https://news.ycombinator.com/item?id=49027892

Points: 369

# Comments: 229

Alcohol use acutely reduces the levels of these enzymes which convert paracetamol into it's toxic byproduct as ethanol preferentially binds to the same enzyme for it's own metabolism. Therefore, acute alcohol consumption can reduce the harmful effects of paracetamol.

The reverse is true for overdose in the context of chronic alcohol use, when the liver adapts to long-term alcohol exposure by increasing the levels of enzymes, therefore rapidly metabolising paracetamol into it's toxic byproduct and worsening harm.

Source: doctor

As a side comment, the lack of medical knowledge displayed in HN threads paired with the absolute confidence some verdicts are delivered with is worrying, and something I thought this forum would be better at than other sites (looking at you, reddit). Paracetamol and NSAIDs (including ibuprofens) are safe drugs if taken to the package directions. Some of the ideas shared in this thread about taking one over the other, or not taking one ever etc, are not rational. Please consult your doctor if you are worried about your particular situation, but generally OTC medicines are not dangerous if taken to the package instructions.

Accidental overdoses of paracetamol are exceeding rare, but intentional ones are common.

Daniel Berntsson is still involved with Mullvad and part-owns Mullvad's parent company with his co-founder.

The National certainly is.

DOI: Scotsman not in favour of independence.

1: https://en.wikipedia.org/wiki/The_Herald_(Glasgow)#Political...

I will also say I know the team who wrote the guidelines for use of these therapies. I believe they were mostly finished before the infected blood scandal became a big story. Politics didn't come into it.

[1]: https://www.bbc.co.uk/news/articles/c4nnn51rdrzo

I sincerely hope this doesn't happen - as I say this as a monthly donor.

Comments URL: https://news.ycombinator.com/item?id=43303903

Points: 2

# Comments: 1

I don't have the ins and outs of your case. I'm a student, not an obsterician, or neonatologist. That said, I do know delivering a 25 weeker is insanely risky even if perfect care is provided, for both his immediate outcomes and avoiding long-term disability. (80% of babies born before 26w have some form of disability e.g low IQ, blindness, etc [1]).

No sane obstetrician is going to deliver based on a family opinion like that - it is a true last resort. If you were wrong, or less lucky, as horrible as it is to say, your son would not be with us and the surgeon would be out of a job with the "what if" on their conscious (which trust me, all obstericians have anyway).

When your son needed to be delivered, it sounded like he was delivered. Frankly no neonatal respiratory distress at 22 weeks sounds insanely lucky to me; normally before 35 weeks it's a concern.

I can't say if this was a failure of the medical professionals in charge of your care or not, but from the information you've given us it doesn't sound like it. Tens, maybe hundreds of patients will have presented identically to your partner with a far less severe diagnosis. Getting their babies out early could have left them permanently disabled or dead, on the offchance it was percreta/accreta/increta: especially in the absence of definitive imaging, which they did attempt to perform. Medicine is not perfect by a long shot. Managing uncertainty is one of the many skills of senior doctors.

Medicine isn't as simple as a lot of people in this thread think it to be.

DOI: Medical Student

[1]: https://www.tommys.org/pregnancy-information/premature-birth...

There is no shortage of doctors. There is a shortage of consultants/GPs.