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“No convincing evidence” that depression is caused by low serotonin levels

bmj.com

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Re: “No convincing evidence” that depression is caused by low serotonin levels

#61

Post by robocat »

narrator wrote: post #50

The crisis in mental health is that suicide levels have been rising since 2000. This is good evidence that the new drugs are worse than the old drugs. If you look at consumers rating of drugs they're on, mao inhibitor anti-depressants like nardil have very high ratings, especially compared to SSRIs. Unfortunately, the drug companies don't like competing with generics, so it goes that the newest drug is considered the…

> The crisis in mental health is that suicide levels have been rising since 2000. This is good evidence that the new drugs are worse than the old drugs.

Or this is good evidence that cellphone usage is causing suicide (~1/3 of people in US had cellphones in 2000, ~100% do now).

Your causality is poorly explained.

Re: “No convincing evidence” that depression is caused by low serotonin levels

#62

Post by arsome »

zeckalpha wrote: post #36
PragmaticPulp wrote: post #18

SSRIs raise extra-synaptic serotonin levels within the first hour of taking them. However, their efficacy against depression takes weeks or even months to manifest. We've known this for decades, and as a result the "chemical imbalance" theory of depression hasn't been a real contender in depression research for a long, long time. The key thing to understand is that serotonin levels don't have to be low for SSRIs to i…

Hence the first S and the I in SSRI. A filter in certain areas increases other areas. Doesn't change overall values.

The S for Selective actually means it only works on serotonin, compared with say, an SNRI, which works on both serotonin and norepinephrine. Impacting the overall values is in fact pretty much the only thing it does.

Re: “No convincing evidence” that depression is caused by low serotonin levels

#63

Post by throw__away7391 »

ldjkfkdsjnv wrote: post #41

Too tired to type a cogent paragraph. Just that I have seen lives ruined by SSRIs.

Same here. I've seen multiple people after getting along fine for years get prescribed these meds, and within two years end up completely unable to function, hold a job, maintain composure during a conversation (breaking down in tears or becoming violently angry), cook their own food, etc. and need to talk to a therapist multiple times a week.

I'm sure "they're doing it wrong", but these were fully licensed doctors, prescribing drugs in an approved manner.

Re: “No convincing evidence” that depression is caused by low serotonin levels

#64

Post by _moof »

ggm wrote: post #51
PragmaticPulp wrote: post #42

Earlier quoted context omitted.

> 1. they prescribe both boosters, and inhibitors, to treat the same symptoms. This suggests the aetiology of disease here, is not well defined by a single behaviour because the same symptom (depression, anxiety) is responsive in some people to suppressing of a chemical imbalance, and in others to boosting it. "Chemical imbalance" isn't actually taught as the root cause of depression. I suspect your psychologist migh…

I'm not a psychiatrist or psychologist. He is, and has professional standing. You're judging him, on my paraphrases of what is said to me. Perhaps what you really should be saying is "don't try to represent the views of professionals in a field you are not an expert in" which btw, I would take as good advice. None the less, I think the substantive point stands: the field is not in unity about the applicability of the…

Psychiatrists are medical doctors. Psychologists are not (and can't prescribe medicine). There is a huge difference.

Re: “No convincing evidence” that depression is caused by low serotonin levels

#65

Post by _yoqn »

sn0w_crash wrote: post #32
walrus01 wrote: post #19

I have a completely unscientific, subjective theory that some significant portion of depression in the population as a whole is caused by the economic circumstances that some people live in. Things like being trapped in a dead end job to keep healthcare benefits in the USA, living in a never ending treadmill of debt.

I know plenty of depressed rich people. I understand your theory but spend a week in the Hampton’s and you’ll see some real sad souls.

Yeah they are probably into some extremely toxic, unnatural things that cause them to secretly hate themselves. I wonder how much shady sexual shenanigans happens in the households of the top 1%? Plenty of drugs, gossip, gluttony, lust, etc.

Happiness comes from the overcoming of not unknowable obstacles toward a known goal. It's the journey, not the destination. And the trick is to set another goal once you attained the one you're on.

