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Areas › Low mood and hard feelings › When everything feels flat
Desvenlafaxine is venlafaxine after the liver has done its work, given directly. The point of that is fewer differences between people who process drugs quickly and slowly, and a little less trouble with interactions. Sensible reasons, modest gains. If you are offered the newer one, the honest question is which of those problems you actually have.
Talk about the blessings of your Lord (Quran 93:11). A smaller, steadier gain is still worth naming out loud rather than waving away.
الضحى
وَأَمَّا بِنِعۡمَةِ رَبِّكَ فَحَدِّثۡ
talk about the blessings of your Lord
Qur’an 93:11read it in the library
Translation: M.A.S. Abdel Haleem, The Qur'an, Oxford University Press, 2004.
A good rationale predicts a plausible effect rather than a large one. A meta analysis of the best possible self exercise, where people write about their own best possible future, found small increases in positive mood and optimism that tended to fade fairly quickly. Sound reasoning and modest results often sit together.
Carrillo A, Rubio-Aparicio M, Molinari G, Enrique Á, Sánchez-Meca J, Baños RM. (2019). Effects of the Best Possible Self intervention: A systematic review and meta-analysis.. PloS one doi
Strength of evidence: one line of research. A single study, or a theoretical account.
Taking out a step that varies between people makes a drug more predictable, not more powerful.
Raising a dose does not simply raise the benefit. It raises everything the drug does, including the parts nobody was asking for.
Never come off an antidepressant on your own. The taper belongs to the prescriber, and for some drugs it needs to be slower and longer than people expect.
No option comes without a cost. The useful question is not which medicine has side effects, it is which side effects you could live with.