A low dose of moclobemide is the best all-in-one neuropharmaceutical I have so far found. For me, it boosts energy levels, mood, motivation and self-confidence. On it, I am also more optimistic about life in general. Worrying and anxiety were mostly absent from my life.
On the other hand, on moclobemide, I am also less “deep” and less capable of feeling profound feelings. I also feel that it makes me a little less intelligent because my thinking process is more shallow, which may be a consequence of feeling more “content”.
Because of these downsides, I stopped taking moclobemide a couple of months ago. I sometimes miss the upbeat attitude and the carefreeness I often experienced on moclobemide. However, I do not want to sacrifice some of my depth or cognitive abilities.
Let us say that on moclobemide my energy and mood increase by 25% but my cognition and emotional depth decrease by 10%, would I continue to take it? And if I could see the evolution of my life with and without moclobemide, 10 years from now, which life would I choose?
Unfortunately, a similar conundrum plagues almost every one of my interventions. Every intervention has risks, downsides, and side effects. However, to make things fair, doing nothing has risks and downsides as well.
- On moclobemide, I am in a better mood most of the time. I also have more self-confidence. However, I am also slightly less sharp and less capable of feeling profound feelings.
- When I was on semaglutide, I experienced little hunger and I never thought about food. Also, my food choices were automatically much better. On the other hand, I needed to count calories to make sure I was eating enough. Furthermore, I am sure that semaglutide distorted my mesolimbic reward system in subtle ways – even if I cannot point my finger at what the effects were specifically.
- The days after taking ketamine I feel absolutely fantastic – probably the best I ever feel. However, ketamine is likely at least somewhat neurotoxic even at therapeutic dosages and thus I could be making a tradeoff with my future self.
- On rapamycin, I age more slowly, it likely helps with preventing a plethora age-related diseases (e.g., dementia, cancer, atherosclerosis), but it may also subtly reduce my vitality and neuroplasticity, at least in the short term. Off the rapamycin, I get sick less often and I am also subtly more vital but I (probably) age faster and am more prone to getting many age-related diseases.
- On microdoses of finasteride, I will presumably age much better from a visual aspect, particularly my hair and skin, which is mostly what we judge age by. It may also prevent me from ever losing my hair, which happens to over 50% of males in their 40s. On the other hand, the reduction in DHT levels may subtly reduce my “manliness” (e.g., dominance behavior).
- On rasagiline, I have more “umpfh”, my productivity is higher, and my life has more “juice”. My sense of purpose is greater and the range of activities I enjoy is increased. On rasagiline, for me, procrastination does not exist and most of my behavior becomes quite goal-oriented. However, just casually enjoying things becomes harder and I have this urge to be productive all of the time. Furthermore, the increased levels of dopamine make me slightly more aggressive and irritable than I would normally be and I feel that on rasagiline I am a somewhat worse human being.
- On thyroid hormones I have more energy (particularly in the morning), and good energy levels are one of the most important things in life. However, thyroid hormones seem to dehydrate me. Furthermore, on thyroid hormones, I am a tad more restless. What is more, T3 is ideally taken three times daily and therefore supplementing with it is a hassle.
- Huel shakes make decent nutrition super simple and easy. I know exactly what I am getting and they take 1 minute to prepare. While the taste is okay at best and they are not satisfying to consume, they are incredibly convenient to prepare. Furthermore, for some unknown reason, Huel shakes dehydrate me, which screws up my voice.
- Whenever I keep my body fat around 10% or lower, I look better, particularly my face. On the other hand, keeping my body fat that low causes me to feel and perform worse and also my libido is lower. Furthermore, with low body fat, my estradiol is lower than it should be (which has a host of secondary issues) and my vitality is also affected. However, I overall feel more comfortable in my own body, which is an important component of my feeling of self-worth.
- On modafinil, I am very productive. However, I do things more thoroughly than intended, I am slightly robotic, and it screws up my sleep.
- Nicotine gum boosts my cognition. On the other hand, it is addictive and I would rather not be addicted to anything.
- I love the pick-me up effect caffeine gives me and also the taste of coffee. On the other hand, caffeine overall reduces my baseline energy levels and also screws up my sleep. After a couple of weeks, I seem to need to the coffee just to feel normal.
- On TRT, my energy, drive, focus, and libido increased. However, after already two months, I got hair in places I did not have hair before. Furthermore, TRT leads to faster aging (particularly from a visual aspect).
- Pitolisant makes me roughly 10% more awake at all times without having a stimulant effect. However, the major downside is its high financial price.
- Psychedelics are a fantastic way to get more death-bed clarity into my life. However, I do feel that they subtly reduce my drive because I rethink what is truly important to me, which changes my priorities. There is a fair chance, that psychedelics reduce the positive impact I would have on others over the course of my life.
The point is that there is very little biological free lunch and most interventions I have ever tried had downsides and therefore tradeoffs. Sure, supplements have very little downsides but just as small are the upsides. In general, the bigger the upsides of an intervention (such as modafinil, testosterone, psychedelics, low body fat levels as a young male), the greater the downsides.
Most importantly, inaction is also action. For example, if I have been feeling low-energy for years, this has huge direct costs on any domain of my life. As such, not intervening has downsides and tradeoffs as well. Such is life.It is all about knowing the downsides and deciding whether something is worth it for me or not.
I feel that to judge the true effect of an intervention, many things have to be considered, including:
- How does the intervention affect how I feel on a daily basis? Given that life is just a string of days one after the other, subjective moment-to-moment well-being has some intrinsic value.
- How does the intervention affect my lifestyle choices? Here, things can get quite complex quite fast. For example, while drinking alcohol per se is “bad”, the second-order consequence of a couple of drinks with good friends is the camaraderie and better social connections, which then has a host of other ramifications on my health and well-being even though alcohol is “bad” in the first order.
- How does the intervention affect other bodily system? For example, an antidepressant may cause me to gain weight, which may then lead to insulin resistance, which then comes with its own set of long-term problems.
- How does the intervention affect my emotions & behavior? For example, an antidepressant may reduce my empathy and thus affect my ability to relate well to others. Or something that stimulates my libido may worsen my long-term romantic relationship by mismatched sex drives between my partner and me.
- How does the intervention affect long-term health? We have to differentiate between direct effects (for example, amphetamines being associated with dementia) vs. indirect effects (for example, amphetamines being associated with greater productivity and thus wealth and therefore the ability to afford better doctors).
- How much does the intervention cost and/or how much time does it take? This is mostly about opportunity costs. For example, what if I used the 15 minutes I need to prepare healthy food for a meditation session and opted for slightly less healthy food? Or what if I went for a 30-minute jog instead of a sauna session?
Generally, I try to optimize, among other things, for vitality above other things because I feel that being vital is important for everything. If I could choose, I would probably choose emotional intensity over cognition (up to a certain point) because how strongly I feel determines how rich my life is (which is very important to me) and it also affects how much empathy I have for others. It probably all depends on someone’s starting point. If somebody has a lot of energy already, then why enhance that further possibly to the detriment of other domains?
Some people would go for personal happiness, others would go for impact. I personally am more in the personal happiness camp – which is much more and deeper than just being “happy” all the time but rather revolves around meaning.
Disclaimer
The content available on this website is based on the author’s individual research, opinions, and personal experiences. It is intended solely for informational and entertainment purposes and does not constitute medical advice. The author does not endorse the use of supplements, pharmaceutical drugs, or hormones without the direct oversight of a qualified physician. People should never disregard professional medical advice or delay in seeking it because of something they have read on the internet.