Hacker News Board Hacker News, browsed like a classic message board
Live data from Hacker News

FDA Approves First Oral Treatment for Postpartum Depression

fda.gov

Post reply on HN
Print view View original

281–290 of 299 posts

Re: FDA Approves First Oral Treatment for Postpartum Depression

#281

Post by staticman2 »

afavour wrote: post #280
staticman2 wrote: post #277

Earlier quoted context omitted.

>>>"It's insane to me that a group of educated and seemingly intelligent people seem to think they understand more about drug safety and prescribing than the FDA, researchers and physicians." I'm currently on a psychiatrist prescribed drug which is illegal in Japan, which means I have to discontinue it before an upcoming trip. This is not a new drug, it's a generic. So is it "insane that a group of educated and seemi…

I think there’s a meaningful difference there. A disagreement between two highly qualified groups of doctors seems valid. A disagreement between a group of highly qualified doctors and someone who did some research on the internet does not.

"A disagreement between two highly qualified groups of doctors seems valid."

Well... if we're talking psychiatrists, they choose the thing they wanted to be highly qualified in. So, any potential "expert" that would disagree with their research methods was selected out so as to not become an expert in the first place.

I guess if I have a point it's that I don't think shouting "trust the science" or "trust the experts" and beating one's chest is contributing much to the conversation.

Re: FDA Approves First Oral Treatment for Postpartum Depression

#282

Post by haldujai »

staticman2 wrote: post #281
afavour wrote: post #280

Earlier quoted context omitted.

I think there’s a meaningful difference there. A disagreement between two highly qualified groups of doctors seems valid. A disagreement between a group of highly qualified doctors and someone who did some research on the internet does not.

"A disagreement between two highly qualified groups of doctors seems valid." Well... if we're talking psychiatrists, they choose the thing they wanted to be highly qualified in. So, any potential "expert" that would disagree with their research methods was selected out so as to not become an expert in the first place. I guess if I have a point it's that I don't think shouting "trust the science" or "trust the experts…

What's insane is that seemingly intelligent people with zero medical training or research experience somehow think they have the capability to determine drug safety or whether a disease exists and merits treatment with pharmacotherapy.

> So, any potential "expert" that would disagree with them was selected out so as to not become an expert in the first place.

Anyone with some form of training or practical experience in an academic biomedical field (clinical or research) and has knowledge of how to synthesize and analyze evidence in order to make logical arguments may be considered a relevant expert, this is a much larger group than psychiatrists and is how FDA committees are constructed.

Most notably this includes (and is not limited to) other physicians and providers, pharmacologists, pathologists, physiologists and epidemiologists.

> I guess if I have a point it's that I don't think shouting "trust the science" or "trust the experts" and beating one's chest is contributing much to the conversation.

One should absolutely "trust the experts" when it comes to determining safety of a therapeutic or definition of a disease. These are determined by scientific processes and debate based on evidence and not philosophical thoughts and feelings.

Given how complex modern life is one has to defer to experts and regulators on many things beyond medicine. Some other examples: motor vehicles, aviation, building codes, financial institutions and encryption.

> I'd also say that the more I've learned about psychiatry (including as a customer) the lower the opinion I have of it.

The limitations in psychiatric medicine and research are widely acknowledged and not a novel insight that the FDA and medical community are ignorant of as many commenters here seem to believe.

Re: FDA Approves First Oral Treatment for Postpartum Depression

#283

Post by slim »

xyzzy_plugh wrote: post #142

Since every top level comment here is a borderline tire fire, let me be the first to say: This is great news. We need better treatments for PPD, which is real and very serious that can cause long term lasting effects in serious cases without treatment, and can sadly even be fatal. Quality of life has risen steeply over the past several decades but mothers still walk an unpaved road. It's deeply worrying the lack of s…

actually, where I live people used to live in multi-generational homes, where first time mothers had already had the chance to be trained on maternity from a young age by watching their sisters, wives of their brothers, sisters of their parents etc... also by having a chance of taking care of children younger than them including babies, all of this being group activities where girls get to collaborate, so highly educative. I'd argue parenting and maternity was not a problem in that lost society (although there were other problems)

Re: FDA Approves First Oral Treatment for Postpartum Depression

#284

Post by saagarjha »

ksenzee wrote: post #259
saagarjha wrote: post #118

Earlier quoted context omitted.

It is generally rare that Hacker News comments make me physically cringe. This is, unfortunately, one of those times.

The fact that I’m a woman (who has given birth and had PPD, twice) gives it that extra je ne sais quoi.

Have you considered just being a man?

Re: FDA Approves First Oral Treatment for Postpartum Depression

#285

Post by nemo44x »

habinero wrote: post #265
nemo44x wrote: post #249

Earlier quoted context omitted.

That’s darkly humorous. That a persons depression is the only thing stopping them from killing themselves. And to get to a better state they have to cross the stage where they are still depressed but have acquired a “can do” attitude. End of day I think scrambling the brain is almost always the wrong choice. That these things are so heavily prescribed and marketed - what does that say?

It says nothing. They don't "scramble" your brain, or artificially make you happy, or any of the other ignorant things people have said. You are exactly the same person on AD as you are off of them. This is like pretending that anyone who gets antibiotics is weak and if you just exercise, you can beat infected wounds. Before antibiotics, people just died from wounds. Before AD, people spent their whole lives trapped…

I don’t think it’s anything line antibiotics. I don’t judge people for taking brain scramblers but I think it’s obvious they are vastly over prescribed. 20% of women are on some form of them. There’s no way that’s natural. There must be a reason you don’t see the mass adoption of these kinds of drugs in most other countries.

