Vortioxetine: probably not for me

Today I’ve run out of antidepressant, which makes it time to re-evaluate antidepressant. The one in question is vortioxetine: a somewhat obscure substance which—according to my recollection of reading this blog post a year ago—was synthesized to do what more serendipitous antidepressants do but better, and seems to maybe make people mildly smarter. I’ve been taking it for about a year, at various dosages. I’ve also been logging various things including my mood most days that whole time. So one might think it would now be simple to tell if it was any good.At a high level, my average mood was exactly the same to one decimal point in 2025 before starting vortioxetine and during all days since then when I’ve logged taking it. So that looks pretty damning. But also, complicating this experiment, a bunch of other things are continually going on in my life. And if we look at the week immediately before and after starting it there was a sharp improvement (and to a lesser extent the week immediately before and after increasing the dosage the first time.) So that seems like evidence of it doing something, against the backdrop random walk of other circumstances. Notably however, this is not at all how drugs like this are supposed to work—they are meant to rev up over weeks, not take you from mostly 3s and 5s to mostly 6s and 7s overnight.Looking at other measures of mental health (e.g. anxiety, crying), all seem to be the same or worse compared to the months prior to starting it. That seems very easily attributable to random variation in other factors, but is also a lack of positive evidence.Overall I’m calling it for bleh. But I’m curious about this phenomenon where antidepressants are sometimes great for the first week, exactly when they aren’t supposed to be.Discuss