5 ms·

From the article: > They can also increase suicidal ideation. A very close family member committed suicide, after Prozac dosage adjustments made his brain che

by shswkna 10mo ago

From the article: > They can also increase suicidal ideation. A very close family member committed suicide, after Prozac dosage adjustments made his brain chemistry go haywire. This happened 30 years ago, and it has been known to us that Prozac can cause this, since then. The Guardians headline is way, way understating the real situation here.

carsoon 10mo ago
The problem with suicidal depression is that if someone has created the thought pattern that death is best, then removing the symptoms of depression (lethargy, lack of energy, no willpower) now gives the person the ability to actually follow through with the act. Medications almost always target symptoms and never address root causes.
- shswkna 10mo ago
  Yes, this is what happens.
  - kittensmittens5 10mo ago
    No it's not.
- kittensmittens5 10mo ago
  [flagged]
- kayodelycaon 10mo ago
  Yup. Depression medication can significantly help the emotional symptoms, but that takes longer to be effective. I’m bipolar and a lot of the medication I take does not become fully effective for months. For me, my medication slowly became more effective over years as my brain no longer had to compensate for hardware problems.
- fragrom 10mo ago
  This is what my psychiatrist more or less warned me about when I went on medication; that a lot of people who are suicidal lack the energy and ability to plan their suicide, and medications can sometimes undo those particular symptoms and people manage to end themselves. I'm not sure what kinds of studies have been done about it, but I've had a few therapists same similar ideas. If it's not a studied phenomenon, then it has folks that believe it exists.
  - doubled112 10mo ago
    Sometimes willpower improves before mood.
  - autumnstwilight 10mo ago
    I'd like to make the point that even if this does occur, it doesn't mean, "therefore this medication shouldn't be used/is worse than doing nothing," just that awareness and caution is needed. I went through a frankly terrible few months on my current meds because they removed the emotional numbness before removing the bad feelings. However, once that was over they effectively gave me my life back after 10+ years of continual exhaustion and brain fog.
    - deleted 10mo ago
      [deleted]
  - DANmode 10mo ago
    [flagged]
    - DANmode 10mo ago
      This gets even more interesting when you realize many SSRIs are antibacterials.
      - JumpCrisscross 10mo ago
        It gets less interesting when one notices that social animals are much more prone to depression. Inflammation and depression are linked. Infection causes inflammation. It doesn’t follow that depression is caused by infection.
- pixelready 10mo ago
  Finding everyone’s cow is expensive and time consuming: https://antidepressantcow.org/2020/02/the-story-of-the-antidepressant-cow https://antidepressantcow.org/2020/02/the-story-of-the-antid... But is the only true cure to the suffering. We’d have to undergo a massive reorganization of society (and upset a few hefty profit margins) to prioritize that, so we settle for the messy symptom management we have.
  - deleted 10mo ago
    [deleted]
  - cornstalks 10mo ago
    That story doesn’t work for people with depression who otherwise have very good lives. I grew up in a stable household with a loving family and both parents present and supportive. I’ve never had financial hardship, either as a kid depending on my parents to provide or as an adult providing for myself and family. I did very well in school, had plenty of friends, never had enemies, never got bullied or even talked bad about in social circles (so far as I know…). I have no traumatic memories. I could go on and on, but despite having a virtually perfect life on paper, I have always struggled with depression and suicidal ideation. It wasn’t until my wife sat down and forced me to talk to a psychiatrist and start medication that those problems actually largely went away. In other words, I don’t think there’s a metaphorical “cow” that could have helped me. It’s annoying we don’t understand what causes depression or how antidepressants help, and their side effects suck. But for some of us, it’s literally life saving in a way nothing else has ever been.
    - hirvi74 10mo ago
      First of all, I want to write that I am glad you found something that worked so that you are able to remain here with us. Though, I am curious about the, "otherwise have very good lives" part. Whose definition are you using? It seems the criteria you laid out fits a "very good life" in a sociological sense -- very important, sure. You could very well have the same definition, and perhaps that is what I am trying to ask. Would you say you were satisfied in life? Despite having a good upbringing, were you (prior to medication) content or happy? I am by no means trying to change your opinion nor invalidate your experiences. I just struggle to understand how that can be true. As someone that has suffered with deep depressive bouts many times over, I just cannot subscribe to the idea that depression is inherently some sort of disorder of the brain. In fact, I am in the midst of another bout now. One that's lasted about 3 or so years. To me, I have always considered emotions/states like depression and anxiety to be signals. A warning that something in one's current environment is wrong -- even if consciously not known or difficult to observe. And if anyone is curious, I have analyzed this for myself, and I believe the etiology of my issues are directly linked to my circumstances/environment. > I don’t think there’s a metaphorical “cow” that could have helped me. The smart-ass in me can't help but suggest that maybe medication was your cow?
- squishington 10mo ago
