The Adam Ragusea Podcast What antidepressants do to appetite and digestion, with Dr. Tony Ragusea (E84)
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Nov 27, 2023 
In this conversation, Dr. Tony Ragusea, a board-certified clinical psychologist with a postdoc in psychopharmacology, delves into the effects of antidepressants, focusing on SSRIs like sertraline. He discusses their complex impact on appetite and digestion, as well as the crucial gut-brain connection. Personal anecdotes illuminate the societal pressures surrounding body image and emotional eating. Dr. Ragusea also highlights the importance of professional guidance in mental health treatment and shares his passion for creative outlets like woodworking and photography.
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How SSRIs Work
- SSRIs block serotonin reuptake, increasing serotonin in the synaptic gap and stimulating post-synaptic neurons more than usual.
- The therapeutic effect likely comes from downregulating receptors, desensitizing the neuron, altering gene expression over weeks.
Serotonin's Role in Gut Effects
- Most serotonin receptors are in the gut, not the brain, influencing gut function.
- SSRIs disrupt serotonin reuptake in the gut, likely causing inflammation and common side effects like upset stomach and diarrhea.
Adam's Appetite Drop Story
- Adam experienced a strong appetite drop and weight loss on sertraline, only cannabis could restore his appetite.
- This effect felt profoundly physical and not related to mood changes, suggesting a gut or microbiome impact.