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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

#351

Post by kurikuri »

varispeed wrote: post #337
fragcula wrote: post #336

> Other clinicians say, however, that the notion of depression being because of a simple chemical imbalance is outmoded anyway, and that antidepressants remain a useful option for patients alongside other approaches including talking therapies. This is the key line in the summary. The concept of attacking an idea no one really believes is really a straw man. More importantly the modern practice of medicine is "eviden…

> are tested as to if they work, not how they work Should they be doing both? I can't imagine shipping code that I don't know how it works, but it passes tests... Otherwise, you'll get pseudoscience - just mix random chemicals and see how patient reacts, rinse and repeat until something works...

>Should they be doing both?

Yes, but with different aims. The learning about ‘how a treatment works’ is useful for developing new potential treatments and new hypotheses, but the mechanism itself is not necessary nor sufficient in its potential treatment efficacy.

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

#352

Post by dang »

armatav wrote: post #230
PragmaticPulp wrote: post #58

Earlier quoted context omitted.

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…

So unbelievably unread and wrong. Ketamines anti-depressant effects are some of the longest lasting in pharmaceutical history. Tolerance is carefully managed by your infusion provider to not build up. The long term efficacy is insanely good - which is why we approved it in the first place. The psychedelic experience is necessary to approach the more permanent end of the spectrum - this is by the "evidence" that you a…

Please don't break the site guidelines like this, regardless of how wrong someone else is or you feel they are. It makes the thread significantly worse.

Also, posting this way discredits your position, which in the case that you happen to be right, is quite a bad thing.

If you wouldn't mind reviewing https://news.ycombinator.com/newsguidelines.html and taking the intended spirit of the site more to heart, we'd be grateful.

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

#353

Post by dang »

eyelidlessness wrote: post #127
tuxie_ wrote: post #75

Earlier quoted context omitted.

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.

We're glad you're alive. Please don't take HN threads into flamewar.

People have different experiences/backgrounds. It's both inevitable and natural that there are different points of view on this or any other complex topic.

https://news.ycombinator.com/newsguidelines.html

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

#354

Post by fredgrott »

The problem with these studies is....

That they focus on one sub-system instead of how the sub-systems interact together.

My bias, I solved my ADHD control problems by researching how serotonin, dopamine, adenosine, ne, and cdb together regulate both the increases and decreases in dopamine and all the cofactors needed to increase dopamine production.

The move from one system to full systems based understanding in the Biology and neurology space started in the 1970s as Chaos theory took hold. But it takes awhile to become fully entrenched in each science discipline.

One cannot say that serotonin by itself controls depression as CBD is also involved! Runners know this as runners high is the result of high CDB neurotransmitter levels!

Another fun fact, Cacao and Cocoa have anandamide which is the THC-less way to get that runner high!

Sorry, was a Biology and Chemistry major once...I really cannot get it out my system.

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

#355

Post by pineaux »

fragcula wrote: post #336

> Other clinicians say, however, that the notion of depression being because of a simple chemical imbalance is outmoded anyway, and that antidepressants remain a useful option for patients alongside other approaches including talking therapies. This is the key line in the summary. The concept of attacking an idea no one really believes is really a straw man. More importantly the modern practice of medicine is "eviden…

Most effective treatment for depression = psychedelics. They have been used by shamans for eons for this reason. A lot of modern research into this (including 1000s of research studies from the 50s and 60s) confirms it. It was only because Nixon didn't like the fact that kids were not going to war, that the war on drugs was started.

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

#356

Post by richardatlarge »

ChildOfChaos wrote: post #327

The book lost connections is a really good read on this. It points out the problems in modern society and our lives that lead to depression rather than it just being something that can be solved with a pill. Things like our lack of connection to meaningful work, our lack of connection to each other and our lack of connection to nature all play a big part.

I recommend “The Cult of Pharmacology,” which long ago characterized this serotonin theory as bio-babble reductionism

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

#357

Post by kzrdude »

aahortwwy wrote: post #315
wisty wrote: post #307

Earlier quoted context omitted.

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.

It's common to a lot of treatments that we can't heal the body, we can only help it heal itself. Quite amazing in that sense.

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

#358

Post by fragcula »

openplatypus wrote: post #344
fragcula wrote: post #336

> Other clinicians say, however, that the notion of depression being because of a simple chemical imbalance is outmoded anyway, and that antidepressants remain a useful option for patients alongside other approaches including talking therapies. This is the key line in the summary. The concept of attacking an idea no one really believes is really a straw man. More importantly the modern practice of medicine is "eviden…

IMO key quote the study you referenced: > In conclusion, the anti-anxiety properties of SSRIs appear to be largely dependent on expectancy effects on dopamine signaling while SERT blockade is not sufficient for symptom remission. Drug works, if you believe it does :)

It's a shame that the imagining is so expensive, because I'd love to see a true control arm with placebos and follow up scans.

i.e. if you are on a placebo and are told you will get better how many do?

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

#359

Post by thelittleone »

I highly recommend the book "plant medicines and the imaginal realm".

I've worked extensively with indigenous curanderos (healers) many of who view depression as a sickness undigested emotions and past trauma. This sickness negatively affects perception of their present moment.

In plant medicine ceremony, when past trauma is processed it's frequently accompanied with throwing up which is called "purging" or "getting well".

Outside of ceremony plants are often prescribed as a purgative which are often drunk accompanied by copious water. Purging may happen in both directions.

There is so much to experience in that field, so many lines of beautiful inquiry and in ceremony often a feeling of eternal present moment.

The book puts forward how depression and other sickness come from an altered perception that can be restored by plant medicines.

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

#360

Post by ratww »

coffee_beqn wrote: post #287
ratww wrote: post #256

Earlier quoted context omitted.

Also a happy customer of that one. It worked great for me even with a low dosage and didn’t otherwise negatively impact anything else.

How long were you on and what made you go off it? Four months in I’m feeling better now but I don’t think I want to take it forever

For me it was around the same time Mo3 mentioned they took, maybe a bit more than one year and a half. It's been long, so I don't remember precisely.

However I was in a quite sorry state before... I was having several panic attacks a week. My therapy alone was also not working well, I was doing twice a week. After starting it, everything started falling into place. I never had a panic attack again.

I never had any downside whatsoever from taking them (didn't know they don't go well with summer!), including the regular complaints, it wasn't really a burden on me other than having to buy them monthly and take them every day.

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