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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

#451

Post by heavyset_go »

hintklb wrote: post #185
fgonzag wrote: post #143

Earlier quoted context omitted.

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…

The main issue I see is that the anxiety pill is a way to treat the symptoms, not the cause. Do you think that there is a way to treat the underlying cause and not the symptoms?

Beyond obvious tumors/lesions/clots/abnormalities, we are not even close to being able to identify the cause of organic anxiety or mood disorders even if we wanted to.

We can say certain behaviors, experiences, illnesses and some genetic identifiers can trigger the conditions, but not the underlying cause. We can say things like some therapy and medication can help with the illness, but not the cause.

Not to trivialize therapy, but for many illnesses, not just mental, a portion of it can be described as ways of learning to live with the illness, not necessarily treating the underlying cause.

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

#452

Post by framapotari »

drekipus wrote: post #439
robertakarobin wrote: post #338

Earlier quoted context omitted.

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

I don't give them a walled garden. I let them experience life how they do, and i protect them from predators until they can defend for themselves. (so in this particular situation, maybe highschool / early adult)

From what I understand, some of these predators are knowledge?

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

#453

Post by RickJWagner »

bossyTeacher wrote: post #265
RickJWagner wrote: post #74

Fortunately, there are well documented lifestyle adaptions that can sharply reduce depression. Religion is a good example. https://pmc.ncbi.nlm.nih.gov/articles/PMC3426191/

Swapping one problem for another. Religion sounds like the worst place for someone who is mentally vulnerable. It's like pulling out your credit card in a shopping mall full of salesmen who are under tremendous pressure to make big sales asap

I have seen no studies that suggest such a thing. Hoards of studies suggest religion is good for mental health.

I can be persuaded, though. Can you show research?

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

#454

Post by [deleted] »

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…

[deleted]

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

#455

Post by robertakarobin »

tflol wrote: post #448
robertakarobin wrote: post #394

Earlier quoted context omitted.

My kids go to a ordinary public school. They are very bright, cautious, and thoughtful, and generally pretty happy and upbeat. There is a strong correlation between academic intelligence and mental illness. Being depressed to the point of being suicidal and having a sunny disposition are not mutually exclusive at all. I absolutely agree that it would be disturbing and disappointing for a child to be medicated because…

> My kids go to a ordinary public school. They are very bright, cautious, and thoughtful, and generally pretty happy and upbeat. There is a strong correlation between academic intelligence and mental illness. Being depressed to the point of being suicidal and having a sunny disposition are not mutually exclusive at all. If my parents said this to me the moment I realized what I was on and that I had to deal with comi…

I'm a victim of depression too, and don't think it's fair that you say we "gave up." I would never give up on my child. You imply that we didn't talk to our son, listen to him, and do our best to give him advice before we discussed medication? Don't we all try to make the most well-informed decisions we can?

This decision was made collectively by me, my wife, our pediatrician, the child therapist, the psychiatrist, and for what it's worth also my son. We did extensive research. You may disagree with our decision, but please don't cast aspersions on how much we care.

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

#456

Post by robertakarobin »

directevolve wrote: post #418
jacobgkau wrote: post #113

Earlier quoted context omitted.

Your anecdote has nothing to do with whether it's better than a placebo or not.

The study found the average effect was no different from placebo. It’s plausible, based on anecdotes like the one you’re responding to, that Prozac is harmful for some people, helpful for others, with the expected benefit close to zero. If so, it might be necessary to just try it and see if it’s obviously helping, keep taking if so, stop if not.

This is, in fact, pretty much the exact procedure: try one type of treatment or medication, see if it's obviously helping, and if it isn't try a different treatment or medication. It's imprecise but it's the best we have.

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

#457

Post by robertakarobin »

djtango wrote: post #396
Braxton1980 wrote: post #370

Earlier quoted context omitted.

"why do you feel sad about your girlfriend broke up with you, it happens all the time and you'll probably find someone else" Attitude

I can't tell if you're being sarcastic or not but that is kind of the truth. A breakup is horrible, in its worst case it is similar to an untimely death and can come with grief and maybe even worse because the person is still alive and in your life so you're reminded by their absence even deeper and could experience jealousy, and the drip feed of interaction can elongate the time it takes you to move on with your lif…

Objectively you're right, but I hope you think twice before saying to someone who has experienced a tragedy, "You need to move on." Similarly if you're in an argument with a friend or loved one and they are upset I hope you think twice before saying "You need to calm down" or, "You're overreacting." Objectively those may all be correct, but they are unhelpful, and are likely to have the opposite effect. They minimize the weight of the emotions. Most of us cannot just turn emotions on and off, much as we try and wish we could.

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

#458

Post by robertakarobin »

ggreer wrote: post #339
robertakarobin wrote: post #151

Earlier quoted context omitted.

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 t…

I thought we were talking about long-term effects, i.e. ones that persist to and through adulthood? The sources in that Wiki article appear not to address that.

The clinicians I've interacted with have always warned me of the possible side-effects of psychotropic medications, and said they should be notify immediately if the side-effects appear. I believe this is at least standard procedure, if not legally required?

I do have a low libido. Can't say whether or not that's due to Prozac, but regardless it hasn't negatively affected my life, probably because it was low before I met my wife. If someone enters a relationship while their libido is at one level and then during the relationship it changes considerably then I can certainly see how that could be a major challenge. That's an important thing to weigh when evaluating medication.

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

#459

Post by robertakarobin »

conartist6 wrote: post #411
conartist6 wrote: post #404

Earlier quoted context omitted.

That's what freaks me out about these drugs. You-on-the-pill becomes you, and you can't ever stop.

Sorry, I don't mean to second-guess your choices. There's clearly some very interesting issues here, and my experience is as someone who never felt they had any serious issues with mental health. But I do think that we have this culture where everyone is expected to be OK all the time. Do you worry at all that your son cues in to his parents relationship with the drug? I mean, say it was me, and I knew my parents too…

Prozac doesn't define me. It's just something I take to address a health condition, like an iron supplement for low iron levels or amoxicillin for strep throat. My kids learned about it because they saw me taking a pill every day and asked what it was. No biggie.

To be clear, Prozac is not a "feel-good" pill, it's a "gradually feel more stable" pill. It makes my lows less debilitatingly low and more manageable -- my lows are now largely logical responses to difficult events, as opposed to randomly happening for no reason at all. The effect is very gradual and subtle: you can't really evaluate it until after several weeks, and then the "evaluation" is a conversation about whether your affect has seemed generally more stable recently. An average person taking Prozac would probably notice no effect at all, good or bad. By contrast, a stimulant like Adderrall will have a noticeable effect on anyone within minutes.

My son never asked for Prozac or for a "feel-good" pill. My kids have heard of addiction before so we've talked about pills that do make you feel good and why they're dangerous, and also "dopamine drips" like brainrot on YouTube.

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

#460

Post by biff1 »

robertakarobin wrote: post #456
directevolve wrote: post #418

Earlier quoted context omitted.

The study found the average effect was no different from placebo. It’s plausible, based on anecdotes like the one you’re responding to, that Prozac is harmful for some people, helpful for others, with the expected benefit close to zero. If so, it might be necessary to just try it and see if it’s obviously helping, keep taking if so, stop if not.

This is, in fact, pretty much the exact procedure: try one type of treatment or medication, see if it's obviously helping, and if it isn't try a different treatment or medication. It's imprecise but it's the best we have.

The problem is that taking certain psychotropic medications changes your brain chemistry. It’s not as simple as it sounds. It’s not like trying on shoes. The brain is dynamic and drugs alter it, as does life experience, talk therapy, disease, aging, etc…
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