Prozac 'no better than placebo' for treating children with depression, experts • Hacker News Board

Re: Prozac 'no better than placebo' for treating children with depression, experts

#141

Post by robertakarobin » Fri, Nov 21, 2025, 9:19 PM UTC

techietim wrote: post #123

robertakarobin wrote: post #108

I was very young when my mom started Prozac but do remember how angry and sad she was before compared to after. Years later there was a time when me and my sister noticed our mom was acting a bit strange -- more snappish and irritable than usual, and she even started dressing differently. Then at dinner she announced proudly that she had been off Prozac for a month. My sister and I looked at each other and at the sam…

> my 7-year-old son just started half that dose This is horrifying.

We had/have a lot of reservations about it too, and discussed it at length with our pediatrician over months of observation. We decided what was more horrifying was hearing a 7-year-old — who has supportive family and friends, good health, no traumatic events, no major life changes going on, never worries where food/shelter is coming from — say he feels like "he shouldn't be on Earth anymore" and suddenly react with extreme physical anxiety to almost everything. It was bad enough that he couldn't really implement any of the coping skills he learned in therapy. His therapist hoped that medication would bring him to a baseline where he was able to benefit more from therapy. My family's historical success with Prozac also made the decision more palatable since depression appears to be hereditary.

There has been a phenomenal positive shift in his behavior since he started medication. All that said, another commenter pointed out that the study specifically says that Prozac is no better than placebo for depression, which is similar to but distinct from anxiety, which is what my son is being treated for. My mom and I were both diagnosed with depression, but anxiety may be more accurate -- I'm not sure.

Re: Prozac 'no better than placebo' for treating children with depression, experts

#142

Post by jacobgkau » Fri, Nov 21, 2025, 9:20 PM UTC

pyth0 wrote: post #137

jacobgkau wrote: post #133

Earlier quoted context omitted.

Because 7 years old is borderline too young to even make a depression diagnosis, and that kid's going to have his brain chemistry altered and essentially be addicted to a drug that he'll have to pay for for the rest of his life.

How can you believe it's both "no better than placebo" but also that it's "going to have his brain chemistry altered and essentially be addicted to a drug". SSRIs are not considered addictive, though people can develop a dependence if it provides them significant improvement.

A drug can have real effects while being no better than a placebo for doing something specific (what they're supposed to do).

Re: Prozac 'no better than placebo' for treating children with depression, experts

#143

Post by fgonzag » Fri, Nov 21, 2025, 9:22 PM UTC

techietim wrote: post #123

robertakarobin wrote: post #108

I was very young when my mom started Prozac but do remember how angry and sad she was before compared to after. Years later there was a time when me and my sister noticed our mom was acting a bit strange -- more snappish and irritable than usual, and she even started dressing differently. Then at dinner she announced proudly that she had been off Prozac for a month. My sister and I looked at each other and at the sam…

> my 7-year-old son just started half that dose This is horrifying.

You don't understand what having extreme anxiety at that age feels like.

As someone who lived through that, I refuse to let him. All of memories of school are just feeling anxious about everything, just tight and suffocated, always in a panic. I started living when I started taking anxiety pills at 39 years old, and I can see my 2 year old having the exact same anxiety ticks and fits I have.

I don't know at what age I'll medicate him, but I'll do it as soon as I notice he isn't coping and happy anymore.

Horrifying is forcing him to experience that because you can't comprehend us.

Re: Prozac 'no better than placebo' for treating children with depression, experts

#144

Post by jacobgkau » Fri, Nov 21, 2025, 9:22 PM UTC

robertakarobin wrote: post #141

techietim wrote: post #123

Earlier quoted context omitted.

> my 7-year-old son just started half that dose This is horrifying.

We had/have a lot of reservations about it too, and discussed it at length with our pediatrician over months of observation. We decided what was more horrifying was hearing a 7-year-old — who has supportive family and friends, good health, no traumatic events, no major life changes going on, never worries where food/shelter is coming from — say he feels like "he shouldn't be on Earth anymore" and suddenly react with…

I'd be more interested in where your 7-year-old even learned phrases like "I feel like I shouldn't be on Earth anymore."