It’s also created a culture of using a pill to solve a problem and yes in some extreme cases it’s probably necessary but I think there’s bigger issues and lots of people with very poor values that create lasting unhappiness.

Re: FDA Approves First Oral Treatment for Postpartum Depression

#286

Post by staticman2 »

haldujai wrote: post #282
staticman2 wrote: post #281

Earlier quoted context omitted.

"A disagreement between two highly qualified groups of doctors seems valid." Well... if we're talking psychiatrists, they choose the thing they wanted to be highly qualified in. So, any potential "expert" that would disagree with their research methods was selected out so as to not become an expert in the first place. I guess if I have a point it's that I don't think shouting "trust the science" or "trust the experts…

What's insane is that seemingly intelligent people with zero medical training or research experience somehow think they have the capability to determine drug safety or whether a disease exists and merits treatment with pharmacotherapy. > So, any potential "expert" that would disagree with them was selected out so as to not become an expert in the first place. Anyone with some form of training or practical experience…

>The limitations in psychiatric medicine and research are widely acknowledged and not a novel insight that the FDA and medical community are ignorant of as many commenters here seem to believe.

One might expect someone who acknowledges the limits of psychiatry wouldn't be chest beating so aggressively about the greatness of the scientific process.

One might also expect a person concerned with mental health issues wouldn't throw around the term "insane" so casually.

>These are determined by scientific processes and debate based on evidence and not philosophical thoughts and feelings.

Who needs philosophy? Just have faith, am I right? That's what science is all about. What do we mean by science? Don't ask that kind of philosophical question. Just have faith.

Re: FDA Approves First Oral Treatment for Postpartum Depression

#287

Post by refurb »

linuxftw wrote: post #253
refurb wrote: post #132

Earlier quoted context omitted.

This is such a lazy comment and the fact that you didn't copy paste the paragraph that followed makes me think you have some agenda to push. "The developmental and health benefits of breastfeeding should be considered along with the mother’s clinical need for ZURZUVAE and any potential adverse effects on the breastfed child from ZURZUVAE or from the underlying maternal condition."

Obviously this bit is implied. But, they should have done the safety studies so people can make a fully informed decision. It seems very unlikely they're going to direct all people taking this to stop breastfeeding, because it's going to make it sound like a poison and people won't buy it. Got to put profits first, I guess.

You should educate yourself on the drug development process and FDA regulations.

"More" data is always better, nobody disagrees. But more data costs more and takes more time to gather. So the trade off is - do we approve this medicine now, knowing what the risk are, are do we not and deny patients this medicine?

There is no "safe" drug. There is no drug where all the risks are known. Even the FDA will tell you that. It's all a risk-benefit trade off.

Re: FDA Approves First Oral Treatment for Postpartum Depression

#288

Post by astrange »

senttoschool wrote: post #230
astrange wrote: post #210

Earlier quoted context omitted.

Wikipedia has relatively recent sources, 2017. https://www.sciencedirect.com/science/article/abs/pii/S01650... > Additionally, prevalence was significantly higher in women from low and middle income countries compared to women from high income countries (OR 1.8, 95% CI 1.4–2.2). The overall pooled prevalence was 11.9% of women during the perinatal period (95% CI 11.4–12.5). https://en.wikipedia.org/wiki/Postpartum_de…

Are we assuming that low and middle income countries still live in villages? For example, in Malaysia, most people no longer live in villages but it's counted as a middle income country.

I suppose I don't know which countries are more or less alienated from their extended families, but the US is surely more than averagely sprawled since it's so large and so suburbanized.

Re: FDA Approves First Oral Treatment for Postpartum Depression

#289

Post by Moomoomoo309 »

NoZebra120vClip wrote: post #221
mtlmtlmtlmtl wrote: post #186

Earlier quoted context omitted.

Hey, you know what causes suicide more than anything else? Depression. Especially untreated depression. And no, cannabis is not a mental health panacea now matter how many times you claim it is. In fact it generally seems to worsen depression. Never have I been more depressed than when smoking daily. It's nothing but a crutch.

Charles Whitman received Valium, and he loved his Dexedrine. He brought along a goodly supply of Dexedrine when he climbed the clock tower at the University of Texas. The Columbine kids were well-medicated. Remarkably, despite their prescriptions, they were yet to be diagnosed with any mental illness. When you read about someone who committed crimes, or merely caused a police-involved disturbance, the media will ofte…

The sample size is small enough that the correlation vs causation question still goes strong. You're arguing causation, the FDA argues correlation. Is it because they're taking the drugs, or because they're the type of person who would be taking those drugs and therefore have some kind of issue that needed help? It can be hard to know. Did they have these ideas or desires before taking the medication, or only after? If they are young, is it because of the meds, or because they're an angsty and hormonal teenager who has mental issues, or did the drugs exacerbate that?

It's easy to say "look at all these very public cases where this bad thing happened, and they all have this in common!", but that doesn't tip the needle for correlation vs causation at all imo.

Re: FDA Approves First Oral Treatment for Postpartum Depression

#290

Post by pertymcpert »

senttoschool wrote: post #230
astrange wrote: post #210

Earlier quoted context omitted.

Wikipedia has relatively recent sources, 2017. https://www.sciencedirect.com/science/article/abs/pii/S01650... > Additionally, prevalence was significantly higher in women from low and middle income countries compared to women from high income countries (OR 1.8, 95% CI 1.4–2.2). The overall pooled prevalence was 11.9% of women during the perinatal period (95% CI 11.4–12.5). https://en.wikipedia.org/wiki/Postpartum_de…

Are we assuming that low and middle income countries still live in villages? For example, in Malaysia, most people no longer live in villages but it's counted as a middle income country.

You know by “village” they don’t mean a literal village right? It’s a metaphor.
Post reply on HN