Little evidence that chemical imbalance causes depression, UCL scientists find

[Azure]

Scientists have called into question the widespread use of antidepressants after a major review found “no clear evidence” that low serotonin levels are responsible for depression.

Prescriptions for antidepressants have risen dramatically since the 1990s, with one in six adults and 2% of teenagers in England now being prescribed them. Millions more people around the world regularly use antidepressants.

“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,” said the study’s lead author, Joanna Moncrieff, a professor of psychiatry at University College London and consultant psychiatrist at North East London NHS foundation trust.

“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.

“Thousands of people suffer from side-effects of antidepressants, including the severe withdrawal effects that can occur when people try to stop them, yet prescription rates continue to rise. We believe this situation has been driven partly by the false belief that depression is due to a chemical imbalance. It is high time to inform the public that this belief is not grounded in science.”

The new review of existing studies found that depression is not likely to be caused by a chemical imbalance and said people should be made aware of other options for treating it.

https://www.theguardian.com/society/...y-on-serotonin

This is insane. I personally know many people who are anti-depressants for the exact reasons stated.

[rubecube]

Originally Posted by Azure

https://www.theguardian.com/society/...y-on-serotonin



This is insane. I personally know many people who are anti-depressants for the exact reasons stated.

Jesus Christ. Imagine being The Guardian and putting an article like this behind a paywall.

Not a criticism of you, Azure. I just hate stuff like this.

[Since1984]

No pay wall here:

https://www.sciencedaily.com/release...0720080145.htm

After decades of study, there remains no clear evidence that serotonin levels or serotonin activity are responsible for depression, according to a major review of prior research led by UCL scientists.

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.

[rubecube]

Found a good non-paywall article, and this is what I was curious about:

https://www.newscientist.com/article...ajor-analysis/

However,#Johan Lundberg#at the Karolinska Institute in Sweden says a limitation of the analysis is that it didn’t distinguish between people who had ongoing depression and those who have episodes of depression, whose state at the time they were assessed could affect the functioning of their serotonin systems. “It is key to separately analyse data from studies that examine the same patients when ill and when in remission, to have optimal conditions to examine the hypothesis,” he says.

[Finger Cookin]

I can't believe it's not serotonin!

[Cali Panthers Fan]

This is ####ing fascinating, and truly a gamechanger for treating mental health. Lord knows that a huge chunk of the students I teach are probably on SSRIs.

I'm going to use this in my class as a discussion piece surrounding the validity of individual studies vs. meta-analyses and systematic reviews. Having it be an umbrella review looking at all different aspects simultaneously is even more impressive. Hoping to have a conversation with them about how this evidence changes their perspective on the subject, and then dive into how we should treat mental health issues if pharmacology isn't necessarily the best answer.

[stone hands]

Lots of people are depressed because their life objectively gives them no joy or true satisfaction, they dont understand how to process their emotions, and they hold on to this idea that they must participate in the rat race to buy things to make themselves happy instead of spending their time trying to understand themselves and their true desires and work on what's making them unhappy in the first place

I think SSRI's have their place in individuals who have their #### together and should be happy but are clinically depressed, but they're probably over prescribed for people who have congruent depression, I.e. theres an entirely logical reason they are depressed and they dont have the tools or knowledge on how to tackle it

[Raekwon]

After coming off twice and experiencing the withdrawals even after missing a single dose I would love to see this being true. I'm in the camp of thinking its more related to gut health/issues but also being off and on I do notice the difference (For Anxiety not depression) so definitely would like to see more research as I think I know more people on SSRI than off these days.

[Raekwon]

Originally Posted by stone hands

Lots of people are depressed because their life objectively gives them no joy or true satisfaction, they dont understand how to process their emotions, and they hold on to this idea that they must participate in the rat race to buy things to make themselves happy instead of spending their time trying to understand themselves and their true desires and work on what's making them unhappy in the first place

I think SSRI's have their place in individuals who have their #### together and should be happy but are clinically depressed, but they're probably over prescribed for people who have congruent depression, I.e. theres an entirely logical reason they are depressed and they dont have the tools or knowledge on how to tackle it

This sounds like a take from someone that hasn't experienced true anxiety/depression. Its not something you have control over and its not something you can easily explain besides saying your brain is in control and you are helplessly along for the ride.

[stone hands]

Originally Posted by Raekwon

This sounds like a take from someone that hasn't experienced true anxiety/depression. Its not something you have control over and its not something you can easily explain besides saying your brain is in control and you are helplessly along for the ride.

