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

theguardian.com

271–280 of 561 posts

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

#271

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 was one of those “medicating kids is a terrible idea” people, until I had kids with severe generalised anxiety. It took a lot to convince me to try it, but it made their lives better in such an obvious, immediate way. The whole experience made me a lot more humble about opinions I hold without relevant experience.

It's important to remember that not being a "medicating kids is a terrible idea" person doesn't mean one is a "every medication is a great idea" person. I'm probably like most people where in a perfect world I wouldn't medicate at all, and treat unfamiliar medications with some skepticism. But also I accept that I'm not (and am not interested in being) a medical expert, so if there is a medical need that I can't handle myself I'll take the advice of a clinician who has earned my trust with good reasoning.

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

#272
post #189

Earlier quoted context omitted.

This is one of the most shocking things I have ever read. There is a black box warning for Prozac: ‘Warning: Suicidality and Antidepressant Drugs Increased risk of suicidal thinking and behavior in children, adolescents, and young adults taking antidepressants for Major Depressive Disorder (MDD) and other psychiatric disorders’ Read the package insert: https://www.accessdata.fda.gov/drugsatfda_docs/label/2011/01... T…

We were certainly informed of this. I didn't count it among the long-term health effects. I'm an educated and skeptical person but have never found any reason to distrust my physicians.

I have many reasons for distrusting physicians, but here's a particularly good one: the large drug companies have been fined repeatedly billions of dollars for illegal schemes to convince doctors to prescribe drugs off-label. From a justice department press release (https://www.justice.gov/archives/opa/pr/pharmaceutical-giant...):

'AstraZeneca LP and AstraZeneca Pharmaceuticals LP will pay $520 million to resolve allegations that AstraZeneca illegally marketed the anti-psychotic drug Seroquel for uses not approved as safe and effective by the Food and Drug Administration (FDA), the Departments of Justice and Health and Human Services’ Health Care Fraud Enforcement Action Team (HEAT) announced today. Such unapproved uses are also known as "off-label" uses because they are not included in the drug’s FDA approved product label.

[..]

The United States alleges that AstraZeneca illegally marketed Seroquel for uses never approved by the FDA. Specifically, between January 2001 through December 2006, AstraZeneca promoted Seroquel to psychiatrists and other physicians for certain uses that were not approved by the FDA as safe and effective (including aggression, Alzheimer’s disease, anger management, anxiety, attention deficit hyperactivity disorder, bipolar maintenance, dementia, depression, mood disorder, post-traumatic stress disorder, and sleeplessness). These unapproved uses were not medically accepted indications for which the United States and the state Medicaid programs provided coverage for Seroquel.

According to the settlement agreement, AstraZeneca targeted its illegal marketing of the anti-psychotic Seroquel towards doctors who do not typically treat schizophrenia or bipolar disorder, such as physicians who treat the elderly, primary care physicians, pediatric and adolescent physicians, and in long-term care facilities and prisons.

[..]

The United States contends that AstraZeneca promoted the unapproved uses by improperly and unduly influencing the content of, and speakers, in company-sponsored continuing medical education programs. The company also engaged doctors to give promotional speaker programs on unapproved uses for Seroquel and to conduct studies on unapproved uses of Seroquel. In addition, the company recruited doctors to serve as authors of articles that were ghostwritten by medical literature companies and about studies the doctors in question did not conduct. AstraZeneca then used those studies and articles as the basis for promotional messages about unapproved uses of Seroquel.

"Illegal acts by pharmaceutical companies and false claims against Medicare and Medicaid can put the public health at risk, corrupt medical decisions by health care providers, and take billions of dollars directly out of taxpayers’ pockets," said Attorney General Eric Holder. "This Administration is committed to recovering taxpayer money lost to health care fraud, whether it’s by bringing cases against common criminals operating out of vacant storefronts or executives at some of the nation’s biggest companies."

