No Evidence That Depression Is Caused By Low Serotonin Levels, Finds Comprehensive Review, UCL

[appalachiablue]

Last edited Tue Aug 2, 2022, 07:11 AM - Edit history (2)

Science Daily. No evidence that depression is caused by low serotonin levels, finds comprehensive review. University College London, July 20, 2022.

The New umbrella review -- an overview of existing meta-analyses and systematic reviews -- published in Molecular Psychiatry, suggests that depression is not likely caused by a chemical imbalance, and calls into question what antidepressants do.

Most antidepressants are selective serotonin reuptake inhibitors (SSRIs), which were originally said to work by correcting abnormally low serotonin levels. There is no other accepted pharmacological mechanism by which antidepressants affect the symptoms of depression.

Lead author Professor Joanna Moncrieff, a Professor of Psychiatry at UCL and a consultant psychiatrist at North East London NHS Foundation Trust (NELFT), said: "It is always difficult to prove a negative, but I think we can safely say that after a vast amount of research conducted over several decades, there is no convincing evidence that depression is caused by serotonin abnormalities, particularly by lower levels or reduced activity of serotonin.

"The popularity of the 'chemical imbalance' theory of depression has coincided with a huge increase in the use of antidepressants. Prescriptions for antidepressants have risen dramatically since the 1990s, with one in six adults in England and 2% of teenagers now being prescribed an antidepressant in a given year. "Many people take antidepressants because they have been led to believe their depression has a biochemical cause, but this new research suggests this belief is not grounded in evidence."...

https://www.sciencedaily.com/releases/2022/07/220720080145.htm

[cstanleytech]

1. I suffer from severe depression brought on by my real life situation that I am trapped in with no

way out that I can realistically see other than 6 feet under and I can tell you that when I tried some of the meds they recommended they did zero to help.

[LittleGirl]

3. I'm so sorry to read this

Situational depression seems so familiar to me. I want to send you hugs.

I took SSRIs for about 18 months. It took several medications to find one that wouldn’t make me throw up or cause weight gain and rage. I stopped taking them cold turkey which my doctor warned me not to do but honestly, they weren’t helping and I had no side effects by stopping. I would not recommend that. My therapist listened well but never taught me how to manage my anxiety at all. I fired her because she was useless but I wasn’t angry, I just told her I didn’t need her anymore.

[douglas9]

2. Who Is the Psychiatrist Behind the Antidepressant Study Taking Over Right-Wing Media?

Last week, a study went viral that was widely promoted as proof positive that everything we know about antidepressants is wrong. Helmed by lead author Joanna Moncrieff, a professor of psychiatry at University College London, the study was an umbrella review of research into selective serotonin reuptake inhibitors (SSRIs), one of the primary medications prescribed to people diagnosed with depression. Though most lay people believe that SSRIs work by increasing serotonin levels in the brain, thereby relieving symptoms of depression, the review of 50 years of studies concluded that there is “no clear evidence” that low serotonin levels cause depression to begin with.

The paper was widely picked up by media outlets in the United Kingdom, with some citing the study as evidence that SSRIs don’t work. It was shared and discussed by Pizzagate promoter Jack Posobiec on his podcast, as well as promoted extensively by far-right commentator and professional transphobe Matt Walsh, who tweeted, “Big Pharma has made billions prescribing wonder drugs to treat depression but there was never any solid scientific evidence that the drugs would work. Now we know that the whole thing was built on a myth.” Tucker Carlson spoke about the study on his show, characterizing it as a rejoinder against taking SSRIs in general. “First we were told that SSRIs would save lives. Now we learn they don’t actually work as intended. In fact, the whole idea behind the drug was completely wrong. And yet, and here is the best part, people are ignoring this news and the drugs are still being prescribed.”

https://www.rollingstone.com/culture/culture-news/ssri-right-wing-attack-joanna-moncrieff-1388067/

[Scrivener7]

6. Wow. That puts a different light on it, doesn't it? Thanks for this.

[reACTIONary]

8. Thanks! A good counter weight...

.... to what might otherwise become sensationalized and incomplete reporting.

[appalachiablue]

12. Tx, interesting, & what's real. Some benefitted, others not. A few on the left also opposed SSRIs.

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The Far Right's Next Target for a Bullshit Moral Panic: Antidepressants

> Contrary to what Carlson claimed, the review wasn’t explicitly a condemnation of antidepressants; rather, it was an interrogation into the mechanism by which SSRIs are thought to work. “We have shown that the main hypothesis for how antidepressants might act on the biological mechanisms of depression is not supported by evidence,” Moncrieff tells Rolling Stone via email. “I see our research as linked with the way we understand and evaluate antidepressants, and it logically follows from my other work on the nature of drug action.”

