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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

#301

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?

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It’s pretty tough to exercise or clean your house when getting out of bed feels like an insurmountable task.

Depression isn’t like an infection or cancer—it’s a diagnosis based on established criteria, as are most mental disorders. Experts may disagree on diagnosis or treatment, but that doesn’t make it useless.

By that logic, you might as well say autism is caused by avoiding eye contact—since there’s no blood test for it either.

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

#303

Earlier quoted context omitted.

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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> Depression is caused by laziness and anxiety by hopelessness. My kids know that they aren't permitted to be lazy or say they are bored. They don't have anxiety because they have hope despite circumstances.

This sounds horrible. If I weren't depressed or anxious, being told that I wasn't ever permitted to be lazy or say that I was bored would make me so; and, if I were, then being told that I was lazy and hopeless would make it worse.

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

#304
Harvard: "Exercise is an all-natural treatment to fight depression"

https://www.health.harvard.edu/mind-and-mood/exercise-is-an-...

"Seasonal Affective Order, or SAD ... has been linked to vitamin D, otherwise known as the sunshine vitamin, because the skin absorbs it through exposure to sunlight."

https://www.va.gov/washington-dc-health-care/stories/combati...

"Consider adding some of these steps into your daily routine to improve your mood:"

"Spend time outside to get ample vitamin D ... Eat foods rich in vitamin D (salmon, eggs, tuna, etc.) Take vitamin D supplements"

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

#305
post #231

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.

Death is a long term effect. And I am not exaggerating. I did not feel the need to list any of the myriad other potential long term effects because death seemed sufficiently serious. Edit: in case the OP is reading, I should say also that the package insert won’t mention many other potential long term effects addressed in the literature, like extra pyramidal symptoms (akathisia, Parkinsonism, dystonia, tardive dyskin…

It sounds to me like you're saying suicidality in children either doesn't exist, or shouldn't be treated, or should only be treated with talk therapy. If what you're saying instead is "this SSRI is especially dangerous" then ok, you and I just disagree about what information sources are reliable, and that's probably not a difference we can resolve. But if you're saying suicidality in children shouldn't be treated with medication, I'm curious whether you've ever met a six- or seven-year-old who wants to die. It is terrifying. It needs treatment. And talk therapy in children that age is honestly a joke. In the OP's place I would give my child an SSRI without any hesitation.

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

#306
The disclosure section in the cited research article may indicate a financial interest in the authors being able to say that Prozac is not effective:

“ MAH and JM are co-applicants on the RELEASE and RELEASE + trials in Australia, funded by the Medical Research Future Fund (MRFF) and the National Health and Medical Research Council (NHMRC), evaluating hyperbolic tapering of antidepressants against care as usual. MAH reports being a co-founder of and consultant to Outro Health, a digital clinic which provides support for patients in the US to help stop no longer needed antidepressant treatment using gradual, hyperbolic tapering; and receives royalties for the Maudsley Deprescribing Guidelines. JM receives royalties for books about psychiatric drugs, and was a co-applicant on the REDUCE trial, funded by the National Institute of Health Research, evaluating digital support for patients stopping long-term antidepressant treatment. MP and RL have no conflicts of interest to declare.”

I would caution those in this thread who have never seen or treated patients in any psychiatric clinic or hospital let alone a pediatric one to be careful assuming that they have adequate experience to make sweeping judgements on the utility of antidepressants in children.

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

#307
post #94

Earlier quoted context omitted.

> not some true disorder there's a tool on your desk that might help you solve your problem; what does it matter if the problem is an "appropriate response of your body"? so is pain/anxiety/diarrhea

> stems from living a life that is not true to myself and due to countless failed attempts to be someone I cannot never be. If this is their mindset, they might benefit from CBT more than medication. I'm not against SSRI at all. But after taking them for a few months in my 20's, and experiencing how terrible the withdrawal symptoms are when stopping, I'd be very hesitant to ever start up on them again. I remember hav…

I'm the GP of this comment chain. I actually did a 16 week long trial of CBT with a professional where my symptoms were tracked during each week. I actually ended the 16 weeks worse than before I started.

I later learned that CBT can have that effect on people with ADHD, so I attribute that to being a possible explanation.

I still do therapy, but honestly, I think it's a waste of time and money. I predominantly do it for cathartic purposes and so other people/professionals will stop recommending it.

> terrible the withdrawal symptoms are when stopping

I tried one when I was in my early 20s too. I swore I would never take one again. Withdrawals weren't my issue really. It was the clarity I gained after getting off. I realized how awful I was to people around me. I had such blunted emotions, that I basically became devoid of empathy. I also learned that I needed high levels of anxiety to function, which the medication took away from me.

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

#308

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 feeds empty food, bland sterile shelter, fake friends, and meaningless jobs.

The natural human response to a lack of meaning is hopelessness, and this comes from our society. Pills helps individuals cope with continuing the meat grinder just a little while longer.

I had depression, and I cured it by finding meaning and beauty in the world. I get told "if you can cure it without pills, you never really had it" yeah cool, self fullfilling prophecy in that case innit. Can't cure it, because it doesn't exist without meds. It just comes out of "nowhere" and is here to stay.

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

#309

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]

This is a pretty nasty line to double down on.

I hope you can take your personal anecdotes and add them to a larger body of research and other people's experience to refine your understanding. If you're right that everyone who has Depression is actually just lazy, you'll see lots of support for that. If, instead, you find a lot of different experiences you might conclude that Depression is a pretty nuanced and complicated topic, which might both expand your understanding and help you bring more empathy to the suffering people around you.

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

#310

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…

I don't have a problem with reading papers and doing research, and I never once claimed that the "educated class" has or should have a monopoly on a field. You wouldn't know this, but for the first ten years of my career as a software person I was as a college dropout; I certainly am not someone who is going to get all hot and bothered about people having letters after their names.

That said, I have a tough time believing that spending an hour on Sci-Hub makes you better at diagnosis, yourself or otherwise, than someone who spent a decade being educated with decades of practicing. Thinking that you know better than trained experts because you have an understanding of the very beginning of a field is overwhelmingly tempting but is generally not based in reality. Usually the people who have actually been trained in the field know more about the field than a random person who read a few papers that they thought were "comparatively relatively simple".

I read papers all the time, usually formal methods, but sometimes other fields like medicine, and I will sometimes leave the medical paper thinking that it's "easier" than what I study, but I think that's just Dunning Kruger. I know more about formal methods, so I know a lot more about what I don't know, and thus I feel like it's harder. I don't know a ton about medicine, and since I don't know what I don't know it can feel like I know everything, and I have to fight this urge.

By all means, read about research in whatever ailment you have, I'm not really trying to discourage that, but I feel like dismissing experts in the field is almost the definition of "anti-intellectualism". If you find a study that you think is promising, bring it to your doctor. Hell, bring it to a dozen doctors, multiple opinions isn't a bad thing.

I just don't like the general "don't trust experts" thing that seems to be flying around certain circles now.

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