  My understanding is that the optimal scenario is taking an SSRI in combination with therapy. The SSRI adds flexibility for the brain to respond to therapy and envisage new possibilities. If you don't include therapy, you've just established a new baseline to habituate to.
  - tsimionescu 10mo ago
    This is true overall, but it only works for a limited set of patients. It's pretty likely that what we're calling depression is a different set of diseases that manifest with common symptoms, and SSRIs + therapy work wonders for some variants, but not others. In fact, we actually do know this to be the case already: bipolar disorder also manifests with the same symptoms as depression for some time, and SSRIs + therapy are definitely not enough to treat bipolar disorder. Most likely there are other similar diseases that present with depressive symptoms that we have yet to identify distinctly and don't know how to treat effectively.
- Modified3019 10mo ago
  This is a good thing to know, but should also be noted that the same thing can happen with simply naturally recovering from a depressive episode. The phenomenon should not be considered a reason to not medicate (which I don’t think you are implying, but some may take that as the conclusion). Instead it’s definitely something important to explicitly make people aware of. Depression or the feeling so much mental agony that the idea of escaping with death becomes comforting, is a signal that something is wrong. Realizing this has been important with weathering my own occasional dealings with severe[0]depression, once I realize “something is wrong”, I can start the annoyingly slow process of trial and error making changes to correct things. This turns depression from “how reality is” into “this is just feedback on my body’s state”. It turns things getting worse into either a “this is either a transient state or the wrong solution”. [0] Which I define as the point where any passive ideation (fantasies of dying) starts to enter the gradient of becoming involuntary. As opposed to regular negative thoughts which can (and should) be brushed away as easily as a fly landing on me. Curiously, once I noticed it also affected my ability to experience color. While I could technically see colors, it was like have a mental partial greyscale filter because there was no beauty in it, color was just a meaningless detail.
  - jdietrich 10mo ago
    A sudden improvement in mood is one of the key warning signs for suicide. Often it's genuinely just a sudden improvement, but sometimes it is a byproduct of the relief people experience when they commit to ending their life. If you know someone who is severely depressed, you should watch them very carefully if they suddenly seem carefree. >once I noticed it also affected my ability to experience color A small amount of evidence does support the notion that depressed people literally see the world as being less vibrant. https://pubmed.ncbi.nlm.nih.gov/34689697/ https://pubmed.ncbi.nlm.nih.gov/34689697/ https://cdnsciencepub.com/doi/10.1503/jpn.200091 https://cdnsciencepub.com/doi/10.1503/jpn.200091
ekianjo 10mo ago
Suicidal ideation is a risk for many CNS drugs, and not unique to Prozac as far as I know. But yes this is a major risk factor that needs to be taken in account before such kind of treatments.
EasyMark 10mo ago
Isn't that a possibility with a lot of drugs though? I think it depends on the rate and not a "does or does not" type of questions. Now if the drug doesn't help more than a placebo that's clearly a huge negative, but if it has a high rate of success vs placebo then they will make adjustments and watch out for the side-effect (of course) letting patients know it's a possibility and to report if it starts happening.
salemh 10mo ago
The efficacy of anti-depressants has been consistently over-inflated, so generations were poisoned with side-effects: suicidal ideation, homicidal tendencies, etc. https://pubmed.ncbi.nlm.nih.gov/20616621/ https://pubmed.ncbi.nlm.nih.gov/20616621/ Results: Meta-analyses of FDA trials suggest that antidepressants are only marginally efficacious compared to placebos and document profound publication bias that inflates their apparent efficacy. These meta-analyses also document a second form of bias in which researchers fail to report the negative results for the pre-specified primary outcome measure submitted to the FDA, while highlighting in published studies positive results from a secondary or even a new measure as though it was their primary measure of interest. The STARD analysis found that the effectiveness of antidepressant therapies was probably even lower than the modest one reported by the study authors with an apparent progressively increasing dropout rate across each study phase.*
EB66 10mo ago
I also had a close family member who committed suicide shortly after going on Prozac -- this also happened nearly 30 years ago. His young son later went on Prozac himself (several months after his fathers suicide) and immediately started demonstrating bizarre disinhibited anti-social behavior (e.g., damaging property, stealing from friends, etc). He was immediately yanked off Prozac when he started articulating his own thoughts of suicide. The bizarre anti-social behavior improved after discontinuing Prozac. For some people, Prozac is a very dangerous drug. It is fully deserving of its FDA black label warning (which it didn't have 30 years ago).
- slaymaker1907 10mo ago
  That sounds like mania which is even more likely considering that early depression is often actually bipolar.
  - deleted 10mo ago
    [deleted]

by shswkna 10mo ago

carsoon 10mo ago

The problem with suicidal depression is that if someone has created the thought pattern that death is best, then removing the symptoms of depression (lethargy, lack of energy, no willpower) now gives the person the ability to actually follow through with the act. Medications almost always target symptoms and never address root causes.

