Why?
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...
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.
You are asking for evidence that does not exist because nobody has done good studies on it. That's too high of a bar. There are many drugs and life interventions that we don't have studies on regarding children, but that doesn't mean those things are safe for children. To use an example so ridiculous that we can both agree on it: There are no studies showing long term effects of fentanyl on children. Yet if some parent managed to get a fentanyl prescription for their kid, I think we would both be concerned.
Obviously I'm not implying that giving a child Prozac is as harmful as fentanyl. I'm saying that your line of reasoning proves too much. If someone did get their kid on a dangerous drug, and defended their decision by pointing out that there are no studies on children showing its long term harm, there is nothing you can say to that parent that others in this thread haven't already said to you. That should give you pause.
‘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.
> This is one of the most shocking things I have ever read.
Good grief. I hope you're exaggerating for effect.
What are the long-term effects of suicide?
A 7-year-old kid doesn't understand what suicide really means. Putting them on something that encourages a behavior that they don't understand and has completely catastrophic results isn't a risk I would take with my children.
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.
Are you disturbed by that claim? That's what you're raising your hand to.
'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.
It's horrible that A-Z would illegally market drugs for off-label uses -- I would not disagree for a minute with your reasoning! -- but we retain this "escape hatch" because it is important to patient health
without the off-label "escape hatch," we would not have, for example, the glp-1 class of anti-obesity drugs, or, buproprion for smoking cessation, the most effective drug ever found in its area.
We needed doctors working firsthand with patients, and building "anecdotal" (i.e. case-based) evidence to learn things that really matter on a population level
The subject was specifically about long term brain chemistry changes.
People committing suicide after taking it, while incredibly sad, is completely unrelated.
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
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.
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."
Medication does not remove the need for therapy. If they are stuck in a bad situation and do not have the tools to come out of it, then in therapy they can learn about the tools and techniques.
Medication avoids having that particular day where everything hits rock bottom and the only solution seems to be suicide.
For some people just therapy is not sufficient but need also medication.
Psychiatric illness is something where many people have misunderstandings. Since many people go through depressive episodes, they feel that their experience is the same as others who are facing chronic depression. And since it is not physically visible, it is also hard to empathize with.
No one says you can come out of heart disease or diabetes by just bearing it bravely. Somehow for psychiatric illness people assume that it is something that can be braved out.
Yeah, I did that too, then I took some and I was less goddamn depressed aftwards.
‘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.’
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.