Jan 15, 2023 02:12 AM
https://www.openmindmag.org/articles/ser...-never-was
INTRO: The media went crazy when a study showed low serotonin doesn’t cause depression—but this was something scientists had known all along. The confusion caused some patients to go off effective psychiatric medications, exposing an information gap it’s been hard to bridge. We can do better, and here’s how.
EXCERPTS: For decades now, common wisdom has held that the more serotonin bathing your brain, the less depression you experience and the sunnier your mood and outlook on life. Doesn’t that explain the mighty power of Prozac and other selective serotonin reuptake inhibitor (SSRI) antidepressants, from Zoloft to Paxil, which boost serotonin in the brain?
The reasoning seems to make sense. Serotonin is a neurotransmitter—a chemical that carries messages between brain cells—involved in many functions throughout the brain and body. For instance, serotonin plays a role in heart and gut function and helps regulate sleep and wakefulness. Given the efficacy of SSRIs for some, it would seem safe to assume that low serotonin levels create a chemical imbalance in the brain that can lead to depression.
Last summer, that belief appeared to be upended by a research paper from scientists at University College London. Published in the respected scientific journal Molecular Psychiatry, the report concluded that low serotonin is not a cause of depression, creating more controversy than any psych paper in recent memory.
As the story surged, public outrage grew. Readers began to ask: If low serotonin doesn’t cause depression, then why are so many of us treating it with SSRIs? How could doctors have been so wrong?
As a neuroscientist, I found it frustrating to watch this unfold. Although it seemed shocking and groundbreaking, this paper actually did not tell us anything new about depression. The researchers had not run any experiments or uncovered something novel about the condition. Rather, they had simply summarized the scientific research that had already existed on depression for decades.
Let’s back up a bit. In the 1950s...
[...] So, what exactly is going on here? How can SSRIs be helping if low serotonin isn’t the problem? The (perhaps unsatisfying) answer is that in the brain, things are hardly ever as straightforward as this. ... serotonin levels don’t need to be low for SSRIs to be helpful in treating depression; increasing serotonin could alter the function of some other, downstream system, which then leads to improved mood.
[...] Here’s another way to think of it: If you spend six hours squinting at a computer screen at work, you might have a headache when you get home. You go to the medicine cabinet and take some Tylenol to get rid of it. In this case, the root issue is that your facial muscles have been overworked and spasming, but the Tylenol acts on a different system in your body to simply blunt the pain. It does not relax your muscles, but it does stop your experience of pain, and that’s all you really wanted. SSRIs could be acting in a similar way, addressing the problem indirectly.
[...] Despite all this, the story came as a huge shock to those outside the field and stirred public outrage. The reason? An unfortunate disconnect between science and the public...
[...] So, what is the solution? Perhaps scientists need to be more careful with what they publish. Or maybe media outlets need to be more accurate in their reporting. But is it really the responsibility of either side alone? In an ideal world, the dialogue between scientists and journalists would grow, allowing each side to draw on the strengths of the other... (MORE - missing details)
INTRO: The media went crazy when a study showed low serotonin doesn’t cause depression—but this was something scientists had known all along. The confusion caused some patients to go off effective psychiatric medications, exposing an information gap it’s been hard to bridge. We can do better, and here’s how.
EXCERPTS: For decades now, common wisdom has held that the more serotonin bathing your brain, the less depression you experience and the sunnier your mood and outlook on life. Doesn’t that explain the mighty power of Prozac and other selective serotonin reuptake inhibitor (SSRI) antidepressants, from Zoloft to Paxil, which boost serotonin in the brain?
The reasoning seems to make sense. Serotonin is a neurotransmitter—a chemical that carries messages between brain cells—involved in many functions throughout the brain and body. For instance, serotonin plays a role in heart and gut function and helps regulate sleep and wakefulness. Given the efficacy of SSRIs for some, it would seem safe to assume that low serotonin levels create a chemical imbalance in the brain that can lead to depression.
Last summer, that belief appeared to be upended by a research paper from scientists at University College London. Published in the respected scientific journal Molecular Psychiatry, the report concluded that low serotonin is not a cause of depression, creating more controversy than any psych paper in recent memory.
As the story surged, public outrage grew. Readers began to ask: If low serotonin doesn’t cause depression, then why are so many of us treating it with SSRIs? How could doctors have been so wrong?
As a neuroscientist, I found it frustrating to watch this unfold. Although it seemed shocking and groundbreaking, this paper actually did not tell us anything new about depression. The researchers had not run any experiments or uncovered something novel about the condition. Rather, they had simply summarized the scientific research that had already existed on depression for decades.
Let’s back up a bit. In the 1950s...
[...] So, what exactly is going on here? How can SSRIs be helping if low serotonin isn’t the problem? The (perhaps unsatisfying) answer is that in the brain, things are hardly ever as straightforward as this. ... serotonin levels don’t need to be low for SSRIs to be helpful in treating depression; increasing serotonin could alter the function of some other, downstream system, which then leads to improved mood.
[...] Here’s another way to think of it: If you spend six hours squinting at a computer screen at work, you might have a headache when you get home. You go to the medicine cabinet and take some Tylenol to get rid of it. In this case, the root issue is that your facial muscles have been overworked and spasming, but the Tylenol acts on a different system in your body to simply blunt the pain. It does not relax your muscles, but it does stop your experience of pain, and that’s all you really wanted. SSRIs could be acting in a similar way, addressing the problem indirectly.
[...] Despite all this, the story came as a huge shock to those outside the field and stirred public outrage. The reason? An unfortunate disconnect between science and the public...
[...] So, what is the solution? Perhaps scientists need to be more careful with what they publish. Or maybe media outlets need to be more accurate in their reporting. But is it really the responsibility of either side alone? In an ideal world, the dialogue between scientists and journalists would grow, allowing each side to draw on the strengths of the other... (MORE - missing details)