Re: Prozac 'no better than placebo' for treating children with depression, experts

#145

Post by robertakarobin » Fri, Nov 21, 2025, 9:22 PM UTC

jacobgkau wrote: post #131

BeetleB wrote: post #124

Earlier quoted context omitted.

His anecdote explicitly mentions the possibility of it being a placebo.

No it doesn't. It doesn't contain the word "placebo." Can you quote where it "explicitly mentions" what you're saying it does?

> If I have a good day it's impossible to day whether that's due to Prozac. But since starting Prozac I have been much more likely to have good days than bad. So, since Prozac is cheap and I don't seem to suffer any side effects, I plan to keep taking it in perpetuity.

I was acknowledging that the "good days" could be due to Prozac or could be a placebo effect, but since being on Prozac correlates with having significantly more good days, and I experience virtually no ill effects, I choose to continue with it.

Re: Prozac 'no better than placebo' for treating children with depression, experts

#146

Post by throwaway314155 » Fri, Nov 21, 2025, 9:23 PM UTC

robertakarobin wrote: post #141

techietim wrote: post #123

Earlier quoted context omitted.

> my 7-year-old son just started half that dose This is horrifying.

We had/have a lot of reservations about it too, and discussed it at length with our pediatrician over months of observation. We decided what was more horrifying was hearing a 7-year-old — who has supportive family and friends, good health, no traumatic events, no major life changes going on, never worries where food/shelter is coming from — say he feels like "he shouldn't be on Earth anymore" and suddenly react with…

As someone with bad mental health since I was ~5 and parents who refused to acknowledge it - I think you're making the right decision.

There is however also benefit in updating your priors as new research comes out. I won't say this particular research discounts your experience. But maybe some day your son will prefer a different medication.

Re: Prozac 'no better than placebo' for treating children with depression, experts

#147

Post by robertakarobin » Fri, Nov 21, 2025, 9:25 PM UTC

jacobgkau wrote: post #144

robertakarobin wrote: post #141

Earlier quoted context omitted.

We had/have a lot of reservations about it too, and discussed it at length with our pediatrician over months of observation. We decided what was more horrifying was hearing a 7-year-old — who has supportive family and friends, good health, no traumatic events, no major life changes going on, never worries where food/shelter is coming from — say he feels like "he shouldn't be on Earth anymore" and suddenly react with…

I'd be more interested in where your 7-year-old even learned phrases like "I feel like I shouldn't be on Earth anymore."

Yes, us too. Beats us. Sure wasn't around our house, and we can't imagine any family/friends/TV/whatever he may have learned it from.

Re: Prozac 'no better than placebo' for treating children with depression, experts

#148

Post by fgonzag » Fri, Nov 21, 2025, 9:25 PM UTC

potatocoffee wrote: post #135

jacobgkau wrote: post #133

Earlier quoted context omitted.

Because 7 years old is borderline too young to even make a depression diagnosis, and that kid's going to have his brain chemistry altered and essentially be addicted to a drug that he'll have to pay for for the rest of his life.

O cool. Do you have any appointments I can book for my kid?

Mine too! Only 2 years old but I can already see the massive anxiety bursts in him.

If this guy has a non chemical cure, I'm all for it. In fact I'm actively researching children psychologists to stave off the meds as much as we can, the problem is that 99% of psychologists are quacks, so choosing them is tough.

Re: Prozac 'no better than placebo' for treating children with depression, experts

#149

Post by mkehrt » Fri, Nov 21, 2025, 9:25 PM UTC

I'd really be curious about distribution of the result they see. The folklore is definitely that that there's vary high variance in how people respond to SSRIs, and not recommending them because the average value is low is pretty irresponsible.

Re: Prozac 'no better than placebo' for treating children with depression, experts

#150

Post by DANmode » Fri, Nov 21, 2025, 9:25 PM UTC

criddell wrote: post #112

DANmode wrote: post #110

Earlier quoted context omitted.

When your normal lymphatic processes (and glymphatic processes) are slowed, or near-halted.

It might be worth using those words rather than detox inefficiency because the latter conjures thoughts of woo peddlers.

Yes,

it turns out toxins (environmental, die-off and waste of cells from infection, dietary, lifestyle) are important to everyone,

not just vegans in Sandler movies.