Hence why I included the part about people with clinical depression/anxiety

But therapy is something that needs to be taken with medication, your mind and your body work in tandem, you cant fix one without the other

[Azure]

Originally Posted by rubecube

Jesus Christ. Imagine being The Guardian and putting an article like this behind a paywall.

Not a criticism of you, Azure. I just hate stuff like this.

Hmmm, wasn't a paywall for me. But yeah, stupid.

[Ozy_Flame]

Psilocybin treatment is one method that should really be considered for those suffering with depression/anxiety/stress/trauma.

And larger issues need to be addressed, such as social pressures to perform and conform. For example, in North America there is a prevalent attitude to work to live combined with low pay that doesn't enable people to get beyond struggling with basic needs. I think Raekwon is right.

There is as much social progressive change needed as there is medicinal approaches, at least in my opinion.

[Harry Lime]

I'm curious about two things : first being whether the circumstances of prescription are being misdiagnosed, and general practitioners should not be the ones making that judgement, and the second I was pessimistically just waiting to hear that this study was funded by the Church of Scientology.

[PepsiFree]

Originally Posted by stone hands

Hence why I included the part about people with clinical depression/anxiety

But therapy is something that needs to be taken with medication, your mind and your body work in tandem, you cant fix one without the other

This might not be entirely scientific, just a way to explain it in simple terms, but in my eyes the job of medication is to "clear the slate" so therapy has a foundation to work from.

I will always find it bizarre the people who mock or reject therapy, say they don't need it, whatever. It's sad to me. The mind needs maintenance as much as anything else. Therapy, especially CBT, is incredibly effective when people are open and fully engaged.

[Russic]

This could be one we look back on and realize we should have figured out earlier. I believe medication has its place, but given the rates of prescriptions out in the wild, rates of anxiety/depression/OCD should be plummeting and we're certainly not seeing that.

[rubecube]

This study also seems specific to SSRIs when we now live in a world where there are alternatives to SSRIs for depression.

[rubecube]

Originally Posted by PepsiFree

This might not be entirely scientific, just a way to explain it in simple terms, but in my eyes the job of medication is to "clear the slate" so therapy has a foundation to work from.

I will always find it bizarre the people who mock or reject therapy, say they don't need it, whatever. It's sad to me. The mind needs maintenance as much as anything else. Therapy, especially CBT, is incredibly effective when people are open and fully engaged.

It's also not really available to many people who need it. Is it any wonder we're relying on pharmaceutical band-aids when we have barely any semblance of affordable and accessible mental health infrastructure?

[Azure]

Originally Posted by Harry Lime

I'm curious about two things : first being whether the circumstances of prescription are being misdiagnosed, and general practitioners should not be the ones making that judgement, and the second I was pessimistically just waiting to hear that this study was funded by the Church of Scientology.

Well with the video of Tom Cruise flying around.

https://twitter.com/user/status/1550435611227484161

[Hack&Lube]

Originally Posted by Azure

This is insane. I personally know many people who are anti-depressants for the exact reasons stated.

I would not mark this off an insane if there is sound science there. Anti-depressants may simply mask or dull the symptoms of the causes of depression - which itself is a very vibrant area of study and inconclusiveness.

I am intimately familiar as a sufferer of clinical depression two decades ago and I went through many Alberta health professionals and cocktails of medications and therapy sessions and none of them worked for me.

What finally worked was changing the actual conditions of my life. I don't find this hard to believe as your body naturally gets serotonin and endorphin highs from exciting activities such as roller coasters and doing sports. If your life conditions are mired in misery, rejection, darkness, isolation, and general bad outcomes, you are definitely going to have a distinct deficit of neurotransmitters. In these cases, the medications may simply be artificially trying to top you up but the underlying conditions of your life are still the root cause and not a chemical imbalance for some people.

I do realize that the above sounds like a Tom Cruise thing to say but this is my personal experience.

If anything, I wish I had not taken them as I am still suffering debilitating physical side effects of those anti-depressants 20 years later.

[Azure]

Originally Posted by rubecube

It's also not really available to many people who need it. Is it any wonder we're relying on pharmaceutical band-aids when we have barely any semblance of affordable and accessible mental health infrastructure?

Well, big pharma is gonna big pharma.

Are people really shocked over this finding?

It is really the first time a 'drug' has been stated to be a fix-all when it really isn't, but big pharma just wants to keep making billions?