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206 points pseudolus | 24 comments | | HN request time: 1.88s | source | bottom
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robertakarobin ◴[] No.46008748[source]
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 same time went, "Ohhhh!" Mom was shocked that we'd noticed such a difference in her behavior and started taking the medication again.

I've been on the exact same dose as her for 15 years, and my 7-year-old son just started half that dose.

If I have a good day it's impossible to day whether that's due to Prozac. But since starting Prozac I have been much more likely to have good days than bad. So, since Prozac is cheap and I don't seem to suffer any side effects, I plan to keep taking it in perpetuity.

What I tell my kids is that getting depressed, feeling sad, feeling hopeless -- those are all normal feelings that everyone has from time to time. Pills can't or shouldn't keep you from feeling depressed if you have something to be depressed about. 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 -- and that's called Depression, which is different from "being depressed."

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techietim ◴[] No.46008941[source]
> my 7-year-old son just started half that dose

This is horrifying.

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1. potatocoffee ◴[] No.46008992[source]
Why?
replies(1): >>46009017 #
2. jacobgkau ◴[] No.46009017[source]
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.
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3. potatocoffee ◴[] No.46009065[source]
O cool. Do you have any appointments I can book for my kid?
replies(1): >>46009161 #
4. pyth0 ◴[] No.46009085[source]
How can you believe it's both "no better than placebo" but also that it's "going to have his brain chemistry altered and essentially be addicted to a drug". SSRIs are not considered addictive, though people can develop a dependence if it provides them significant improvement.
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5. jacobgkau ◴[] No.46009119{3}[source]
A drug can have real effects while being no better than a placebo for doing something specific (what they're supposed to do).
replies(1): >>46009189 #
6. fgonzag ◴[] No.46009161{3}[source]
Mine too! Only 2 years old but I can already see the massive anxiety bursts in him.

If this guy has a non chemical cure, I'm all for it. In fact I'm actively researching children psychologists to stave off the meds as much as we can, the problem is that 99% of psychologists are quacks, so choosing them is tough.

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7. robertakarobin ◴[] No.46009175[source]
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 topping out at 5'10" and never hitting 6' like my dad. :)
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8. pyth0 ◴[] No.46009189{4}[source]
Okay, so what makes you believe that about prozac (or SSRIs) then?
replies(1): >>46009731 #
9. potatocoffee ◴[] No.46009363{4}[source]
There's only so many times a kid can get sent home from school for biting/kicking/punching before you realize you need some professional help and will do anything to help the poor kid. I wish you luck.
10. ckw ◴[] No.46009589{3}[source]
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...

The fact that you were not informed about this should serve as proof that you cannot blindly trust what doctors tell you. They will absolutely kill you out of ignorance or incompetence, and never even realize their responsibility.

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11. jasonfarnon ◴[] No.46009657{3}[source]
The whole point of the linked article is that the drug is no better at placebo at treating depression but also carries a host of known side effects, besides unknowns when it comes to long term use. They're not saying it's inert.
12. ckw ◴[] No.46009731{5}[source]
Here’s a paper from last year: The nature and impact of antidepressant withdrawal symptoms and proposal of the Discriminatory Antidepressant Withdrawal Symptoms Scale (DAWSS) https://doi.org/10.1016/j.jadr.2024.100765

‘Highlights

• Antidepressant withdrawal can be severe and protracted.

• It produces characteristic physical and emotional symptoms.

• All symptoms were more severe after stopping than before starting antidepressants.

• We identified the 15 most discriminatory withdrawal symptoms in our sample.

• Withdrawal did not differ between people with physical or mental health diagnoses.’

13. ksenzee ◴[] No.46009800{4}[source]
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.

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14. wredcoll ◴[] No.46009941{4}[source]
This is such a blatant misrepresentation of the parent post that it feels almost bad faith.

The subject was specifically about long term brain chemistry changes.

People committing suicide after taking it, while incredibly sad, is completely unrelated.

replies(1): >>46010472 #
15. ryandrake ◴[] No.46009988{5}[source]
I'll raise my hand in agreement. This thread is definitely one of the most disturbing sub-threads I've ever read on HN.
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16. ksenzee ◴[] No.46010026{6}[source]
It’s disturbing that a seven-year-old was treated for suicidality? Or it’s disturbing that people are opposed to such treatment?
17. ckw ◴[] No.46010116{5}[source]
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 dyskinesia).

Another edit: ask GPT-5 ‘What are the long term side effects of Prozac use which aren’t addressed in the package insert?’ for a list.

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18. robertakarobin ◴[] No.46010239{4}[source]
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.
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19. opo ◴[] No.46010413{3}[source]
I appreciate how open and honest you have been in this discussion. While it might be that taking Prozac is the best choice for your child, I have to admit I would never let a pediatrician prescribe Prozac (or any other SSRI) - this is enough outside their normal training, I would want to consult with a specialist. Can't you get a referral to a pediatric psychiatrist of some sort?
20. ckw ◴[] No.46010472{5}[source]
There is no effect which is more long term than death. It is incredible to me that this is not obvious. But if you want other potential long term effects:

Lower bone mineral density, increased risk of fractures, osteoporosis

Sexual dysfunction / PSSD (Post-SSRI Sexual Dysfunction)

extra pyramidal symptoms (akathisia, Parkinsonism, dystonia, tardive dyskinesia)

emotional blunting / apathy

slowed thinking, brain fog

increased risk of gastrointestinal bleeding

QT prolongation

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21. ckw ◴[] No.46010709{5}[source]
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.

22. robertakarobin ◴[] No.46010851{6}[source]
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 same medication? That's a far cry from committing to forcing him to take the medication his whole life, or trying some mystery drug with which I have no familiarity.
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23. ksenzee ◴[] No.46011243{6}[source]
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.
24. ckw ◴[] No.46011311{7}[source]
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 twenties my depression lifted and never returned. I look back on my life, which has been filled with hardship, and I feel positively disposed to the suffering. The suffering made me who I am. I feel strongly that my character would be diminished had I not experienced it.

On the other hand, I watched family members take these drugs, and their lives seem somehow dulled-- filled with banal tragedy, like staying in a bad marriage, or not being particularly interested in their grandchildren. I have a theory that the drugs make palatable that which otherwise wouldn't be, hence they stay in the bad marriage, the bad job, and they watch their bad TV and eat their bad food and everything is fine. I've also seen one of them go off the drugs, and for a couple months they were a much more vibrant person. I saw them express joy. I feel a low grade rage toward the industry that I've been deprived of this version of them. I do entertain the possibility that I'm imagining it all. Maybe things really would have been worse without the drugs. But I am glad no one ever insisted, or even strongly advocated I take them myself.