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

theguardian.com

331–340 of 561 posts

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

#331

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…

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Did you stop reading before he described the extensive consultations with the pediatric psychologist?

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

#332
post #312

Earlier quoted context omitted.

I, like every other person who hasn't been living under a rock, am abundantly aware of corruption in Big Pharma and medicine. If my mother and I have both taken a given well-known medication for decades and found it effectively treated a condition that may be hereditary with no negative side effects, and my son is demonstrating symptoms similar to mine and my mother's, is it unreasonable to tolerate my son trying the…

My deepest views on this subject are personal, subjective, and more controversial. I have watched several family members take antidepressants for upwards of four decades, and I myself suffered terrible depression throughout my childhood and teenage years. Despite my depression, I always avoided antidepressants for some ineffable reason-- a hunch, a nebulous suspicion, I'm not sure what to call it. Somewhere in my mid…

To be clear, nobody ever insisted or strongly advocated that I take medication — suggested maybe, but it was entirely my decision. And I completely agree about the importance of hitting "rock bottom." That's something I struggle with as a parent: wanting to make sure my kids have plenty of opportunities to fail, yet fail in a way that isn't irreversibly damaging. If at rock bottom I had simply killed myself rather than starting Prozac I wouldn't be around to have benefited from it.

A large part of me dislikes being on any sort of medication long-term, and think most people have the same dislike. I have gone off of Prozac a few times and always found that I gradually became frustrated and depressed again, and as you said the reason for the dislike is ineffable, so I chose to go back on. I'm fortunate to have a life with no bad marriage, no bad job, and very little trauma at all, which is also unfortunate since it means despite years of therapy and introspection and travel and hobbies and other varied experiences I've never been able to find any cause for the depression and therefore no way to fix it, other than medication. It makes me think of Captain Picard: "It is possible to commit no mistakes and still lose. That is not a weakness; that is life."

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

#333
post #160

Earlier quoted context omitted.

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Not that I agree or disagree with the underlying claim but a call to "credentialism" to dismiss someone's opinion is not as strong in 2025 as you think it is. The last few years have been a proof that even the "experts" are following strong political or personal ideology. Also we don't live in the 18th century anymore. A lot of knowledge (especially around medicine) is open to the world. People can read papers, under…

> People can read papers, understand research etc.

Then he should cite the papers, point out the research, etc. Rather than dismissing the entire discipline and all its practitioners with a wave of the "common-sense mental illness isn't real" wand.

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

#334

Earlier quoted context omitted.

This just reads as Dunning Kruger-esque to me. You think that because you know how to read a technical paper in engineering, you're as or more competent than a doctor. Yes, experts are wrong all the time, they have the disability of being human, but this seems like an extremely anti-intellectual take.

sorry but your take seems to be the anti-intellectual here. You seem to think that the educated class got a monopoly on knowledge on that field, yet after that claim to know that experts are wrong all the time. The anti-intellectual take is to give up on trying to understand as much as you can in a field because you don't have the right credentials to do so. Yes, medical papers are not that complicated to read. That…

Nobody who seriously read and understood the literature in a given field would issue a blanket dismissal of all the experts in that field. My experience is that reading papers and research leads one to understand WHY the professionals get it wrong - because you start to understand the nuances.

I'm not saying you issued such a dismissal, but the comment that started this thread did so.

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

#335

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During my first manic episode I was handed sertraline. This pushed the mania full send and I lost a lot of time that I can't account for, things I did I can't remember but friends have recalled. Climbing the house to get in through the upstairs window whilst having the house key on me. Locking myself in my room for a week or two convinced I was the real world John Connor and Arnie was looking for me. Blowing all my s…

> I'm terrified of SSRIs now.

Surely the massive amounts of cocaine and MDMA bear some responsibility.

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

#336
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…

I suspect the biggest, but not the only, problem with these supposedly weak SSRI/SNRI numbers we routinely see in clinical trials has to do with the definition of depression, with the diagnosis itself. For example it has some of the worst inter-rater reliability across the entire DSM (meaning that two doctors are least likely to both reach the same diagnosis in the same patient independently). So if you start from a poorly defined set, which likely encompasses some genuine affective disorders, people going through difficult times, undiagnosed personality disorders, dysthymic ADHDers, burned out ASDs, and God knows who else - yeah, you'll get poor performance data. Every psychiatrist knows intuitively that SSRIs/SNRIs do work, even if you have to trial a few. Also, without arguing about the number, that 15% is not exactly the same 15% for each drug.

