Too many “You this’s” and “You that’s.” I am not the subject here. Rather than speculate about what I think, I suggest asking me, if necessary. However, I would prefer an impersonal exchange of ideas.

I find this to be a standard ploy when I express skepticism about antidepressants. The issue shifts away from antidepressants to the more crucial questions of how open-minded I am and what my issues are.

Been handling car trouble…

Yes, I’ve run across that reasoning before. I suppose it has its merits, but I ask a cost-benefit-risk question. Does a few points better than placebo justify the costs of the treatment, the many known side-effects — some substantial — and the risks of long-term usage, for which SSRIs were never tested nor were intended?

I know people who’ve been on SSRIs since the 90s. They’ve given up trying to get off them. I think that counts for something.

If SSRIs worked for depression as well as antibiotics do for infections, that would be a different calculation. But they don’t.

I’m reminded of the all the masking and social distancing for Covid. Sure, there are studies showing they are marginally effective. But the larger questions of trade-offs were mostly not asked and those who did ask were often stigmatized.

I don’t believe the science is nearly as settled as SSRI advocates portray.

https://www.youtube.com/watch?v=bKaVI-IStNE
“Why doesn’t English have genders? Well… it did!”

Um, but what if they’re NOT “messing up”?
That is, what if they’re “messing up” intentionally?
That is, what if there’s a reason to this seeming “madness”, a purpose for this seeming “incompetence”?

…which questions are certainly nothing new…falling, as they do, under the by-now-well-known rubric of “When is a ‘conspiracy theory’ NOT a conspiracy theory?….

I don’t think we should look to Arnold Kling’s substack for advice on the efficacy of fluoxetine, but neither do I think that his comment discredits everything else he’s ever written. In fact, my impression is that most of his posts are uncommonly clear and carefully composed.

It sounds as if you’ve already made up your mind about fluoxetine and other SSRIs, but if you’re curious about the current standard medical consensus, then you might want to look at the Cochrane Review article entitled “Fluoxetine versus other types of pharmacotherapy for depression” (https://tinyurl.com/2p92bbnj).

The Cochrane Review article makes very modest claims, but accurately assesses current treatment options. On the other hand, if you’ve rejected all pharmacological treatments for depression, this article probably won’t interest you.

P.S. For what it’s worth, my own personal, unscientific view is that fluoxetine is wildly over-prescribed. This has nothing to do with my original comment on the relationship between school closings and race. Unless you’ve found my remarks depressing. You wouldn’t be the first.

I think anti-depressants have been overused. But the fact that they don’t seem much more effective than placebo is true of many many drugs. However, antidepressants do seem to work somewhat better than placebo, generally – although, as with a lot of medical research, it’s hard to design a good experiment and really the jury is still out.

As far as the risk of suicide goes, that’s very hard to examine, too (see this). And more people are depressed to begin with, especially young people.

I don’t know Arnold Kling or EducationRealist, but Kling did such a sloppy, maddening hit job via blockquotes declaiming against those skeptical of SSRIs and the serotonin imbalance theory of depression that I wouldn’t trust anything else he had to say without checking thoroughly.

The issue is that “Nature,” a premier science journal (not without its problems), published an article debunking the conventional view on serotonin and depression:
_____________________________________

The main areas of serotonin research provide no consistent evidence of there being an association between serotonin and depression, and no support for the hypothesis that depression is caused by lowered serotonin activity or concentrations. Some evidence was consistent with the possibility that long-term antidepressant use reduces serotonin concentration.

–“The serotonin theory of depression: a systematic umbrella review of the evidence”
https://www.nature.com/articles/s41380-022-01661-0
_____________________________________

There’s not much science in the criticism. Mostly character attacks against skeptics and much harrumphing that the Wrong Question was being asked and Strawman Attacks!

Kling’s conclusion is basically “The Authorities know what they are doing, so shut up”:
_________________________________

I am willing to bet Bryan that over the next three years, the most credible, high-quality research on depression helps to justify and support pharmacological treatment for it.
_________________________________

Sure, Arnold. Prozac (fluoxetine) was introduced in 1987. They’ve had plenty of time to make their case, but somehow they haven’t gotten around to it. But it’s a lock within three years.

Meanwhile, 13% of Americans have taken an antidepressant in the past month, and usage of antidepressants has increased by 64% from 1999 to 2016: (Antidepressants are mostly SSRI drugs.)

https://www.apa.org/monitor/2017/11/numbers

Yet, the US suicide rate from 2000-2018 increased by 35% (with a modest reduction of 2% in 2019):

https://www.bu.edu/sph/news/articles/2022/us-suicides-are-stagnant-or-on-the-rise-among-many-groups/

Since suicide is often the result of depression, one might suppose that putting one out of eight Americans on antidepressants would reduce, not increase, the suicide rate.

OTOH, suicide is listed as a potential risk of antidepressants. Hmm.

Apparently legit FBI training docs tell you what to look for.
US history, approval of the Constitution heavily represented in the lists …

https://twitter.com/Stambo2A/status/1554569384324104193
https://twitter.com/Stambo2A/status/1554569594450452490

https://www.dailymail.co.uk/news/article-11076011/Bristol-Harbour-festival-white-middle-class.html