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Comment by staticman2 | Hacker News Reader

I've seen a post like this before on reddit.

We know SSRI's really do cause permanent sexual dysfunctional in a small minority of people, small enough that this side effect doesn't come up in traditional FDA tests.

If a side effect is extremely rare it would be impossible or at least impractical to prove in a population.

Grandparent could be right or wrong about how the drug affected them, maybe their brain suffered from other issues and the timing of the medications was purelycoincidental, but if they are correct, your dismissive response is exactly what we'd expect given when they are saying sounds unusual/ improbable.

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> If a side effect is extremely rare it would be impossible or at least impractical to prove in a population.

This is also true for a non-existent side effect. I’m not trying to tell GP he is wrong, just that from a reader’s perspective, extraordinary claims require extraordinary evidence.

This isn't a good fit for the phrase "extraordinary claims require extraordinary evidence."

Grandparent's report is hard to verify, not extraordinary.

These drugs are approved based on statistical safety profiles in limited trial populations, not on a scientific consensus that absolutely nobody on Earth will ever experience a unique adverse reaction.

Also, I never said that you, the reader, had an obligation to change your worldview based on Grandparent's report.

Millions of people take SSRIs on a daily basis without these dramatic symptoms. Millions more tried them (for much longer periods than 5 days) and then desisted from treatment without major lifelong mental alterations. So yes, I would say GP’s experience is ‘extraordinary’, i.e., outside of the ordinary expectation

How did you determine that "Millions more tried them... and then desisted from treatment without major lifelong mental alterations"?

Someone literally just told you this happened to them, and your reaction was "I don't believe you," followed by a confident statistic you apparently invented.

Do you think if one person in a million took a drug and had their emotional system altered, a siren would go off? That the TV would be interrupted by an all-seeing oracle declaring a medical anomaly?

If a rare side effect occurs, it looks exactly like this: scattered individuals complaining on the internet.

You're misapplying the Carl Sagan popularized aphorism "extraordinary claims require extraordinary evidence" and apparently think the meaning of an aphorism can be determined by looking up one of the keywords in the dictionary, rather than, say, the Wikipedia article on the aphorism itself.

> How did you determine that "Millions more tried them... and then desisted from treatment without major lifelong mental alterations"?

We have lots of public data on SSRI usage (20+ million in the US alone each year) and discontinuation rates. The drugs themselves are decades old and have been through countless trials and studies, and of course there are databases like FAERS that track reports of adverse drug reactions.

Is your assertion that this is false? That in fact the typical SSRI patient is mentally/emotionally crippled by the drug? Doctors and public health agencies are hiding a public health catastrophe to sell genericized pills that cost tens of dollars a month?

Of course severe side effects can and do happen. Doesn’t mean every bad thing that happens to a person who happened to take SSRIs for a few days should be taken as a big cautionary tale.

Please engage in good faith.

I asked you how you determined "Millions more tried them... and then desisted from treatment without major lifelong mental alterations"?"

I took that to mean you were confident 0 out of several million people had lifelong alterations.

Any other interpretation of what you meant would suggest you are not responding to anything I wrote and simply writing non sequitors.

It seems to me you said something indefensible (0 out of 1 million people had permanent damage, there is no possibility you have data to show this) and are now trying to change the subject to something less insane (the typical patient has no permanent harm?)

Since PSSD wasn't recognized until 2019 I know you are full of hot air in suggesting if these drugs caused unusual problems we'd know about it by now:

https://www.psychologytoday.com/us/blog/side-effects/201906/...

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