shswkna 10mo ago
Yes, this is what happens.
- kittensmittens5 10mo ago
  No it's not.
kittensmittens5 10mo ago
[flagged]
kayodelycaon 10mo ago
Yup. Depression medication can significantly help the emotional symptoms, but that takes longer to be effective. I’m bipolar and a lot of the medication I take does not become fully effective for months. For me, my medication slowly became more effective over years as my brain no longer had to compensate for hardware problems.
fragrom 10mo ago
This is what my psychiatrist more or less warned me about when I went on medication; that a lot of people who are suicidal lack the energy and ability to plan their suicide, and medications can sometimes undo those particular symptoms and people manage to end themselves. I'm not sure what kinds of studies have been done about it, but I've had a few therapists same similar ideas. If it's not a studied phenomenon, then it has folks that believe it exists.
- doubled112 10mo ago
  Sometimes willpower improves before mood.
- autumnstwilight 10mo ago
  I'd like to make the point that even if this does occur, it doesn't mean, "therefore this medication shouldn't be used/is worse than doing nothing," just that awareness and caution is needed. I went through a frankly terrible few months on my current meds because they removed the emotional numbness before removing the bad feelings. However, once that was over they effectively gave me my life back after 10+ years of continual exhaustion and brain fog.
  - deleted 10mo ago
    [deleted]
- DANmode 10mo ago
  [flagged]
  - DANmode 10mo ago
    This gets even more interesting when you realize many SSRIs are antibacterials.
    - JumpCrisscross 10mo ago
      It gets less interesting when one notices that social animals are much more prone to depression. Inflammation and depression are linked. Infection causes inflammation. It doesn’t follow that depression is caused by infection.
pixelready 10mo ago
Finding everyone’s cow is expensive and time consuming: https://antidepressantcow.org/2020/02/the-story-of-the-antidepressant-cow https://antidepressantcow.org/2020/02/the-story-of-the-antid... But is the only true cure to the suffering. We’d have to undergo a massive reorganization of society (and upset a few hefty profit margins) to prioritize that, so we settle for the messy symptom management we have.
- deleted 10mo ago
  [deleted]
- cornstalks 10mo ago
  That story doesn’t work for people with depression who otherwise have very good lives. I grew up in a stable household with a loving family and both parents present and supportive. I’ve never had financial hardship, either as a kid depending on my parents to provide or as an adult providing for myself and family. I did very well in school, had plenty of friends, never had enemies, never got bullied or even talked bad about in social circles (so far as I know…). I have no traumatic memories. I could go on and on, but despite having a virtually perfect life on paper, I have always struggled with depression and suicidal ideation. It wasn’t until my wife sat down and forced me to talk to a psychiatrist and start medication that those problems actually largely went away. In other words, I don’t think there’s a metaphorical “cow” that could have helped me. It’s annoying we don’t understand what causes depression or how antidepressants help, and their side effects suck. But for some of us, it’s literally life saving in a way nothing else has ever been.
  - hirvi74 10mo ago
    First of all, I want to write that I am glad you found something that worked so that you are able to remain here with us. Though, I am curious about the, "otherwise have very good lives" part. Whose definition are you using? It seems the criteria you laid out fits a "very good life" in a sociological sense -- very important, sure. You could very well have the same definition, and perhaps that is what I am trying to ask. Would you say you were satisfied in life? Despite having a good upbringing, were you (prior to medication) content or happy? I am by no means trying to change your opinion nor invalidate your experiences. I just struggle to understand how that can be true. As someone that has suffered with deep depressive bouts many times over, I just cannot subscribe to the idea that depression is inherently some sort of disorder of the brain. In fact, I am in the midst of another bout now. One that's lasted about 3 or so years. To me, I have always considered emotions/states like depression and anxiety to be signals. A warning that something in one's current environment is wrong -- even if consciously not known or difficult to observe. And if anyone is curious, I have analyzed this for myself, and I believe the etiology of my issues are directly linked to my circumstances/environment. > I don’t think there’s a metaphorical “cow” that could have helped me. The smart-ass in me can't help but suggest that maybe medication was your cow?
squishington 10mo ago
My understanding is that the optimal scenario is taking an SSRI in combination with therapy. The SSRI adds flexibility for the brain to respond to therapy and envisage new possibilities. If you don't include therapy, you've just established a new baseline to habituate to.
- tsimionescu 10mo ago
  This is true overall, but it only works for a limited set of patients. It's pretty likely that what we're calling depression is a different set of diseases that manifest with common symptoms, and SSRIs + therapy work wonders for some variants, but not others. In fact, we actually do know this to be the case already: bipolar disorder also manifests with the same symptoms as depression for some time, and SSRIs + therapy are definitely not enough to treat bipolar disorder. Most likely there are other similar diseases that present with depressive symptoms that we have yet to identify distinctly and don't know how to treat effectively.
Modified3019 10mo ago
This is a good thing to know, but should also be noted that the same thing can happen with simply naturally recovering from a depressive episode. The phenomenon should not be considered a reason to not medicate (which I don’t think you are implying, but some may take that as the conclusion). Instead it’s definitely something important to explicitly make people aware of. Depression or the feeling so much mental agony that the idea of escaping with death becomes comforting, is a signal that something is wrong. Realizing this has been important with weathering my own occasional dealings with severe[0]depression, once I realize “something is wrong”, I can start the annoyingly slow process of trial and error making changes to correct things. This turns depression from “how reality is” into “this is just feedback on my body’s state”. It turns things getting worse into either a “this is either a transient state or the wrong solution”. [0] Which I define as the point where any passive ideation (fantasies of dying) starts to enter the gradient of becoming involuntary. As opposed to regular negative thoughts which can (and should) be brushed away as easily as a fly landing on me. Curiously, once I noticed it also affected my ability to experience color. While I could technically see colors, it was like have a mental partial greyscale filter because there was no beauty in it, color was just a meaningless detail.
- jdietrich 10mo ago
  A sudden improvement in mood is one of the key warning signs for suicide. Often it's genuinely just a sudden improvement, but sometimes it is a byproduct of the relief people experience when they commit to ending their life. If you know someone who is severely depressed, you should watch them very carefully if they suddenly seem carefree. >once I noticed it also affected my ability to experience color A small amount of evidence does support the notion that depressed people literally see the world as being less vibrant. https://pubmed.ncbi.nlm.nih.gov/34689697/ https://pubmed.ncbi.nlm.nih.gov/34689697/ https://cdnsciencepub.com/doi/10.1503/jpn.200091 https://cdnsciencepub.com/doi/10.1503/jpn.200091

