[shswkna]

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]

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.

[Modified3019]

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.

[fragrom]

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.

[pixelready]

Finding everyone’s cow is expensive and time consuming: 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.

[squishington]

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.

[shswkna]

Yes, this is what happens.

[kayodelycaon]

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.

[EB66]

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]

That sounds like mania which is even more likely considering that early depression is often actually bipolar.

[ekianjo]

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]

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]

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/

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.*