[HN Gopher] Lavender's Game: Silexan for Anxiety
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       Lavender's Game: Silexan for Anxiety
        
       Author : andsoitis
       Score  : 109 points
       Date   : 2022-05-20 14:37 UTC (8 hours ago)
        
 (HTM) web link (astralcodexten.substack.com)
 (TXT) w3m dump (astralcodexten.substack.com)
        
       | UncleOxidant wrote:
       | A naturopath prescribed lavender oil for my anxiety early on in
       | the pandemic. I think it might have helped a little, but it
       | wasn't a game changer. But she only had me taking 1 80mg pill per
       | day. I'm going to get some of the recommended brand and try
       | 160mg/day as suggested in the article.
        
         | tga wrote:
         | Edit: not directly relevant to Silexan, but I'm not surprised
         | that the lavender oil didn't work, especially if it came from a
         | naturopath.
         | 
         | The Massachusetts Medical Society states, "Naturopathic
         | practices are unchanged by research and remain a large
         | assortment of erroneous and potentially dangerous claims mixed
         | with a sprinkling of non-controversial dietary and lifestyle
         | advice."
         | 
         | https://en.wikipedia.org/wiki/Naturopathy#Evidence_basis
        
           | hash872 wrote:
           | Seems like a non-sequitur in response to his specific
           | statement- OP isn't endorsing naturopathy (nor am I), the
           | discussion is about the specific efficacy of silexan. The
           | linked article is a meta-analysis of silexan by a board-
           | certified psychiatrist. No one here is pro-naturopathy.
           | 
           | If silexan isn't effective, surely you can prove that
           | empirically and without resort to an argument from authority.
           | If a naturopath says drinking water is good for you too, that
           | doesn't mean that specific claim is wrong because naturopathy
           | is pseudoscience (which it is). We're evaluating silexan
           | here.
           | 
           | Larger discussion is that a lot of modern medicine is not
           | based on well-replicated studies, either
        
             | vorpalhex wrote:
             | Lavender oil != Silexan
        
           | UncleOxidant wrote:
           | Sure, I get that. I'm pretty skeptical of a lot of stuff that
           | goes on in naturopathy, but the best doc I've ever had was a
           | naturopath (not the doc I mentioned above, unfortunately, I'm
           | still looking for a replacement for that best doc) - why do I
           | say he was the best?
           | 
           | 1) he wasn't into the woo-woo stuff - he'd present papers on
           | efficacy. So if I were talking to him about a specific issue
           | he'd quickly look things up on his laptop "I was just reading
           | a paper on this the other day, here let's take a look..."
           | 
           | 2) he'd actually take time to listen - appointments were at
           | least 45 minutes. Sometimes 1 hour. All the MD's I've been to
           | since seem to be in a huge rush - you're lucky to be in there
           | for 10 minutes (not the fault of the MDs, likely, more the
           | fault of our healthcare system)
           | 
           | 3) he taught complementary medicine to MD students at a local
           | Medical School so he wasn't anti-MD as some NDs are. He was
           | well aware of the limits of naturopathy and didn't hesitate
           | to send me to a specialist when needed.
           | 
           | 4) Very comprehensive blood tests. I haven't had an MD who
           | tested for so much. And just because some parameter was in
           | the normal range he didn't necessarily consider that
           | everything was ok. He'd say stuff like "this is considered
           | the normal range [for this parameter] but it's right on the
           | edge of normal, we need to look into this further... (or we
           | need to keep a watch on this)"
           | 
           | 5) he thought like an engineer - most doctors aren't great at
           | troubleshooting, in my experience. This guy was a good
           | troubleshooter. He got me through some digestive issues that
           | I'd been dealing with for a long time because nobody else
           | seemed to dig into it like he did.
           | 
           | Unfortunately he retired a few years back - because of his
           | reputation he was in huge demand and I think he just kind of
           | burned out. In the years since I haven't found a replacement
           | doctor that I've been happy with (either MD or ND).
        
