Scott Alexander highlights and responds to expert comments on his previous posts about Zulresso and Zuranolone, covering various aspects of these drugs and related topics. Longer summary

Scott Alexander summarizes and responds to comments on his previous posts about Zulresso and Zuranolone. The post covers various topics including drug pricing, mechanism details of GABA receptors, etymology of drug names, tolerance development, progesterone's effects, and personal experiences with progesterone. Scott expresses appreciation for the expertise of his commenters, particularly in biomedical topics, and acknowledges learning new information from them. Shorter summary

Scott Alexander proposes using high-dose oral progesterone as a potential low-cost alternative to Zulresso for treating postpartum depression, based on pharmacological research. Longer summary

Scott Alexander explores the possibility of using high-dose progesterone as a cheaper alternative to Zulresso for treating postpartum depression. He explains that Zulresso is a metabolite of progesterone and presents research suggesting that a specific regimen of oral progesterone could potentially mimic the effects of Zulresso. The post discusses the pharmacokinetics, dosing schedule, and potential cost savings, with progesterone treatment costing only about $11 compared to Zulresso's $35,000. Scott acknowledges potential obstacles in implementation but hopes researchers will investigate this approach further. Shorter summary

Scott Alexander compares three gabapentinoid drugs (gabapentin, pregabalin, and phenibut), exploring their effects, mechanisms, and the mysteries surrounding their differing efficacies despite chemical similarities. Longer summary

Scott Alexander discusses three gabapentinoid drugs: gabapentin, pregabalin, and phenibut. He compares their effects, mechanisms, and mysteries surrounding their differing efficacies. Gabapentin is described as subtle at low doses and problematic at high doses. Pregabalin is noted for its effectiveness in anxiety treatment but its high cost. Phenibut, while not FDA-approved, is praised for its strong anti-anxiety effects but warned against due to addiction potential. The post explores possible explanations for the differences between these chemically similar drugs, including dosing discrepancies, absorption rates, and receptor interactions. Scott also touches on the broader implications for drug research and the complexities of psychopharmacology. Shorter summary