[Delphinus]

4. Well,

thirty years ago I went through a severe depression. I tried one medication after another until they found an older drug that worked like a charm. I was on it for about four years and was able to go off it. Don't know if it was an SSRI, but it truly saved my life.

[MindHowYouGo]

5. I hate gifts for the right-wing

Not a fan of big pharma and the FDA but I've had depression for 30+ years and sometimes antidepressants work for a while and I welcome those periods of respite.

The paper's key point isn't new, we don't understand the biochemistry of depression

What's new is how easily it serves the right-wing agenda

A few other key points about the study and its author Joanna Moncrieff from the Rolling Stone article

Moncrieff’s work is frequently promoted by an organization called Citizens Commission on Human Rights (CCHR), which touts itself as a “mental health industry watchdog” and was established by the Church of Scientology, which is virulently opposed to psychiatry and medical interventions for mental illness.

It describes mental illness as a diagnostic category as an effort on behalf of the state to exert mind control tactics over individuals who refuse to conform to societal standards, referring to psychiatry as “the arena in which the conflict between freedom and health comes most sharply into focus.”

In the past, she [Montcrieff] has also compared Covid vaccine mandates to forced psychiatric care. “Forced treatment in psychiatry is rightly controversial and limited, but now we are forcing thousands to have Covid jab,” she tweeted last December.

To read Moncrieff’s paper and conclude that antidepressants do not work, as many on the right have, is the wrong message to take away from the study. “[The paper] doesn’t undermine the efficacy of antidepressants for those people for whom they work,” says [medical psychologist Joseph] Comaty.

[appalachiablue]

13. That is really concerning, thanks for posting.

[John1956PA]

7. I take 100 mg of a serotonin reuptake inhibitor daily. It helps with my mild chronic depression.

I believe it also helps with my mild chronic obsessive-compulsive disorder. When I started on the medication, it took a month before I believed it to be effective. My initial dose was 50 mg. After about one year, I thought that I could benefit from a higher dosage. My doctor agreed that 100 mg per day would be worth trying. After increasing to that dosage, I believed that I was where I should be. I have stayed on the 100 mg daily dosage for almost one year. I do not think that that I want to exceed the 100 mg per-day dosage.

[reACTIONary]

9. Thanks for your perspective! nt

[hlthe2b]

10. For all that take this as the last word on the issue, I'd suggest taking a breath and waiting to see

This study has yet to receive the rebuttal expected from other experts in the field and we will surely see some well-informed "back and forth. I do not take this as conclusive. That said, I have long thought SSRIs to be incredibly overprescribed and their use needs to be reevaluated.

[appalachiablue]

14. Good idea, let's see more. Agree about overprescribing & need for review.

[Mosby]

11. The "chemical imbalance" theory never had empirical support.

Most clinicians have known this for decades, but succumbed to the medicalization of mental illness because of money.

[appalachiablue]

15. Some truth to that unfortunately.

[Fiendish Thingy]

16. Beware of meta-analysis, it is a flawed methodology with high potential for bias

And this study is a meta-analysis compiling other meta-analyses.

https://pubmed.ncbi.nlm.nih.gov/7950571/

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3868184/

https://absolutelymaybe.plos.org/2015/06/30/another-5-things-to-know-about-meta-analysis/

https://absolutelymaybe.plos.org/2014/01/20/5-key-things-to-know-about-meta-analysis/

https://www.researchgate.net/post/What_are_the_disadvantages_of_doing_a_meta-analysis

https://www.science.org/content/article/meta-analyses-were-supposed-end-scientific-debates-often-they-only-cause-more

As a retired mental health professional who has worked closely with psychiatrists, I found it both puzzling and frustrating that some people respond quite well to SSRI’s and others don’t. It can sometimes take several trials of various SSRI’s to find the right medication. Even then, some folks still struggle with depression that doesn’t respond to SSRI’s. A significant amount of research has shown that the combination of therapy and medication is far more effective at treating depression than either alone.

There is also a newer generation of depression medication, SNRI’s (serotonin-norepinephrine reuptake inhibtors) which have helped some folks.

[BWdem4life]

17. Interesting that this would come out right now

Less than 3 months afyer I finally gave up on anti-depressants after nearly 12 years.

Hopefully more people will now consider exercise and other options as a first course of action. Key word being “action.”