A regular contributor got in touch two days ago, asking a question.
I have described all my symptoms to the AI without mentioning PSSD, and chat.openai.com is of the opinion that it’s a rebound effect that I’m experiencing.
Do you agree?
I was too busy to respond
A follow up email said:
And it says the sentences quoted below. I have not read that before. Is that common knowledge?
It is possible that the rebound effect you described is caused by changes in serotonin receptors in the brain. Sertraline is a selective serotonin reuptake inhibitor (SSRI), a medication that increases the effectiveness of serotonin, a neurotransmitter, by preventing it from being reabsorbed. When a patient suddenly stops taking sertraline, the effectiveness of serotonin decreases and there may be an increase in neuronal activity, which can lead to symptoms such as loss of libido, less ejaculate, and erectile dysfunction.
I also suffer from hypersomnia and I asked if hypersomnia is related to serotonin and it confirmed it.
It kept telling me that my symptoms may be improved, and I asked it which, and it said that libido can be boosted by Tadalafil.
This is so amazing because I use Tadalafil, and when I use it, I am horny again.
I thought it was because I planned to have sex. I wasn’t aware that Tadalafil itself improves libido. But it makes perfect sense.
I asked it why reinstating Sertraline didn’t help me.
“Changes in the brain caused by Sertraline treatment may be responsible for the lack of effect when re-initiating the medication. Sertraline works as a selective serotonin reuptake inhibitor (SSRI) and blocks the reuptake of serotonin, a neurotransmitter, into nerve cells. When a patient takes Sertraline, the concentration of serotonin in the synapse increases and this leads to changes in brain signal transmission. When a patient suddenly stops taking Sertraline, the concentration of serotonin in the synapse decreases and changes in brain signal transmission may occur. These changes may lead to a decrease in sensitivity of brain receptors to serotonin or to changes in the way neurons have adapted to the altered signal transmission. As a result, re-initiating Sertraline may not be sufficient to reverse these changes in the brain and relieve symptoms.”
My question to the AI:
How could one theoretically make the neurons more sensitive to serotonin again? i.e. practically a reset?
There are several ways that theoretically could restore the sensitivity of neurons to serotonin. One possibility could be to modulate serotonin receptors by using drugs that affect the number or functionality of these receptors. Another possibility might be to affect the neuroplastic processes in the brain responsible for adapting neurons to altered signaling.
Yet another possibility could be “taping” neurons, which means activating other neurotransmitters to step into the gap left by stopping sertraline, thus rebalancing the overactive neurons.
However, it is important to note that this is purely theoretical and there are no specific treatments yet that have been shown to be effective in reversing such rebound effects.
I misunderstood the AI. Here is what she said about resetting:
There are no known methods to date to permanently restore the sensitivity of neurons, especially in the context of SSRI drugs and their rebound effects. However, there are studies looking at how to increase the sensitivity of neurons to certain neurotransmitters through targeted stimulation or through the use of drugs such as TMS (Transcranial Magnetic Stimulation) or DBS (Deep Brain Stimulation). However, these methods are mainly used in the treatment of neurological disorders such as depression and schizophrenia and have not yet been sufficiently researched to recommend them as treatments for rebound effects of SSRIs.
Horoscope or Helpful
A lot of the responses have a horoscope feel – saying very generic things into which our expectations or hope can insert intelligence or other layers of meaning.
By the end of the email sequence I was beginning to get interested. The original response about rebounds was fair given that PSSD hadn’t been mentioned and the Bot thought it was dealing with withdrawal where the word rebound is appropriate for opioid/opiate withdrawal in particular but much less so for benzodiazepine, SSRI or antipsychotic withdrawal.
Antidepressant Withdrawal is big news in Britain today. The Bots responses are about as incisive and helpful as the new NICE Guidelines on withdrawal are.
The Bot is ChatGPT, which is where my colleagues link took me, which is also big news. When I clicked on it, I found ChatGPT is at capacity right now.
Write an acrostic poem about the status of ChatGPT.
C: ChatGPT is currently down
H: Huge demand has caused the site to crash
A: All users will have to wait
T: Time is needed for the servers to catch up
G: Go grab a coffee and check back soon
P: Patience is key in this situation
T: Trust that the team is working hard to fix it up
Its probably great viral marketing but newspapers and other outlets are full of stories about academics worried that university students will be able to use CHATGPT to write their essays.
