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

bmj.com

101–110 of 625 posts

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

#101

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

They have been saving mine. My anxiety has been improving tremendous amounts since starting both an SSRI and therapy a few months ago. Therapy came a couple months after starting an SSRI, but I was already feeling a tangible improvement before even starting that.

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

#102
post #8

This is completely unsurprising and indicative of how limited our understanding of the brain is. It reminds me of Pfizer's work on gabapentin. A professor from Northwestern was working on GABA antagonists (by modifying GABA itself) and eventually came up with the drug. It was hailed as a great example of "structure-based drug design". The drug was approved by the FDA and efficacious for a number of issues like neurop…

Do you have links to more info on this? Sort of an armchair pharmocologist and had never heard this about gabapentin. I thought it was a straight up gaba agonist like phenibut. But makes sense that it would be different given its very unusual dose response curve/self potentiation. (Probably making anyone who actually knows what they're talking about cringe. Take it easy, lol)

Gabapentin was designed as an antagonist (the structure is basically GABA with a big bulky group on it).

You can just google older papers on gabapentin. Just like most drugs it impacts a number of different receptors in the body. We still don't fully understand them all.

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

#103

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

This is a dangerous thing to spread, in my opinion. I have struggled with depression and anxiety for years, but during COVID it hit me like nothing I have ever experienced before. I would have probably died during COVID without finding a doctor to prescribe me medicine. And I don't think it would have been suicide. I would have probably become dehydrated and/or starved or become mal-nutritioned because it was a literal war to eat. I was having to wash down food with water after chewing it enough to swallow. (Note that I never had COVID, which would have been impossible having barely left my house during the first 9 months of 2020.) I couldn't sleep and would wake up wide awake and stressed at 4-5am. I couldn't relax. Was having panic attacks. It was pure and quite literal torture. My body and mind was literally on fire with stress activity. I honestly probably should have been hospitalized long before I finally got help.

While not fun working through the gamut of medicines, some of them finally pulled me through it all. It took almost a year to fully recover with dedication to the medicine and modifications of it and therapy.

If I didn't have a good family and primary care doctor, I guarantee I would have died in some manner unless hospitalized.

People need to realize there is danger to their words. Psychiatry is nowhere near perfect, but people are trying. It is an incredibly difficult thing to understand. But I feel people who speak against medicine have never truly experienced deep depression or anxiety. A panic attack can hit you sitting on the couch, and then by literally doing nothing, your heart rate can reach 200bpm and massive amounts of hormones making your chest and skin feel like it's burning, and next thing you're calling an ambulance because you think you aren't breathing.

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

#104
post #96
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…

There's no such thing as good / bad cholesterol. This is untrue. There is lots of data to suggest elevated LDL is a risk of cardiovascular disease and that high HDL lower risk. Pfizer's drug failed because of safety issues, not because "There's no such thing as good / bad cholesterol".

> there is lots of data to suggest elevated LDL is a risk of cardiovascular disease

Elevated LDL is a symptom of inflammation. It is not a cause and lowering it doesn't help. The research mixed up cause vs correlation.

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

#105
post #85
post #68

Earlier quoted context omitted.

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

I support psychadelic legalization but at the same time I wonder how much of the antidepressive effect of psychadelics is just from giving space for thought in your day to day life. For exmaple, the modern human wakes up, starts scrolling instagram, goes to work, goes home, continues scrolling instagram, then sleeps. There is no period of reflection or introspective thought, since every mundane activity where you cou…

For my first infusion, I didn't wear an eye-mask and I was kind of incapacitated as I watched people come and check on my vitals. I felt this deep sense of caring that we are all in this world together and love is the most important thing.

It's not just time to reflect, but also a new perspective which is hard to allow to enter the mind due to all the anxieties of the world.

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

#106
Anecdote but I always noticed change in sleep patterns after starting antidepressants. Actually, terminal insomnia (you wake up and then are unable to fall asleep) are characteristic of chronic depression. Add to this that SSRI causes increase in sleep hours (maybe even quality?) and then you have a theory about how it might just have been due to lack of sleep after all?

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

#107

There are many people who are anti-psychiatry who would probably still benefit immensely from treatment. My worry is that such people will look at this and say: "see look, the psychiatrists got it wrong. I was right to question treatment all along; Anti-depressants don't work." But the message here isn't that SSRIs don't work for depression. It's that depression is a complex illness and can't be reduced to a single c…

It's less a specific study and more that almost none of their research is reproducible and there have been a number of serious breaches of trust, like Prozac being widely prescribed to kids and turning out to be horrifically bad for them.

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

#108

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…

> This is good evidence that the new drugs are worse than the old drugs.

That's incorrect. There's good evidence that economics, in combination with lack of funding for suicide prevention programs is driving the increase in suicide rates. See https://www.bbc.com/news/world-us-canada-44416727

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

#109
post #56

Earlier quoted context omitted.

Bolts of lightning can be factually wrong, it sounds.

Sure, but it would be more constructive to explain why it's wrong. GP's comment has some interesting ideas and it would be better to directly refute them than just claiming they're "factually wrong".

Sorry, thought it would be obvious.

> Depression is a disease of despair,

> The question is really how to address the despair.

It's known that people have genetic predispositions to depression. People experience depression due to many causes. Not all causes are known and we don't have very good understanding of the mechanisms, but it's just not damn likely that we can treat this as a purely psychological / environmental issue.

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