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

theguardian.com

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

#161

Post by NoMoreNicksLeft »

BeetleB wrote: post #132
hirvi74 wrote: post #43

I can't bring myself to try an SSRI. I just cannot do it. I've got a prescription for an NDRI on my desk, and I still won't take it. I am not anti-psychiatry either. I take psychiatric medication for a different condition already. But something about anti-depressants just doesn't sit well with me. As crazy as it may sound, I think a lot of my depression stems from living a life that is not true to myself and due to c…

> As crazy as it may sound, I think a lot of my depression stems from living a life that is not true to myself and due to countless failed attempts to be someone I cannot never be. As far as I am concerned, depression is just a symptom of my situation and not some true disorder. It's true for some, but be wary of such a generalization. It took many years of people telling me the same thing before I understood what th…

> "Having an objectively crappy life is normal. Being depressed about it isn't."

Sounds like a philosophy more than a science. What does "normal" even mean in this context? Are we talking about something measurable? For instance, if the number of people who were depressed about those circumstances doubled (or quadrupled) would it then be normal, and there would be no reason to treat it (because it's normal)?

If you have an objectively crappy life, but not just ignore it and instead are incapable of even noticing, that sounds a little like dysfunction to me. It's not some superpower, it's a micro-lobotomy.

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

#162

Post by robertakarobin »

jacobgkau wrote: post #130
kstrauser wrote: post #126

Earlier quoted context omitted.

Why? If a kid has diabetes, would it be horrifying to treat it? Why would it be different for a neurochemistry issue that makes the same kid tired and sad all the time?

Because the problem's not a "neurochemistry issue" (that theory's been debunked and the "chemicals" in play have never been known), and the solution is "no better than placebo."

Can you provide a source for that theory having been debunked? I agree that data has been found that is at odds with the various neurochemical theories but am not aware of the neurochemistry link as a whole having been definitely debunked.

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

#163

Post by 0134340 »

potsandpans wrote: post #103
lemming wrote: post #23

Our 11 year old daughter was seriously depressed recently. N=1, but fluoxetine was life changing (and potentially life saving) for her, at least.

Genuine question (which I accept may be too personal to answer): what does depression in someone that young look like? How is it different from the expected hormonal changes that an adolescent is expected to go through?

Probably something like Boy Interrupted[0]. Sad story and something I can sympathize with having some of the same feelings very early on despite having a rather normal upbringing and siblings not showing signs of it.

0: https://en.wikipedia.org/wiki/Boy_Interrupted

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

#164

Post by Razengan »

area51org wrote: post #115
Razengan wrote: post #111

> treating depression Most of the "treatment" is apparently just telling people to stop feeling sad [0], or giving them drugs [0] https://old.reddit.com/r/thanksimcured but no one bothers to take the time out to sit down and figure out WHY they feel sad and FIX THAT FOR THEM. That takes too much work. Sometimes depression is this vague feeling that this world is just wrong. That Damocles' sword of mortality. The nagg…

Depression isn't just feeling sad. It's not necessarily caused by anything external. You cannot necessarily just "figure out why" you feel bad; that's really not how it usually works.

> You cannot necessarily just "figure out why" you feel bad

Well, of course, if you anesthetize someone they can't feel anything. If you cut off the physical pathways of ""feeling sad"" then they can't feel sad, but is that really the same as "fixing" the reason for why they were feeling sad in the first place?

Unless the reason was that the physical causes are running haywire and making someone feel sad when they otherwise wouldn't, but how often is that just uhh a lazy scapegoat? "Oh this person has no reason to feel sad, something must be wrong in their brain"

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

#165

Post by CGMthrowaway »

Zak wrote: post #127

A post on HN a couple years ago discussed research showing antidepressants only work for about 15% of patients: https://news.ycombinator.com/item?id=37671529 The thing is, they work very well for that 15%. I suspect the eventual conclusion will be that depression is a syndrome with multiple causes rather than a single condition, and SSRIs treat one of the causes. Edit: Mark Horowitz is one of the authors of both stud…

The NNT[1] of Prozac, and SSRIs in general, has been previously estimated around 6. Meaning that treatment is more helpful than a sugar pill in only 1 out of 6 cases (a dirty secret).

Meanwhile the NNH[2] is as low as 21, that is 1 in 21 cases will stop due to negative side effects.

Source: https://www.aafp.org/pubs/afp/issues/2008/0315/p785.html

[1]Number Need to Treat, that is, number of patients you need to treat to prevent one additional bad outcome

[2]Number Needed to Harm, that is, number of patients you need to treat to generate side effects so bad that someone halts treatment

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

#166

Post by lawlessone »

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."

It sounds to me how a someone would describe feeling suicidal when they don't know the word for it.

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

#167

Post by GOD_Over_Djinn »

robertakarobin wrote: post #162
jacobgkau wrote: post #130

Earlier quoted context omitted.

Because the problem's not a "neurochemistry issue" (that theory's been debunked and the "chemicals" in play have never been known), and the solution is "no better than placebo."

Can you provide a source for that theory having been debunked? I agree that data has been found that is at odds with the various neurochemical theories but am not aware of the neurochemistry link as a whole having been definitely debunked.

[flagged]

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

#168

Post by DANmode »

Modified3019 wrote: post #158
DANmode wrote: post #110

Earlier quoted context omitted.

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

Calling it lymphatic impairment would be more straightforward.

Lymphatic inefficiency, maybe.

Impairment sounds too permanent, when this is often an intermittent, “on average” sort of issue - not a complete freeze.

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

#169

Post by DANmode »

purple_turtle wrote: post #118
DANmode wrote: post #110

Earlier quoted context omitted.

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

Can you link any evidence supporting this claim?

Beyond the links in other comments?

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

#170

Post by DANmode »

purple_turtle wrote: post #120
DANmode wrote: post #97

Earlier quoted context omitted.

Correct. It’s caused by inflammation, one of the causes being: detox inefficiency.

Can you link any evidence supporting this claim? This term sounds like a standard-issue woo.

Replied to your other request too: see other comments, ask for what’s missing for you.
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