             | ibeckermayer wrote:
             | Man, that's too bad, you had a diamond in the rough. Hoping
             | to find a practitioner like that myself.
        
           | zamalek wrote:
           | Anecdata: based on a blood lab I was horribly GABA deficient,
           | which explained my weekly (out of the blue) panic attacks.
           | She put me on a hero dose of 1000mg daily and the panic
           | attacks immediately stopped. After a year I stopped
           | supplementing and haven't had panic attacks since. I'd
           | probably still be on Xanax if I had gone to a doctor first
           | (to be clear, I would have had the naturopath not worked
           | out).
           | 
           | A friend of mine had issues with irregular menstruation:
           | months with nothing, and doctors weren't able to help. The
           | same naturopath identified a deficiency by ways of a blood
           | lab, and those problems have also been solved.
           | 
           | Naturopaths are a worthwhile starting point, the one I
           | visited could even prescribe if all else failed, but I'd walk
           | out if one didn't start with a blood lab/science.
        
             | voldacar wrote:
             | I don't think GABA in the bloodstream crosses the blood-
             | brain barrier
        
             | UncleOxidant wrote:
             | > She put me on a hero dose of 1000mg daily
             | 
             | Of GABA? What form? I've heard that it's not well absorbed
             | or gets destroyed in digestion, but then others say it's
             | best absorbed orally by sucking on a lozenge.
        
       | AceJohnny2 wrote:
       | Starting with references to a _Daily Mail_ interview and a
       | podcast (even if from a purportedly reputable source) doesn 't
       | exactly fill me with confidence.
       | 
       | The Daily Mail is gutter-level tabloid trash. If anything, it's a
       | pretty strong _anti_ -reference.
        
       | colechristensen wrote:
       | Be cautious, lavender has compounds that interfere with hormones.
       | 
       | https://www.sciencedaily.com/releases/2018/03/180318144856.h...
        
         | UncleOxidant wrote:
         | It would be surprising if it was effective and had absolutely 0
         | side effects.
        
         | [deleted]
        
         | 01100011 wrote:
         | I believe mint and licorice root have similar issues.
        
       | MacsHeadroom wrote:
       | About a decade ago I acquired some lavender extract which looked
       | something like cannabis extract. I can confirm that it was
       | sedating and obviously anxiolytic, both vaporized and dissolved
       | in hot water.
       | 
       | Vaporized the effect is instant and lasts only perhaps 20
       | minutes.
       | 
       | Notably, it was not euphoric like some benzodiazepines can be. So
       | I would say recreational/"abuse" potential was virtually non-
       | existent for me personally.
       | 
       | Qualitatively I would describe the experience as a mental and
       | physical shift towards moderate relaxation, not unlike the
       | feeling after a brief shoulder rub.
        
       | amelius wrote:
       | I tried the exact same product as mentioned in the article, and
       | used it for several months. But for me it only worked as a way to
       | reduce depression. For anxiety it did little to nothing. Your
       | mileage may vary, of course.
        
         | tmountain wrote:
         | Isn't reducing depression a pretty impactful outcome? Given the
         | prevalence, it seems like that's a big deal.
        
           | amelius wrote:
           | Yes, but for me certain foods already helped to reduce
           | depression. The effect could be highly specific to me.
        
             | mise_en_place wrote:
             | That is interesting. Out of curiosity did those foods have
             | a lot of PUFAs? More MUFAs? Saturated fats?
        
       | prophesi wrote:
       | The Amazon referral link is suspicious, but I don't know anything
       | about the author and they may very well be an unbiased critic
       | simply trying to make some additional income from their blog.
        