ekianjo 10mo ago

Suicidal ideation is a risk for many CNS drugs, and not unique to Prozac as far as I know. But yes this is a major risk factor that needs to be taken in account before such kind of treatments.

EasyMark 10mo ago

Isn't that a possibility with a lot of drugs though? I think it depends on the rate and not a "does or does not" type of questions. Now if the drug doesn't help more than a placebo that's clearly a huge negative, but if it has a high rate of success vs placebo then they will make adjustments and watch out for the side-effect (of course) letting patients know it's a possibility and to report if it starts happening.

salemh 10mo ago

The efficacy of anti-depressants has been consistently over-inflated, so generations were poisoned with side-effects: suicidal ideation, homicidal tendencies, etc. https://pubmed.ncbi.nlm.nih.gov/20616621/ https://pubmed.ncbi.nlm.nih.gov/20616621/ Results: Meta-analyses of FDA trials suggest that antidepressants are only marginally efficacious compared to placebos and document profound publication bias that inflates their apparent efficacy. These meta-analyses also document a second form of bias in which researchers fail to report the negative results for the pre-specified primary outcome measure submitted to the FDA, while highlighting in published studies positive results from a secondary or even a new measure as though it was their primary measure of interest. The STARD analysis found that the effectiveness of antidepressant therapies was probably even lower than the modest one reported by the study authors with an apparent progressively increasing dropout rate across each study phase.*

EB66 10mo ago

I also had a close family member who committed suicide shortly after going on Prozac -- this also happened nearly 30 years ago. His young son later went on Prozac himself (several months after his fathers suicide) and immediately started demonstrating bizarre disinhibited anti-social behavior (e.g., damaging property, stealing from friends, etc). He was immediately yanked off Prozac when he started articulating his own thoughts of suicide. The bizarre anti-social behavior improved after discontinuing Prozac. For some people, Prozac is a very dangerous drug. It is fully deserving of its FDA black label warning (which it didn't have 30 years ago).

slaymaker1907 10mo ago
That sounds like mania which is even more likely considering that early depression is often actually bipolar.
- deleted 10mo ago
  [deleted]