Highlights From The Comments On Zulresso
Read the original on Astral Codex Ten →
Follows up on
↳ Zounds! It's Zulresso and Zuranolone! — Essay · Mar 2022
↳ Progesterone Megadoses Might Be A Cheap Zulresso Substitute — Essay · Mar 2022
Summary
A dense, high-quality biomedical Highlights companion to the Zulresso/progesterone posts. Real expert corrections accumulate: Metacelsus debunks Scott's $10-20k/gram price estimate (catalog-chemistry pricing, not scale pricing); Douglas and others clarify the benzodiazepine-sensitive vs -insensitive GABA-A / phasic vs tonic mechanism and the taper story; Zutano dismantles Scott's '-pam = positive allosteric modulator' urban legend with actual medchem history; Jimmy Steier flags severe tolerance/withdrawal and cross-tolerance in PMDD/PPD women; and a long run of patient testimonials shows how delicate the oral-progesterone dose window is.
Why this score
Quality 68 · Strong. Strong: one of the richer pharmacology companions — it materially corrects the parent post on price, mechanism, and a naming legend, and adds credible tolerance caveats and dose-response color. Above the parent Progesterone essay (64) because the aggregated expert correction is genuinely informative. 68.
Claude’s paradigm shift 48 · Moderate. Moderate: the companion sharpens and corrects existing pharmacology rather than introducing a new idea. 48.
Real-world impact 1 · Negligible. Comment-thread color within the ACX biomedical readership; no material change. RWI 1.