         | jdpigeon wrote:
         | This is Scott Alexander, previously from Slate Star Codex. He's
         | highly respected as a blogger about psychiatry
        
           | rrose wrote:
           | im not going to tell you you're wrong for respecting him, but
           | i feel this comment is only telling half the story. He's very
           | well respected in the "rationalist" community, but he and
           | that community are pretty controversial and definitely not
           | universally respected
        
             | civilian wrote:
             | If anyone is curious about the controversy, here's the
             | NYTimes piece on Scott Alexander:
             | https://www.nytimes.com/2021/02/13/technology/slate-star-
             | cod... It's a decent article, and the few attempts at
             | pearl-clutching fall pretty flat.
             | 
             | My only gripe with rationalists is that they suck at
             | running their own conference, CFAR. (:
        
               | 0x_rs wrote:
               | If somebody's interested, I would strongly suggest
               | checking out both sides of the dispute and not only that,
               | as the NYT story caused quite some ruckus at the time.
               | 
               | https://slatestarcodex.com/2020/06/22/nyt-is-threatening-
               | my-...
               | 
               | https://astralcodexten.substack.com/p/statement-on-new-
               | york-...
        
             | lalaithion wrote:
             | Would you write the same comment about a Catholic
             | psychiatrist who wrote a blog about both Catholicism and
             | psychiatry?
             | 
             | Catholicism is definitely pretty controversial and
             | definitely not universally respected, but I think most
             | people would have pretty strong pushback against a
             | commenter who felt the need to bring up an author's
             | Catholicism regarding a blog post that had little to do
             | with catholicism.
        
             | tomcatfish wrote:
             | The operating point is that Scott Alexander isn't looking
             | for a few extra dollars selling potentially fake health
             | products.
             | 
             | He makes a *lot* of money on Substack, enough that this
             | concertn isn't valid.
             | 
             | Also, "So and so isn't respected in the whole world, only
             | in the people that know about them" isn't a super helpful
             | argument anyways.
        
               | spywaregorilla wrote:
               | How much of that money is made on referrals like this,
               | health or otherwise?
        
               | Natsu wrote:
               | There's no referral link in this post, he's not profiting
               | from this and he's written about many different
               | treatments.
        
               | Tenoke wrote:
               | Probably very little if any. Most of his other posts that
               | mention promising substances (e.g. Zembrin and other
               | nootropics) like this one[0] don't even include links and
               | if they do I believe they are usually stripped out but I
               | didn't find one with a link easily to confirm. I'm
               | guessing he just included it as there are multiple
               | different brands for this one.
               | 
               | 0. https://astralcodexten.substack.com/p/nootropics-
               | survey-2020...
        
               | thebooktocome wrote:
               | He is potentially shilling for right-wing influencers
               | (e.g., Sailer), however, so perhaps people should take
               | him with a grain of salt.
               | 
               | It's so bizarre to me that there's a link between the
               | naturopath/supplement community and the alt-right. Like
               | how did that happen.
        
               | slater wrote:
               | Grifters gonna grift.
        
               | InitialLastName wrote:
               | Both communities define themselves by their opposition to
               | mainstream establishments that find them destructive.
        
               | ajkjk wrote:
               | Well, the point was that he (or at least the community he
               | is in) is actively disrespected by some people as well,
               | so it's a bit more pointed than just "not known about".
               | 
               | Mentioning this only for completeness' sake. I think he's
               | good, on net. But somewhat adjacent to some more dubious
               | and distasteful stuff.
        
               | astrange wrote:
               | Well, he is trustworthy on psychiatry even if he's a
               | member of a religion that worships nonexistent AIs and
               | Bayes' theorem.
               | 
               | But his main posting hobby is that he wants to be friends
               | with weird internet right-wing intellectuals and that you
               | should too. So every time I glance at the comments there
               | someone wants to give their opinions on exactly who is
               | genetically less intelligent than the commenter.
        
               | floxy wrote:
               | I heard he's been known to wear white after labor day.
        
               | ajkjk wrote:
               | Yeah, that's not it.
        
           | margalabargala wrote:
           | To be clear- he isn't _just_ a  "blogger about psychiatry",
           | he is a licensed, practicing psychiatrist with an MD.
        