Re: “No convincing evidence” that depression is caused by low serotonin levels

#66

Post by eyelidlessness »

chx wrote: post #57

There's a significant population of science denying cranks and so those who want to raise legit concerns about the quality and alas, often motivation of medical studies are easily grouped with those. But: 1. There's no such thing as good / bad cholesterol. This is complete baloney and Pfizer lost a staggering amount of money when a drug raising good cholesterol got as far as human trials -- and failed them. There is…

> The diagnosis and treatment of ADHD in adults but most especially in children is extremely suspect.

Go on…

(I’m adult diagnosed, for disclosure, but please do go on and tell me how suspect my diagnosis was, how I shouldn’t have been diagnosed as a child, how my medication is harmful. Go on and tell me about my life which you know better than I do.)

Re: “No convincing evidence” that depression is caused by low serotonin levels

#67

Post by asveikau »

PragmaticPulp wrote: post #42
ggm wrote: post #23

My psychologist tells me that in his profession there is a significant gulf emerging between the ones who feel the prescribing is justified, and the ones (like him) with significant concerns: 1. they prescribe both boosters, and inhibitors, to treat the same symptoms. This suggests the aetiology of disease here, is not well defined by a single behaviour because the same symptom (depression, anxiety) is responsive in…

> 1. they prescribe both boosters, and inhibitors, to treat the same symptoms. This suggests the aetiology of disease here, is not well defined by a single behaviour because the same symptom (depression, anxiety) is responsive in some people to suppressing of a chemical imbalance, and in others to boosting it. "Chemical imbalance" isn't actually taught as the root cause of depression. I suspect your psychologist migh…

> It doesn't make sense to make blanket statements about "the drugs" when psychiatric drugs differ widely in this regard.

> I'd be cautious of taking advice from anyone who makes blanket statements about "the drugs". This is bordering on uninformed anti-psychiatry.

Yeah, as someone who has been close to people who need antipsychotics, I sometimes feel the anti-antidepressant crowd extrapolates to all psychiatric drugs and this is very scary. Especially since people with conditions like schizophrenia or bipolar frequently think they don't need medication.

Re: “No convincing evidence” that depression is caused by low serotonin levels

#68

Post by jb1991 »

PragmaticPulp wrote: post #58
mathgladiator wrote: post #53

As a member of the anti-psychiatry side after seeing primary care doctors wreck my mother... I think we will see a sea change in how we approach this with things like psychedelics. I recently got treated with six weeks of Ketamine, and it works. If you ever thought about rebooting your brain, then I recommend it. However, you really have to surrender yourself to the experience; it is a very intentional act.

Ketamine treatment is interesting, but it's not really a replacement for SSRIs. The anti-depressant effects of Ketamine are unfortunately relatively short-lived. Tolerance also seems to develop to the effects over time. There are some adventurous providers experimenting with frequent ketamine dosing over long periods of time, but the results haven't really been great from what I've seen. Also, a psychedelic experienc…

How about psilocybin? One recent article posted here suggested something like one dose every six months had measurable impact on depression.

Re: “No convincing evidence” that depression is caused by low serotonin levels

#69

Post by asveikau »

throw__away7391 wrote: post #63
ldjkfkdsjnv wrote: post #41

Too tired to type a cogent paragraph. Just that I have seen lives ruined by SSRIs.

Same here. I've seen multiple people after getting along fine for years get prescribed these meds, and within two years end up completely unable to function, hold a job, maintain composure during a conversation (breaking down in tears or becoming violently angry), cook their own food, etc. and need to talk to a therapist multiple times a week. I'm sure "they're doing it wrong", but these were fully licensed doctors,…

Are you sure it isn't the condition that they were seeking treatment for that contributed to these things?

I'll give an example, I read once that about 60% of people with bipolar disorder are unemployed. It isn't the diagnosis that does that.

So I just read that comment as "they sought treatment and ever since they were a wreck". Seems like the causality could go the other way.

Re: “No convincing evidence” that depression is caused by low serotonin levels

#70

Post by GauntletWizard »

imadierich wrote: post #29
GauntletWizard wrote: post #12

Depression is caused by a shitty life. Most people with depression are trapped in an abusive relationship, though often it is with themselves. They're trapped by fear of admitting failure and making changes.

a lot of times its a abusive mindstate.... a lot of really really down bad people have went on to do great things. its all about your perspective

Absolutely. The best parts of modern psychology are CBT and finding a better mind state. The drugs sometimes help shake up your mind enough to find that.
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