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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

#121

Post by clsec »

refurb wrote: 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…

Don't get me started on Gabapentin! I just got off of it after 11 yrs (serious spinal cord injury - neuropathy). Initially, after my surgery, I was on 12 different drugs (not all related to my injury). Over the last 5 years I've been slowly weening myself off of them one by one trying to figure out what was causing me so many side effects. It turns out that the last thing I quit was Gabapentin, which was last month. Amazingly, all the side effects disappeared once I stopped. I'll never take it again.

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

#122

Post by smolder »

I'm going to go out on a limb and guess the prominence of depression is largely caused by a broken interface with the world at large. The traps created by modern society wherein you struggle for other people's benefit are better designed than ever before. What our social machine procedurally treats as progress is advances in subjugation. Depression may often be an artifact of "efficiency" with respect to extracting value from the population at large. We might need to dial back the exploitation of the currently-exploitable class to have a sustainable society, assuming pills don't work. In different terms, maybe we have too many rich people (exploiters) in a situation where it's clearly very foolish to keep growing in number (and productivity) to support them. Maybe we just need to rebalance our economy to make it work better for those currently exploited and endemically depressed people.

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

#124

Post by klodolph »

lettergram wrote: post #80
klodolph wrote: post #38

Earlier quoted context omitted.

Bolts of lightning can be factually wrong, it sounds.

No doubt, but this article is about how the SSRIs don’t seem to be effective. To be clear a disorder (ie depression disorder) can be caused by a variety of factors, including (but not limited to): genetics, environment, trauma, illness, etc. Given that’s the case, some drugs may help ease symptoms (depression being the symptom), but finding and correcting the root cause (if possible) is important. Unfortunately, the…

> No doubt, but this article is about how the SSRIs don’t seem to be effective.

Where does the article say that?

> Given that’s the case, some drugs may help ease symptoms (depression being the symptom), but finding and correcting the root cause (if possible) is important.

It's not for lack of trying.

> Unfortunately, the medical industry as a whole has very little reason to try and “cure” these diseases / disorders. Why would a therapist? Why would a pharmaceutical company? Recurring revenue to ease symptoms is perfect.

That explanation doesn't have any legs.

By this theory, dentists have no incentives for prophylaxis, but in practice, that's a large part of what dentists do and it's very effective. By this theory, the medical industry wouldn't choose to eradicate any infections diseases, since it can make money from treatment. It turns out we can and do eradicate infectious diseases, but it is difficult, expensive, and time-consuming. We've only successfully eradicated two infectious diseases and only one of those affects humans in the first place.

If you look at other infectious diseases, there are tons of diseases which can be outright cured and tons which can't. This isn't for lack of trying, it's just that these diseases are different. You can kill bacteria with antibiotics, but if you get HIV, the best we can do is antiretroviral therapy.

Treatment of symptoms with pharmaceuticals is often a rational, good decision. There are simply too many diseases for which we don't have any known cure. Depression is one of them. The disease is too complicated, or the cure is too difficult, or our understanding of depression is too primitive, or some combination of all three. So we have stuff like SSRIs, which are known to work for some people.

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

#125

Post by mccorrinall »

asveikau wrote: post #69
throw__away7391 wrote: post #63

Earlier quoted context omitted.

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.

While I only had positive experiences with SSRI so far, I can definitely say that substances can cause suicidal thoughts. When I took xanax, I had a lot of suicidal thoughts and really had to fight to not kill myself. It’s just like being on autopilot and having to fight against autopilot who wants to crash your car into a wall.

I could imagine that SSRI can activate this autopilot for some people and worsens their negative thoughts.

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

#126

Post by sammalloy »

yomkippur wrote: post #21

Psilocybin has been quite promising and many people report positive changes.

Came here to say this. Although few people are aware of it, it is said behind closed doors that for some people, it is a cure for depression, although it’s very controversial to make that claim in public, and obviously, it needs to be used carefully and with great respect.

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

#127

Post by eyelidlessness »

tuxie_ wrote: post #75
eyelidlessness wrote: post #66

Earlier quoted context omitted.

> 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.)

Don't take it personal. Both things can be true, you can have adhd and adhd can be overdiagnosed, doesn't mean that none of those diagnostics are valid. I'm sure you must be tired of people telling you about how overdiagnosed adhd is, I'm sorry about that, but don't take it personal, it's just a person on the internet.

> Don't take it personal

Oh I take it personally. I’m alive today because I sought diagnosis and treatment. I very nearly wasn’t alive from the consequences of being undiagnosed and untreated. I very probably would be dead today if I had taken this “just person on the internet” more seriously than I already had. I’m more than tired of people offering their ignorant opinions about stuff they don’t understand.

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

#128

Post by walrus01 »

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.

By far one of the weirdest things I saw recently was ketamine clinic advertising on various forms of social media. Very slickly produced.

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

#129

Post by toomuchtodo »

chx wrote: post #104
refurb wrote: post #96

Earlier quoted context omitted.

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.

High sugar diet the cause (“Western Die” and whatnot)?
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