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No evidence depression is ‘caused by chemical imbalance’ finds comprehensive review

#1
C C Offline
https://www.eurekalert.org/news-releases/959220

INTRO: 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.

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.” (MORE - details)
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#2
Magical Realist Offline
I don't know why then antidepressants are known to work by increasing concentrations of serotonin in the brain. Why would they alleviate depression if serotonin levels have nothing to do with it?
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#3
C C Offline
(Jul 20, 2022 06:54 PM)Magical Realist Wrote: I don't know why then antidepressants are known to work by increasing concentrations of serotonin in the brain. Why would they alleviate depression if serotonin levels have nothing to do with it?

Scientists don't know what actually causes depression, as another report about this study pointed out. So as the extended excerpt at bottom alludes, this should goad treatment experts to stop pretending to patients that they do know. Rather than, say, this meta-analysis literally removing "chemical imbalance" as a lingering possibility (including as one cause among many).

Also, "Molecular Psychiatry" is subsumed under the unreliable social or human sciences, so the view will likely change again at some point in the future. There are ever only trends occurring there, nothing fixed and substantive. 

The overarching goal of the individual studies conducted over the years was often simply to get published [publish or perish] or to please the administrative policies of the applicable institutions [The intellectual & moral decline in academic research]. Since that specific research was sloppy or compromised in its pursuit of either garnering attention or conforming to establishment dictates, this meta-analysis review either then inherits their flaws/biases or exposes that authoritative conclusions going any direction were unfounded. I.e., back to the first paragraph above: "We don't know what causes depression." [Peer review is the wheel of misfortune]

This: UCL and WHO scientists urge nations to collaborate for vaccine equity .... seems to indicate that the University College London is itself a good virtue posturer, so nothing to be alarmed about on that front. The recent results are just part of the incessant flip-flopping of the above science category of disciplines. 

The researchers say their findings are important as studies show that as many as 85-90% of the public believes that depression is caused by low serotonin or a chemical imbalance. A growing number of scientists and professional bodies are recognising the chemical imbalance framing as an over-simplification. There is also evidence that believing that low mood is caused by a chemical imbalance leads people to have a pessimistic outlook on the likelihood of recovery, and the possibility of managing moods without medical help. This is important because most people will meet criteria for anxiety or depression at some point in their lives.

The authors also found evidence from a large meta-analysis that people who used antidepressants had lower levels of serotonin in their blood. They concluded that some evidence was consistent with the possibility that long-term antidepressant use reduces serotonin concentrations. The researchers say this may imply that the increase in serotonin that some antidepressants produce in the short term could lead to compensatory changes in the brain that produce the opposite effect in the long term.

While the study did not review the efficacy of antidepressants, the authors encourage further research and advice into treatments that might focus instead on managing stressful or traumatic events in people’s lives, such as with psychotherapy, alongside other practices such as exercise or mindfulness, or addressing underlying contributors such as poverty, stress and loneliness.

Professor Moncrieff said: “Our view is that patients should not be told that depression is caused by low serotonin or by a chemical imbalance, and they should not be led to believe that antidepressants work by targeting these unproven abnormalities. We do not understand what antidepressants are doing to the brain exactly, and giving people this sort of misinformation prevents them from making an informed decision about whether to take antidepressants or not.”

Co-author Dr Mark Horowitz, a training psychiatrist and Clinical Research Fellow in Psychiatry at UCL and NELFT, said: “I had been taught that depression was caused by low serotonin in my psychiatry training and had even taught this to students in my own lectures. Being involved in this research was eye-opening and feels like everything I thought I knew has been flipped upside down.

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#4
Syne Offline
(Jul 20, 2022 06:54 PM)Magical Realist Wrote: I don't know why then antidepressants are known to work by increasing concentrations of serotonin in the brain. Why would they alleviate depression if serotonin levels have nothing to do with it?

Placebo.
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#5
Syne Offline
Took em long enough. I learned that chemical imbalance was hokum over twenty years ago, from a neural surgeon who simply looked that the actual evidence.
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#6
Magical Realist Offline
(Jul 20, 2022 11:13 PM)Syne Wrote:
(Jul 20, 2022 06:54 PM)Magical Realist Wrote: I don't know why then antidepressants are known to work by increasing concentrations of serotonin in the brain. Why would they alleviate depression if serotonin levels have nothing to do with it?

Placebo.

https://www.psych.ox.ac.uk/news/all-anti...nt%20drugs.
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#8
RainbowUnicorn Offline
im on SSRI's
i have been before twice 10 years ago & then roughly 10 years before that.

the first time i was put on SSRI's was for cluster migraines
the 2nd time was for psychiatric help
the 3rd time was for psychiatric help

ive done loads of MDMA LSD Meth so i have a good working practical knowledge of how i feel with different drug effects like MDMA versus SSRI's

i gues i might be useful in a study to some degree.

depression as a prescribed state in my opinion is a mixed bowl of different things.
i think back to times i have been very sad for one reason or another and thought about how i found self assurance in my state of grief & depression like a warm safe blanket of oblivion.

i suspect serotonin production is very fluid, i heard storys from people saying that heavy MDMA use can cause depression.
however, it is natural to go into a state of emotional depression the day after taking MDMA.
i have always come back to normal on the 2nd or 3rd day from taking large MDMA doses.
lots of sleep seems to help.

i find SSRI's help stabilize my mood & my mood effects everything i do.
i anticipate a time where i will ween myself off them but i dont know when.
i have the past knowledge that i have weened myself off them on 2 previous occasions so i hold that as being a general guide.

psychiatric science is very technical and different for each patient/person

many people drink and use alcohol effectively as a mood stabilizer drug(i dont drink)

a large part of me, while being a little surprised, is not soo surprised as i thought i might be.
its very complicated how the human brain works & all its organs and glands.
im sure the Doctors i see are in the profession because they have a passion for helping people.
so i have trust and faith in them matched with my own sense to look at trying to keep myself educated on some things.

modern people are inherently more complicated than olden-day people
modern life is significantly more complicated than what it use to be.

cant be bothered punctuating my post.
(i naturally punctuate with sentence construction format and paragraphing fyi)
do feel free to ask me any questions regardless of how insensitive they might seem
if its a genuine question i will be happy to answer it.

but i may come back in an hour or 2 & decide to punctuate my post properly.
but i may not
if you cant comprehend my post because your looking for punctuation then your focusing on a fake narrative and attempting to squash things into boxes rather than comprehend something new.

fyi Tongue
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#9
confused2 Offline
To me it looks just fine as it is - if you try to mess about with punctuation you might lose something important
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#10
RainbowUnicorn Offline
(Jul 22, 2022 01:54 AM)confused2 Wrote: To me it looks just fine as it is - if you try to mess about with punctuation you might lose something important

Smile
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