Also, since we're here: the secret knowledge about depression (and affective disorders in general) is that it is an episodic illness, where episodes are measured in weeks or in months. Most people experience just one episode which will end whether or not any medical intervention is undertaken, although the intervention can greatly shorten the course and avoid a potential suicide. But some will not stop at one episode, and can go on to have multiple episodes, perhaps develop melancholic features or even suffer from a lifelong recurrence. It is in the latter groups where medication is the most effective.

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

#337

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…

> Pills are for people who feel depressed but don't have something to be depressed about -- they have food, shelter, friends, opportunities to contribute and be productive, nothing traumatic has happened, but they feel hopeless anyway This warrants a whole different discussion, and I'll be down voted for it, but one that's never addressed: quality over quantity. Pills are the individuals response to a society that fe…

> I cured it by finding meaning and beauty in the world.

That's incredibly fortunate and I'm very jealous of you. How would you recommend one goes about finding meaning and beauty? I'm fortunate to have had lots of unique experiences and traveled to lots of unique places and still haven't found the fulfillment that you seem to. That's basically what depression is: a debilitating feeling of lack of fulfillment, without any idea of what's missing.

I'm happiest when busy building and fixing things. It could be that if I was born 200 years ago into an agrarian society where day-to-day life was focused on building and fixing things to survive, then I would have felt very fulfilled and done quite well. What were gainful full-time jobs back then have been reduced to hobbies now, though: blacksmithing, cobbling, weaving, hunting, making furniture, etc. Hobbies don't fill the hole for me. Sure, a few artisans are still able to turn those into a living, but a large part of the job is marketing and the clients are largely the wealthy elite. I've enjoyed working in food service and construction but it's hard to support a family of 4 doing those. So my career has been in software engineering since that involves building and fixing and pays well, but it still doesn't fill the hole.

If this sounds whiny I'm painfully aware. What right do I have to complain about feeling unfulfilled when there are real problems in the world? And that's the very essence of major depression.

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

#338

Earlier quoted context omitted.

With both my kids in 2nd grade and my wife also a public 2nd grade teacher, I consider myself pretty aware of what kids are being taught these days. They certainly are being gradually introduced to some of the problems of the world, but I think childhood development experts would all agree that's healthy. As for them being told they're the source or victim that's hardly the case. I'm sure there are a few isolated inc…

> but I think childhood development experts would all agree that's healthy. Could it be that we think it's healthy because we can just give meds to the kids that it affects? How would someone even have the ability to say "it's healthy" - I'm struggling to think how it comes about. I think it's healthy for my kids to cry about a worm dying in the garden, but anything less than "anxiety about a dying planet"... Put it…

At what age will you permit your kids to leave the walled garden you've created for them?

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

#339

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.

According to our pediatrician there are no known long-term effects of juvenile Prozac use. The effects may exist, but if they do they are of sufficiently low significance as to not have been detected yet. Interestingly the one possible effect she's aware of is that there may be a correlation with not growing as tall physically as one might otherwise. The data is not conclusive, but it gives me something to blame for…

Your pediatrician is either mistaken or lying. Children and adolescents who take SSRIs for major depressive disorder show increased rates of suicidal ideation, suicidal behavior, and hostility towards others. These effects persist for at least 9 months after starting SSRIs.[1]

Common side effects of long-term SSRI use in adults include weight gain, emotional numbing, loss of libido, and sexual dysfunction. It seems to me that anyone taking SSRIs when their brain is still developing would be more likely to have these side effects, and to have them persist after ceasing use.

It's anecdotal, but I know some people who were prescribed SSRIs during puberty. It's not possible to know how they would have turned out if they hadn't taken these drugs, but as adults I pity them. Their lack of sex drive causes relationship problems, which is especially sad since they do want children. They're starting to get older, so I doubt it'll ever happen.

1. https://en.wikipedia.org/wiki/Selective_serotonin_reuptake_i...

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

#340
post #122
post #2

From the article: > They can also increase suicidal ideation. A very close family member committed suicide, after Prozac dosage adjustments made his brain chemistry go haywire. This happened 30 years ago, and it has been known to us that Prozac can cause this, since then. The Guardians headline is way, way understating the real situation here.

I also had a close family member who committed suicide shortly after going on Prozac -- this also happened nearly 30 years ago. His young son later went on Prozac himself (several months after his fathers suicide) and immediately started demonstrating bizarre disinhibited anti-social behavior (e.g., damaging property, stealing from friends, etc). He was immediately yanked off Prozac when he started articulating his o…

That sounds like mania which is even more likely considering that early depression is often actually bipolar.
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