Comment by ggreer | Hacker News Reader

Comment by ggreer | Hacker News Reader

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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 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...

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.

In addition to the increased rates of suicidal behavior and aggression in children (which we know lasts for at least 9 months, but don't know if it's longer because the study only ran for that long), the Wikipedia article talks about long term effects in adults, at least one of which you have. Why should it be less likely for children to end up with these same issues?

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.

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