The United States also contends that AstraZeneca violated the federal Anti-Kickback Statute by offering and paying illegal remuneration to doctors it recruited to serve as authors of articles written by AstraZeneca and its agents about the unapproved uses of Seroquel. AstraZeneca also offered and paid illegal remuneration to doctors to travel to resort locations to "advise" AstraZeneca about marketing messages for unapproved uses of Seroquel, and paid doctors to give promotional lectures to other health care professionals about unapproved and unaccepted uses of Seroquel. The United States contends that these payments were intended to induce the doctors to prescribe Seroquel for unapproved uses in violation of the federal Anti-Kickback Statute. '

The takeaway is that anytime a physician prescribes you a drug, at the very least you have to check that there hasn't been a gigantic fine levied against the drug maker for illegally tricking your doctor into prescribing it to you.

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

#273

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."

I’m with you on this. Granted my oldest is only 5, but anything profound my kids say can be traced back to something they heard

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

#274
post #209
post #160

Earlier quoted context omitted.

[flagged]

I hope you do realize that this comment thread is linked to an article that includes the words "Prozac no better than placebo" in its headline?

These types of studies are published all the time and can easily be dismissed. Antidepressants are _only_ for major depression. Not mild or moderate. These studies that find no significance compared to a placebo are always tried in patients with all types of depression. Not just major.

It's so common it's a trope. "Antidepressants don't work" says the scientists testing antidepressants on things they're not supposed to work on.

Studies repeated with just major depression all conclude antidepressants are better than a placebo.

Click through the article to the study and you'll find they did not limit their study to must major

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

#275
I don't know if I'd call it "placebo" for me; prozac gave me the worst, most horrible pit of sadness I've ever had in my entire life. I couldn't stop feeling guilty over every single bad thing I have ever done, and it completely killed my appetite and that probably didn't do great for my mood either. I was only on it for about two months until I begged my doc to get me off of it. She told me that it's one of those things that doesn't affect everyone, but since I was already taking Wellbutrin it can have negative effects.

Never again. I'm taking Pristiq now and that has been considerably better.

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

#276
post #247

Earlier quoted context omitted.

Every medication can have severe and permanent side effects, the question is how often that occurs for a particular drug, and how that stacks up against the quality-of-life improvement from taking that drug.

> Every medication can have severe and permanent side effects SSRIs are by an order of a magnitude worse than any other common medication in that respect. Moreover, like I said there's little evidence these drugs actually achieve any quality-of-life improvement beyond a placebo effect.

SSRIs are very bad, but antipsychotics are worse. There are many other reasons, but a demonstrative one is that there is a cumulative annual risk as high as 7% of developing a permanent movement disorder when on them.

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

#277

Earlier quoted context omitted.

> Depression is caused by laziness [...]. My kids know that they aren't permitted to be lazy. Do you really believe this, or do you believe your children aren't depressed? Your comment is not in accordance with science. Depression is a complex topic. I'm having trouble imagining a way to be more wrong. Is this satire?

[flagged]

You can use me as an example! When I got diagnosed I was very physically active and also quite clean.

One of the hardest things for me with depression is the incredible guilt I have. What right do I have to be depressed when my life is objectively fine? Why should I get therapy when that might mean one less space for someone who is dealing with trauma or poverty or something else that gives them a "right" to be depressed? This causes a feedback loop of guilt leading to more depression and vice-versa.

Like I tell my kids, it's normal to sometimes feel depressed or hopeless. If you're dealing with a difficult circumstance then it's reasonable to have those feelings, and the only way to address those feelings is to deal with the circumstance. What's not normal is feeling depressed and hopeless for no logical reason at all.

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

#278
post #254

Earlier quoted context omitted.

I know several depressed people that exercise every day and live in a clean house.

That's unfortunate. Ask they why they are depressed and see if there is any way to fix it.

You think they don't ask themselves that question all day, every day?

reddit.com/r/thanksimcured

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

#279

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…

[flagged]

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

#280

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.

I had terrible anxiety as a child and what I experienced dramatically affected the core of who I am. It is engrained in me and I struggle with it daily, though after decades I have surpassed a good portion of it. If a small dose can help someone have a somewhat "normal" childhood, then its worth a try.
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