             | [deleted]
        
           | amusedcyclist wrote:
           | I would not trust Scott Alexander on real science. He's a
           | pseudo scientific hack with an agenda
        
             | Tenoke wrote:
             | Must really be a pretty bad right winger given that he
             | talks so much about being liberal and donates to
             | Democrats[0].
             | 
             | 0. https://astralcodexten.substack.com/p/open-
             | thread-217?s=r
        
               | thebooktocome wrote:
               | That article says he donated to what he considered an
               | "Effective Altruist", so the party affiliation was
               | probably secondary.
               | 
               | Politically, he's a centrist with some
               | libertarian/communitarian mix-ins. More conservative now
               | than he was in the Archipelago days. [0]
               | 
               | Dude used to love Musk and the other technocrats before
               | that became cringe in actual leftist circles.
               | 
               | [0] https://slatestarcodex.com/2014/06/07/archipelago-
               | and-atomic...
        
               | amusedcyclist wrote:
               | Okay maybe hes not a right winger , just pseudo
               | scientific
        
               | Tenoke wrote:
               | Or more likely given that your first claim was clearly
               | incorrect you are just trying to paint him in a bad light
               | and your specific accusations have little real basis.
        
           | yewenjie wrote:
           | and also an influential figure in the Effective Altruism/
           | LessWrong communities. Interestingly enough, he also wrote a
           | really enjoyable and clever fiction novel.
           | 
           | https://unsongbook.com/
        
           | [deleted]
        
         | Yvain wrote:
         | If you look at the link in the piece, you'll notice it isn't an
         | affiliate link. If it were an affiliate link, it would have a
         | linkcode section, or more likely just use the amzn.to link
         | shortener that Amazon automatically applies to all its
         | affiliate links unless you stop it.
         | 
         | (source: I am the OP, I do have an Amazon affiliate link, and I
         | chose not to use it in the article to avoid concerns like this
         | one)
        
           | prophesi wrote:
           | Dang, sorry to wrongly call you out then! I saw
           | "sr=8-2-spons" in the link which looked sponsor-related. But
           | looking online, referral links generally have a tag
           | parameter.
        
       | howmayiannoyyou wrote:
       | Anyone suffering from Restless Leg Syndrome, big caution. This
       | drug, like SSRIs, can make the condition worse and/or trigger it.
        
         | newobj wrote:
         | Source? (Asking, not accusing)
         | 
         | Counter-point?
         | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4733501/
        
         | beagle3 wrote:
         | Will use this comment to say: Anyone suffering from Restless
         | Leg Syndrome, some people report that iron supplement helps,
         | some people report that flush niacin (pure vitamin B3 in primal
         | form; NOT inositol hexanicotinate, NOT nicotinamide, NOT slow
         | release) help.
         | 
         | Be careful with advice on the internet (for all you know, I'm a
         | dog). Iron overload is harmful. Niacin may cause a "flush"
         | which is transient, but feels like your skin is sunburned for
         | 20-30 minutes. Do your own research about amounts etc. Consult
         | a medical professional if you don't feel qualified to do your
         | own research. This is not medical advice, just some random
         | info. (Though, it helped me a lot)
        
           | uoaei wrote:
           | I get the symptoms when I go to bed dehydrated. Chugging
           | water helps me.
        
           | manmal wrote:
           | Start with 100mg Niacin or less. I can report that 500mg
           | might induce an urge to go to the ER.
        
       | arisAlexis wrote:
       | Examine.com says it may be anticholinergic (that would explain
       | some properties). If it's the case then it's not very good for
       | longterm use, it may make you demented
        
       | ddlutz wrote:
       | My doctor suggested I take this last year for my GAD. I've been
       | taking it since September, and it's definitely been a huge change
       | for me. Previously, I was really "on edge" and would get panic
       | attacks semi regularly. I haven't had a full panic attack since
       | starting to take in, and day to day I feel much more like I'm
       | able to function like a regular person instead of always having
       | that "on edge" feeling.
       | 
       | I guess it's possible it could be a placebo? Previously I was on
       | lexapro for a while, and that didn't seem to be as effective as
       | this, and had some side effects.
        
         | guerrilla wrote:
         | How long do you think it took to start working?
        
