Scott explores GABA-A receptor subunits, their effects, and how various drugs interact with them, discussing potential for more selective drug development. Longer summary

This post explores GABA-A receptor subunits and their role in psychiatric drugs and supplements. It explains the structure of GABA-A receptors, focusing on the alpha subunits and their associated effects. The post discusses how different drugs like benzodiazepines and zolpidem (Ambien) interact with these subunits, and mentions attempts to create more selective drugs. It also touches on the role of GABA receptors in alcohol's effects and the classification of Z-drugs. The author includes personal experiences with supplements claiming to have selective GABA modulation. Shorter summary

Scott Alexander examines Zulresso and Zuranolone, two neurosteroid drugs for postpartum depression, discussing their efficacy, challenges, and potential future applications. Longer summary

Scott Alexander discusses Zulresso (allopregnanolone) and Zuranolone, two related drugs for treating postpartum depression. He explains their mechanisms, efficacy, and the challenges in their development and usage. The post covers the history of allopregnanolone research, its connection to GABA and hormones, clinical trials, and potential future applications. Scott also discusses the high cost of Zulresso, its limited availability, and the mixed results of Zuranolone in treating regular depression and anxiety. The post ends with predictions about the future of these drugs and related research. Shorter summary

Scott Alexander examines the development and effectiveness of vilazodone and vortioxetine, two antidepressants designed to work faster and better than SSRIs, but which ultimately failed to live up to expectations. Longer summary

Scott Alexander discusses the development and effectiveness of two antidepressants, vilazodone and vortioxetine, which were designed to combine SSRI effects with 5-HT1A partial agonism. He explains the theoretical basis for their development, involving the role of presynaptic 5-HT1A autoreceptors in delaying SSRI effectiveness. The post then evaluates the clinical performance of these drugs, finding that despite their innovative design, they don't significantly outperform older antidepressants in efficacy, onset speed, or side effect profile. Scott expresses confusion about the theoretical underpinnings of these drugs and why pharmaceutical companies invested so heavily in their development. Shorter summary

Scott Alexander humorously describes his observations at the American Psychiatric Association meeting, highlighting pharmaceutical influence, social justice focus, and historical context of psychiatry. Longer summary

Scott Alexander attends the American Psychiatric Association meeting and shares his observations in a humorous photo-essay. He notes the overwhelming presence of pharmaceutical advertising, the conference's focus on social justice issues, the presence of Scientology protesters and CIA recruiters, and the abundance of new but seemingly unnecessary psychiatric drugs. He reflects on the historical context of psychiatry, including its past political biases and progress over time, while critiquing the current state of the field and its relationship with drug companies and social trends. Shorter summary

Scott explores the theory that clozapine's unique effectiveness in treating schizophrenia may be due to its combined action on dopamine and glutamate systems, potentially opening avenues for safer treatments. Longer summary

This post explores why clozapine is considered uniquely effective among antipsychotic drugs for treating schizophrenia. Scott discusses recent research suggesting clozapine's superiority may be due to its action on the glutamate system, specifically as an NMDA receptor agonist, in addition to its dopamine-blocking effects. He explains that adding NMDA modulators to other antipsychotics improves their efficacy, but not when added to clozapine, possibly because clozapine already has this effect. The post speculates that if this theory is correct, it could lead to safer treatments combining standard antipsychotics with NMDA agonists, avoiding clozapine's serious side effects. However, Scott notes that more research is needed to confirm this hypothesis and overcome regulatory hurdles. Shorter summary

Scott Alexander explores why recreational drugs like ketamine and MDMA have shown more promise in treating mental health conditions than intentionally developed pharmaceuticals, suggesting a new direction for drug research. Longer summary

Scott Alexander discusses the surprising effectiveness of ketamine and MDMA in treating depression and PTSD respectively, noting that these recreational drugs have shown more promise than intentionally developed pharmaceuticals. He speculates on why this might be, suggesting that drugs with strong effects on the brain, even if originally used recreationally, might be more likely to have significant therapeutic benefits. Scott proposes that pharmaceutical research might be more productive if it focused on chemicals with powerful psychoactive effects, rather than prioritizing minimal side effects. He acknowledges potential counterarguments, including the possibility that ketamine's antidepressant effects may come from a non-psychoactive metabolite. Shorter summary

Scott Alexander compares the disconnect between American and Russian psychopharmacology to having different chemical elements, exploring why effective Russian psychiatric drugs are unknown in America. Longer summary

Scott Alexander discusses the stark contrast between American and Russian psychopharmacology, using an analogy of different chemical elements to illustrate the disconnect. He points out that many effective Russian psychiatric drugs are virtually unknown in America, despite having good evidential support. The post explores reasons for this divide, including FDA approval processes and legal concerns, and highlights the resulting limitations in treatment options for conditions like anxiety. Scott suggests that while the system's incentives lead to this seemingly irrational situation, a gray market for these drugs has emerged online. 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

Scott presents a humorous list of fictional drugs banned by the FDA, each with unexpected and often ironic consequences. Longer summary

This post is a satirical list of fictional drugs banned by the FDA, each with a unique profile and an often ironic or paradoxical reason for its ban. The drugs range from treatments for pre-traumatic stress disorder to antibiotics for intelligent bacteria. Each drug description includes its intended use and the unexpected consequences that led to its ban. The post uses humor and creativity to explore themes of unintended consequences in medicine, the complexities of drug development, and the sometimes absurd nature of bureaucratic decision-making. Shorter summary

Scott Alexander examines the life cycle of medical ideas, discussing how promising treatments often get stuck in a 'grey area' between proven and alternative medicine. Longer summary

Scott Alexander discusses the life cycle of medical ideas, focusing on three examples from about five years ago: Zamboni's multiple sclerosis theory, Gat and Goren's prostatic hyperplasia theory, and minocycline for schizophrenia. He explores how the medical community responds to new ideas, the challenges of getting promising treatments approved and widely used, and the role of drug companies in this process. Scott notes a 'grey area' between proven medicine and alternative medicine, where promising ideas often languish, and reflects on the potential for new organizations to speed up the evaluation and adoption of these ideas. Shorter summary

Scott Alexander presents a roundup of recent scientific and medical studies, covering topics from hallucinations to obesity genetics to schizophrenia treatment. Longer summary

This post is a collection of various scientific and medical studies and news. It covers a range of topics including hallucinations, diet and longevity, gene-environment interactions in psychiatry, life-extending drugs, fibromyalgia, chemical education, drug company tactics, sleep theories, psychotherapy effectiveness, obesity genetics, and schizophrenia treatment. Scott provides brief summaries and commentary on each item, often with a mix of scientific insight and humor. Shorter summary

A short story about a genie granting a wish for the cure to cancer, with a twist highlighting the practical challenges of drug development and approval. Longer summary

This post is a short fictional story about a genie and a wish. The narrator frees a genie from a lamp and is granted one question. They ask for the cure for cancer, and the genie provides a specific answer: a compound called oxymercuriphine from the venom of the two-toed toad of Toronto. The twist comes when the genie, while technically fulfilling the wish, points out the practical difficulties of bringing such a cure to market due to the expensive and time-consuming FDA approval process. Shorter summary