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Comment by ksenzee | Hacker News Reader

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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> Note that the black box warning has nothing to do with long-term effects of the medication

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.

I respectfully submit you might feel differently about it if your child were suicidal. When someone has to be watching them 24/7 already for fear they'll hurt themselves, the black box warning is a lot less worrisome. SSRIs prevent more suicides by far than they cause. It's that first few weeks where they can have a paradoxical 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 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.

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.

right which is why they are treating the depression (which leads to suicidal tendencies) which is a symptom of depression, with prozac. that's what the prozac is for. to prevent death

Prozac and other SSRIs are proven to cause MORE suicidal tendencies in children.

I'll raise my hand in agreement. This thread is definitely one of the most disturbing sub-threads I've ever read on HN.

It’s disturbing that a seven-year-old was treated for suicidality? Or it’s disturbing that people are opposed to such treatment?

The specific thing they were shocked by was the claim of no long-term effects.

Are you disturbed by that claim? That's what you're raising your hand to.

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