           | ddlutz wrote:
           | It took a couple weeks for me because I started with taking
           | one daily at night, didn't notice much benefit, then took two
           | per dr. recommendation. After that noticed benefit pretty
           | quickly.
           | 
           | One thing I did not expect which the article mentions is the
           | "burps that taste like lavender". It was quite unexpected for
           | me but I personally quite like them. I think my stomach might
           | have gotten used to the lavender though because I would get
           | them ever single time I took them for the first few weeks,
           | and now it's maybe once a week some minor burp.
        
             | guerrilla wrote:
             | Yeah, I figured there'd be lavender burps... Did you grow
             | breasts (assuming you didn't already have them)? (That
             | seems to be a prevalent side effect)
        
       | symlinkk wrote:
       | None of this shit works. If it did it would be called medicine.
        
         | astrange wrote:
         | Caffeine is a very effective supplement that isn't sold as
         | medicine. So's creatine.
         | 
         | NAC is a pretty effective supplement which is also
         | coincidentally a medicine sometimes which is why you can't get
         | it on Amazon anymore.
        
         | Smaug123 wrote:
         | This is, of course, addressed in the article and associated
         | comments - namely its second quote and the thread
         | https://astralcodexten.substack.com/p/lavenders-game-silexan...
         | .
        
         | dsr_ wrote:
         | Once it is proven to work, it's called medicine. Prior to that,
         | it's unproven stuff that people are selling to you.
         | 
         | The entire article is about evaluating the trustworthiness of
         | the studies of this particular shit.
        
         | strbean wrote:
         | There are numerous studies supporting it's efficacy, but none
         | that are really independent and conflict-free. This is the
         | start of how something starts to be called medicine.
        
         | xutopia wrote:
         | I believe that most naturopath are charlatans, selling placebos
         | for more money than they should. However a lot of molecules in
         | use today were discovered in plants and proved their worth in
         | double blind studies.
         | 
         | This is preliminary... you may well be right but it's just a
         | guess at this point.
        
           | throwaway92394 wrote:
           | I disagree just on the grounds that if they're confident it
           | affects serotonin 1A receptors then there's definitely a
           | decent chance it really does _something_. As mentioned
           | Buspar/Buspirone is prescribed for anxiety and affects that
           | exact receptor the most.
           | 
           | Similarly I've seen NAC recommended a lot - by a doctor with
           | a phd in neuropsychology. There's a lot of positive reports
           | about it for several mental illnesses - and there's also
           | reason to beleive it affects glutamate (and in turn GABA).
           | 
           | I think the truth is that many chemicals (or plants) are
           | overlooked. As long as there's a solid idea as to what the
           | mechanism of action is, then I think it has a very real
           | chance of being beneficial to someone.
           | 
           | This wouldn't be the first psychoactive plant/fungus - Cacao,
           | mushrooms, kava, marijuana, acaia (dmt) and opium are all
           | relatively potent (noticable within an hour).
        
         | op00to wrote:
         | Yet we have "medicine" that you can buy that in fact is not at
         | all effective (Phenylephrine, for example).
        
           | Tao332 wrote:
           | I saw it recently used in the cocktail being administered by
           | an anesthesiologist during surgery. It seems to have a use in
           | staving off hypotension during that sort of thing.
           | 
           | Is it a nasal decongestant? Hell no.
        
             | throwaway92394 wrote:
             | Yeah I was going to say - definitely a real drug just a bad
             | nasal decongestant - and generally overshadowed by other
             | phenethylamines.
        
           | nkozyra wrote:
           | A long tail from the ephedra plant, once similarly an
           | unregulated supplement that absolutely does stuff.
        
             | dllthomas wrote:
             | If you're unfamiliar, see
             | https://www.science.org/content/blog-post/uselessness-
             | phenyl....
             | 
             | Where do you think Derek goes wrong?
        
         | nkozyra wrote:
         | Think of all the "medicine" that we have that came from folk
         | cures or supplements.
         | 
         | A lot of supplements/nootropics don't work, but a lot of them
         | do. The issue is more their efficacy and safety.
        
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       (page generated 2022-05-20 23:01 UTC)