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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

#311

Post by irjustin »

Etheryte wrote: post #281
eyelidlessness wrote: post #268

There’s no convincing evidence that discussing medical aspects of mental health is productive on HN. Currently my comment that I’m alive has been downvoted at least half a dozen times because I had the temerity to still be alive, be glad to say so, be grateful for my psychiatric care, and reject that any of that is “suspect”. This isn’t the place to discuss psychiatry. Talk to your doctor.

Have you considered that your comment may have been downvoted because you come across unnecessarily hostile, not because of some absurd attack on your person? Similarly, any space is a good space to discuss and spread awareness on mental health — even if only one person finds an idea to help them, whatever their situation may be, it's already a massive positive.

> because you come across unnecessarily hostile

And possibly justified.

A lot of us are armchair psychiatrist from reading articles. OP that you're replying to lives this type of medication and attributes being alive right now to it while a lot of us who have only read articles sit and debate.

A number of these comments can come across as "just eat healthier" to an overweight person or "don't be sad".

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

#313

Post by Traubenfuchs »

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…

5. the drugs can cause permanent sexual side effects (PSSD)

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

#314

Post by philliphaydon »

mjfl wrote: post #306
philliphaydon wrote: post #228

Earlier quoted context omitted.

We know that a group of people who suffer from depression have lower serotonin levels when compared to someone who is considered... not depressed. And we know that SSRI's prohibit or prevent the bodies ability absorb serotonin allowing it to accumulate and be more effective and pull it in line with someone who is not depressed, resulting in the depressed person becoming less or not depressed. So. I'm unsure how my st…

> We know that a group of people who suffer from depression have lower serotonin levels when compared to someone who is considered... not depressed. I thought the whole point of the article was that there is no solid evidence of a relationship between serotonin levels and depression?

The article seems to say that lower levels of serotonin is not the /cause/ of the depression. But it doesn't change the fact that most studies seem to conclude that one of the things we can determine in people who suffer from depression is that they have lower levels of serotonin, and in some of those cases SSRIs help.

Not all forms of depression are caused by serotonin, and anti-depressants may not always be the solution.

Again, my point is we know how SSRIs work and what they do. What we do not know is why some people have lower levels of serotonin or why they absorb it too quickly compared to... non depressed people.

The issue with depression is that its a huge complicated thing that we know a lot about, but at the same time, we also know very little.

I would agree that we over perscribe medication for depression as we do for MANY different things. In Asia, antibiotics is handed out like candy when people are sick. You have the common cold, boom you get antibiotics, despite the fact that colds are caused by virus, and antibiotics only helps with bacterial infections not viral invections.

The US has a major problem with big phama where people can be perscribed medicine for many things, and then have side-affects resulting in more things being perscribed. Painkills for injury > painkillers causing depression > Prozac, Prozac causes insomnia > sleeping pills, sleeping pills causes you to lose sexual drive > viagra, viagra causes you to gain weight > apatite suppresents. It goes on and on.

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

#315

Post by aahortwwy »

wisty wrote: post #307
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…

Maybe just giving the system a kick can be a bit effective (especially in conjunction with a patient trying to change).

If you have a broken arm a cast can be helpful during the healing process, but a cast does not heal a broken arm.

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

#316

Post by cbxyp »

chalst wrote: post #309
cbxyp wrote: post #304

SSRI's are without a doubt the leading cause of divorce and mass shootings in America. The quacks in the medical profession handing them out like candy to people whom it is clearly contraindicated in, without any followup study and usually without any competent analysis of what the drugs are doing to these peoples behavior and brains. Getting my girlfriend off of SSRI's completely changed her life, as she was indicat…

> without a doubt Not a mark of wisdom to use these words about such topics. I agree that SSRIs and bipolar are a tricky mix, but they work for some patients.

Divorce: https://pubmed.ncbi.nlm.nih.gov/23931947/ Mass shootings / violence: https://www.psychreg.org/antidepressants-ssri-mass-shootings...

While they may provide benefit to some patients, the sheer volume of prescriptions and the quite clearly linked effect leads me to stand by my original statement - without a doubt, they are a leading cause of both.

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

#317

Post by mlang79 »

eyelidlessness wrote: post #268

There’s no convincing evidence that discussing medical aspects of mental health is productive on HN. Currently my comment that I’m alive has been downvoted at least half a dozen times because I had the temerity to still be alive, be glad to say so, be grateful for my psychiatric care, and reject that any of that is “suspect”. This isn’t the place to discuss psychiatry. Talk to your doctor.

Complaining about being downvoted on a related topic are not productive either.

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

#318

Post by aahortwwy »

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…

> "Chemical imbalance" isn't actually taught as the root cause of depression.

The article contradicts this.

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

#320

Post by pjc50 »

eyelidlessness wrote: post #268

There’s no convincing evidence that discussing medical aspects of mental health is productive on HN. Currently my comment that I’m alive has been downvoted at least half a dozen times because I had the temerity to still be alive, be glad to say so, be grateful for my psychiatric care, and reject that any of that is “suspect”. This isn’t the place to discuss psychiatry. Talk to your doctor.

HN is only really great on technical issues. Everything else suffers from Engineer's Disease, where a person who has read half a dozen articles suddenly imagines they know a complete discipline. This thread is a prime example of "my googling trumps your life experience".

That said, in countries where pharmaceutical manufacturers are allowed to market prescription medicines, and one was recently convicted for pushing addictive substances on huge numbers of people, a certain amount of skepticism may be warranted.

("medicine X saved my life" and "a large number of people who don't get any real benefit for medicine X are being sold it" and "medicine X may have extremely bad side effects for some people" may co-exist, as well)

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