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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

#221

Post by ckw »

ToucanLoucan wrote: post #193
GOD_Over_Djinn wrote: post #167

Earlier quoted context omitted.

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Probably because the commenter is not a medical professional and isn't qualified to judge the veracity of anything they find. "Do your own research" is a fucking plague on our modern world and is why the internet is like wall to wall grifters now. By all means, Google whatever you like, but if you show up to a doctors office waving WebMD sheets in a medical professionals face, you are going to be mocked and you deser…

I witnessed a pair of doctors prescribe a family member an incredibly dangerous drug for an off label use. The company had been fined $500 million dollars for various illegal schemes to convince doctors to write such prescriptions, but I’m sure the doctors in question were unaware of this. When this family member began to exhibit textbook symptoms of an extremely dangerous (life threatening) condition which could only be caused by the drug in question, the doctors failed to notice, and in fact repeatedly increased the dosage, and added more drugs on top to treat the symptoms caused by the initial drug. It was not until I accompanied my relative to a doctor’s appointment and delivered a carefully designed incantation that they made the correct diagnosis and halted the prescriptions.

So should I not have done my own research?

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

#222

Post by ksenzee »

ryandrake wrote: post #219
ksenzee wrote: post #207

Earlier quoted context omitted.

Note that the black box warning has nothing to do with long-term effects of the medication. It was added specifically because kids were killing themselves within weeks of starting the medication. > This is one of the most shocking things I have ever read. Good grief. I hope you're exaggerating for effect.

I'll raise my hand in agreement. This thread is definitely one of the most disturbing sub-threads I've ever read on HN.

It’s disturbing that a seven-year-old was treated for suicidality? Or it’s disturbing that people are opposed to such treatment?

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

#223

Post by brendoelfrendo »

GOD_Over_Djinn wrote: post #167
robertakarobin wrote: post #162

Earlier quoted context omitted.

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.

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I wouldn't recommend searching for "chemical imbalance debunked" unless you intend to confirm an existing bias. The internet will show you whatever you want, and there are enough people who distrust medical professionals that any search for "debunking" will be a minefield of fringe theories and grifters. I'd recommend someone start generally, searching for information about clinical depression, and then build on that to look at root causes and how the medical understanding of those root causes has changed over time.

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

#224

Post by Razengan »

jdietrich wrote: post #214
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…

If someone is sad for a specific, identifiable and tractable reason, then they are experiencing a categorically different phenomenon to someone who just feels sad all of the time regardless of their life circumstances. One of the key diagnostic criteria for melancholic depression - what we might lazily and inaccurately call biological or "real" depression - is mood unreactivity. Someone with severe melancholic depres…

> Trying to help those people with talk therapy or exercise or companionship would be as futile as using those things to treat hepatitis or gangrene.

I get what you want to say, but to nitpick the analogy: If the "treatment" for gangrene is amputation, then that's not really "fixing" anything. That's just the scorched earth strategy of destroying the afflicted along with the affliction. Like lobotomies. What do people think of them now?

> Someone with severe melancholic depression could win the lottery one week, lose all of their family in a plane crash the next, and feel literally nothing about either event.

Why SHOULD someone feel a specific feeling about any event? If you're subconsciously aware of the ultimate pointlessness of any event, if you're aware that feelings won't change what happened, you won't. You'd move on and handle the new reality in the means available to you.

I'm not saying that medicine should never be used and there's never a "chemical" cause to sadness (or any "wrong" feeling), just that it may be used too often as a lazy escape for the "helpers".

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

#226

Post by [deleted] »

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…

[deleted]

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

#227

Post by denverllc »

atbpaca wrote: post #138

Here the context is prozac FOR CHILDREN, not in general. Yet some people make a point in commenting that SSRIs are ineffective in general because they believe in some big pharma conspiracy. This is spreading misinformation. The truth is that SSRIs are modestly more effective than a placebo for approximately >> one third of the individuals << who try them. In other words, SSRIs are effective for more than 60-66% of ad…

> they believe in some big pharma conspiracy

See: the Sackler family

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

#228

Post by jdietrich »

jasonfarnon wrote: post #200
jdietrich wrote: post #190

Earlier quoted context omitted.

There's one big problem with that - getting seriously depressed people to do 30 minutes of exercise (or anything else) five days a week. "Get more exercise" is excellent advice for someone who feels a bit down, but it's absolutely useless for someone who can barely summon up the strength to eat or brush their teeth.

It gets even harder if you offer them the alternative of just taking a pill. For widespread health policy, we should want the proportion of depressives who will never learn to manage it themselves because a pill is offered to be smaller than the proportion for whom the pill is effective. I had always assumed these pills were effective enough but studies like these make me wonder.

They are by no means mutually exclusive. If you want depressed people to get more exercise, then a really useful starting point is to give them a pill that could rapidly increase their energy and motivation. The idea that people will be stuck on those pills forever is just lazy psychiatry; ongoing maintenance treatment is often the best option for patients with a history of severe depression and a high risk of relapse, but antidepressants are equally useful as a stepping-stone towards self-management.

Bluntly, if someone is capable of actually starting and sticking with an exercise routine, then they aren't very depressed and should not be offered medication as a first-line treatment. Antidepressants are markedly less effective in patients with milder illnesses, so psychotherapy and lifestyle interventions are a far better initial treatment option. It's only when these treatments fail - or when engaging with them is severely impaired by the severity of the illness - that medication becomes the favoured option.

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

#229

Post by plufz »

hintklb wrote: post #198
dekhn wrote: post #186

Earlier quoted context omitted.

In this area, having credentials makes a difference. Experts matter. Few if any non-medical people can read medical papers and make sense of what they say. There is simply far too much context to evaluate such papers, especially in the cases of complex medical conditions.

Sorry but strong disagree here. I have had a lot of Spinal and sleep issues. I have read almost all new literature on this niche subject and I have brought to my spine doctor some new therapy and treatments they had literally no idea about. Those treatments have changed my life. As an engineer I read a lot of deep technical paper as my day job. Medical papers are comparatively relatively simple. The most complex part…

But is that really what you are seeing in this HN comment thread? People who seem very well researched in the biochemicals and meta studies of Prozac? I don’t. :)

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

#230

Post by pizzafeelsright »

robertakarobin wrote: post #147
jacobgkau wrote: post #144

Earlier quoted context omitted.

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.

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