Scott Alexander explains how the vastly higher doses taken by recreational drug users compared to psychiatric patients lead to misconceptions about drug safety in clinical settings. Longer summary

Scott Alexander discusses how recreational drug users consume substantially higher doses of drugs compared to psychiatric patients, which leads to misconceptions about drug safety in clinical settings. He provides examples of ketamine and amphetamines to illustrate this point. For ketamine, psychiatric doses are around 280 mg/month, while recreational users consume about 90,000 mg/month. Similarly, for amphetamines, Adderall patients typically take 20 mg daily, whereas methamphetamine addicts use the equivalent of 1000 mg oral amphetamine daily. Scott argues that many concerns about drug side effects in clinical settings are based on studies of recreational users, and that these concerns may not apply to patients taking much lower doses under medical supervision. Shorter summary

Scott Alexander presents results from an SSC Survey on SSRI usage, covering effectiveness, side effects, and discontinuation experiences among 2,090 users. Longer summary

Scott Alexander presents the results of an SSC Survey on SSRI usage, covering their effectiveness, side effects, and discontinuation experiences. The survey included 2,090 SSRI users and explored various aspects of SSRI use. Key findings include: most users found SSRIs helpful, with Lexapro rated highest and Paxil lowest; SSRIs seemed more effective for anxiety than depression; 70% of users experienced side effects, with sexual difficulties being most common; 15% reported persistent side effects after discontinuation; and discontinuation difficulty varied among different SSRIs, with Prozac being easiest to discontinue. The survey largely confirmed existing psychiatric consensus, with the high rate of persistent side effects being the main surprise. Shorter summary

Scott analyzes various criticisms of antidepressants, concluding they have modest but real benefits over placebo, with important considerations about side effects and efficacy. Longer summary

This post examines various criticisms of SSRIs and antidepressants, addressing claims about their efficacy, side effects, and comparisons to placebo and psychotherapy. Scott analyzes studies on antidepressant effectiveness, discussing issues like publication bias, effect sizes, and the meaning of 'clinical significance'. He explores side effects, particularly sexual dysfunction, weight gain, and emotional blunting. The post concludes that while antidepressants are not miracle drugs, they do have a modest but statistically significant benefit over placebo and can be a reasonable option for many people with depression, especially if they understand and prepare for potential side effects. Shorter summary

Scott Alexander presents a satirical list of fictional drugs banned by the FDA, each with an absurd reason for its prohibition. Longer summary

This post is a humorous fictional list of drugs banned by the FDA. Each drug is presented with a profile describing its intended use, followed by an absurd or ironic reason for its ban. The drugs cover a range of conditions from weight loss to erectile dysfunction, with each ban highlighting unexpected consequences or bizarre side effects. The post uses scientific terminology and real medical concepts to create a sense of plausibility, before subverting expectations with the ridiculous reasons for the bans. Shorter summary