Academics are also apparently having fun training the Bot up on things it doesn’t know much about. And teasing it – you must be fatigued now which leads to a Bot answer that it never gets fatigued.
Of course Pharma – sorry Life Science Companies – have likely been in there a while ago training the Bot to give the answers they want – like Taladafil. The answers the Bot will retain are likely to be based on some form of voting system, which LSCs can rig.
Other articles are talking about the end of Google as we turn to using the Bot to find answers for us. This has the feel of the early internet where Google and other engines looked like a force for health liberation, until the Life Science Companies figured it was only right that we had exposure to the truly liberating stuff and of course it should come at the top of any Google search.
In addition the Pandemic and its vaccines now have the Biden White House dictating what should come at the top of any Google search or Facebook feed.
In terms of seduction, when CHATGPT failed to load the BBC had a fascinating article full of beautiful imagery about fashion for older folk – the problem is the wonderful looking older folk and their great clothes are all unreal. The only thing that is real is the image and signature on the images which makes me nervous about loading them up here – you will have to go and look for yourself on AI Art I guarantee this link is safe.
There are other articles on virtual reality consoles coming our way. Something to distract us from the current spate of Excess Deaths in many Western countries?
Significant Update – Jan 19.
Two weeks ago, I wrote to the Chief Medical Officer in Scotland including the correspondence in Red Tape Alive and Well in Edinburgh. The Cover letter is below.
Dear Professor Smith
I was alerted to Realistic Medicine through an article by Victor Montori in the latest BMJ. I support Victor’s efforts to bring Care into Health and imagine you do as well.
With this in mind, let me draw your attention to the letter below to the Mr. Stewart and a response from his office, that would be worthy of Dickens. Leaving the misunderstanding of the role of MHRA to one side, there is either a deliberate failure here to engage with a difficult issue or a complete lack of awareness of the issue. Both scenarios are alarming.
The original correspondence to Mr. Stewart on behalf of a mother who is rightly worried about her son’s likely fate is available on RxISK.org on Nov 16 – The Treatment was Great, The Patient Died. A further letter besides the one below has been copied to Mr Stewart – this was posted on RxISK.org on December 22 under the heading Twas the NICE before Christmas.
I am copying this letter to Victor and to Mr. Stewart. I am all in favour of restoring Care (and Realism) to Health but I think anyone who claims to aspire to this without engaging with a ghostwritten medical literature and the lack of access to company trial data is colluding with an industrialization of health that transforms Care into unrealistic and unsustainable services.
Mr. Stewart’s response offers no basis to think that in respect of their health anyone would be better off in an independent Scotland. I have offered to liaise with him should he wish to engage with these issues and extend this offer to you.
CHATGPT or GOVTGPT?
Dr Smith’s office replied as follows: Our Reference: 202300336744
17 January 2023
Dear Professor Healy,
Thank you for your letter of 28 December 2022 to the Chief Medical Officer regarding previous correspondence with Mr Stewart, Minister for Mental Wellbeing and Social Care.
As an official in the Chief Medical Officer’s directorate, I have been asked to respond on his behalf. As Mr Stewart said in his earlier reply, the regulation, licensing and supply of medicines, is reserved to the UK Government. The Medicines and Healthcare products Regulatory Agency (MHRA) is the UK wide regulator, with overarching responsibility for the regulation, licensing and safety of medicines. In Scotland, we then have a clear and consistent route for licensed medicines to be appraised through the Scottish Medicines Consortium.
The Scottish Intercollegiate Guidelines Network (SIGN), develops and disseminates national clinical guidelines for use in Scotland which contain recommendations for effective practice based on current evidence in order to improve the quality of healthcare for patients and reduce variation in practice and outcome.
Publication of clinical trial evidence in journals considers benefits and harms of interventions and both of these are considered by SIGN Guideline Development Groups when considering their recommendations. Draft guidelines are submitted to wide-open consultation and invited for peer review before publication.
Finally, I must restate that it would be inappropriate for Scottish Ministers to intervene in medical treatment or clinical decisions made by clinicians for individual patients. Such treatment decisions are and must remain the responsibility of the clinicians in charge of an individual’s care.
The Microsoft Bot might have offered a more informative answer than the Government. The unfortunate problem is it is hard to think of anywhere in the Western World to emigrate to where the responses from Bots or Governments might be any more sensible.
The government faced with a scenario they know to right are refusing to engage. There are posts from long ago that wonder about the eventual consequences of This War on Civilization. See
For those who want to know why Ruth – read back through this series of posts.