The "chemical imbalance" theory of depression is extremely valuable, and it's not even true (2023)

"Lexapro appears to alleviate symptoms of depression and anxiety by increasing serotonin levels," says an advertisement on the Bonkers Institute, a website that archives drug advertisements and also satirizes pharmaceutical claims and dubious science.

"Zoloft works to correct a chemical imbalance in the brain that may be linked to symptoms of depression," reads another advertisement.

“Paxil CR prevents serotonin from being reabsorbed in the transmitting nerve cell. This process increases the availability of serotonin to the receiving nerve cell and may help to restart the transmission of [depression] messages," reads a third advertisement.

As many Epoch Times readers have heard, the serotonin theory of the "chemical imbalance" of depression was recently rejected by a group of researchers at University College London (UCL) in the journal Molecular Psychiatry. After decades of research, there is no evidence that serotonin levels or serotonin activity are responsible for depression, they wrote.In other words, the theory behind selective serotonin reuptake inhibitor (SSRI) antidepressants and their hugely profitable franchise was wrong.

Although the theory has been disputed by scientists for decades, research in molecular psychiatry appears to be the final nail in the theory's coffin: a technical knockout.

"The popularity of the 'chemical imbalance' theory of depression has coincided with an increase in the use of antidepressants," said study lead author Joanna Moncrieff, professor of psychiatry at UCL. “Antidepressant prescriptions have increased dramatically since the 1990s.

“Thousands of people suffer from the side effects of antidepressants, including the severe withdrawal symptoms that can occur when people try to stop taking them, yet prescription rates continue to rise.

"We believe this situation was caused in part by the erroneous belief that depression is due to a chemical imbalance. It is time to let the public know that this belief is not based on science."

A strong drug franchise

It is difficult to overestimate the medical, financial, and sociological implications of the chemical imbalance theory that led to the FDA approval of the SSRI antidepressant Prozac in 1987 and is still being pursued today. A few years ago, Harvard Health Publishing estimated that about 1 in 4 American women in their 40s and 50s took antidepressants.

Thanks to direct-to-consumer (or "seller" as some say) marketing about depression, people with life challenges or occasional low moods picked up the messages of chemical imbalance, self-diagnosed depression, and presented them in clinics.

Problems with family, work, health, money or housing are no longer a reason to feel depressed or down, as aggressive SSRI advertising campaigns suggest; If you were depressed, you had a chemical imbalance, regardless of anything else that might explain your depression (such as the loss of meaning and social connection often seen in modern society).

Whereas the antidepressants that preceded SSRIs, some called monoamine oxidase inhibitors, linked to neurotransmitters in the brain like serotonin, dopamine, and norepinephrine, SSRIs reduced chemistry to a simple problem-solving equation that the public readily accepted. Thanks to the new chemical imbalance of the serotonin depression theory, drug makers had an impressive new business; Doctors, a ready-to-use tool that delights the patient; the media, new trusted advertisers; and Wall Street, hot new stocks, almost overnight. Worldwide SSRI sales are estimated to reach $18.29 billion by 2027.

conventional medicine reaction

psychiatrists and the American Psychiatric Association (APA), which is heavily funded by drug manufacturers (70% of authors of the APA Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, were funded by drug manufacturers, ABC News reported). the first to reject the article on Molecular Psychiatry. The main protest was: "We never promoted the 'chemical imbalance' theory"; No, leave it to the drug makers, the cynics would say, and "nobody really understands why or how antidepressants work."

The "third rail" for physicians funded by drug companies is the suggestion that mental illness may not be due to physical conditions. As Mark Horowitz, co-author of the Molecular Psychiatry paper, said: "An interesting aspect of the studies we reviewed was how strong the impact of adverse life events was on depression, suggesting that low mood is a response to people's lives and cannot be reduced to a simple chemical equation.”

If depression is caused by stress, trauma, pain, loneliness and social conditions such as poverty, as Horowitz suggests, then it would not be amenable to drug treatment. Even worse, if it weren't for a permanent chemical imbalance, as the serotonin depression theory implies, it wouldn't result in prescriptions for lifelong medications that are most sought after and prized by drug manufacturers.

"While looking at depression as a biological disorder appears to reduce stigma, research has shown the opposite, and also that people who believe their own depression is due to a chemical imbalance reduce theirs. Be more pessimistic about chances of recovery ’ Moncrieff said.

Psychiatrist Peter Breggin, dubbed the conscience of psychiatry, explained this finding to The Epoch Times:

“Since the ancient Greeks, doctors have wanted to believe that psychological and emotional suffering must have biological causes. This allowed them to include "mental illness" in their specialty.

"As the massive involvement of pharmaceutical companies in routine psychiatric practice developed during the advent of antipsychotics in 1954, pharmaceutical companies also began to explore the biochemical and biological basis of human experiences such as anxiety, depression, manic depression ( now bipolar). Disorder). ) and schizophrenia.

Then, in the late 1980s, awaiting FDA approval of Prozac for depression, Eli Lilly and Company ran an international advertising campaign claiming that depression was caused by a biochemical imbalance in serotonin. It was clear from the start that this was pure fantasy.

"In my academic books and articles since 1983, I have pointed out the consistent truth that biochemical imbalances in the brains of the insane are not known until the neurotoxic effects of all psychiatric drugs cause them.

“Now, a review article by British psychiatrist Johanna Moncrieff has reaffirmed that research has failed to show a link between depression and abnormalities in serotonin metabolism in the brain. So-called "mental illnesses" are not known to be of genetic or biochemical origin; It's all just propaganda from the medical and pharmaceutical companies."

Breggin and his wife Ginger wrote the new book COVID-19 and the Global Predators: We Are the Prey.

Do not stop SSRIs abruptly, let both parties know

Whether they believe that SSRIs are misleading and overprescribed or valuable treatments, doctors caution patients not to stop the medications abruptly.

In 2018, The New York Times revealed that SSRI antidepressants can be hard to kick and downright addictive (although drug companies prefer to refer to the effects of addiction as "withdrawal syndrome"). Some patients said their doctors did not warn them that they could continue the drugs indefinitely because of the side effects they experience when trying to stop the drugs, such as dizziness, nausea, headaches and brain shock, the paper reported.

Brian, a 29-year-old Chicago resident who asked not to use his last name, said he had taken an SSRI antidepressant for years despite his desire to stop.

"Every time I try to stop, I feel what feels like an electric current in my head and I can't," he said.

The NY Times article provoked a huge reaction from psychiatrists. "By widening the echo chamber of social media, the article creates the unfortunate impression that most patients are forced to continue taking antidepressants for fear of withdrawal rather than preventing recurrence," reads a statement signed by a group of 39 psychiatrists in a letter to the editor. , who described depression as "chronic" and "undertreated". At least 35 of those who signed the letter were from the Columbia University College of Physicians and Surgeons, an institution that received a $250 million gift from former Merck CEO Roy Vagelos and his wife Diana in 2017.

Since their original marketing, SSRI antidepressants have also been known to increase bone loss and the risk of fractures, as well as the risk of the dreaded Clostridium difficile bowel disease.

So why do SSRIs work?

It is well accepted that SSRI antidepressants sometimes work, though not impressively, and not in all patients. But why? A follow-up article by Moncrieff and Horowitz states: "Any drug that alters normal brain activity is likely to have some effect on mood and... normal."

Antidepressants also dampen moods, researchers say, "including not just sadness and anxiety, but also pleasant emotions like happiness and joy," which can lower rates of depression, making the drugs seem effective.

An article in the journal Springer Inflammopharmacology suggests that a possible SSRI mechanism may be "decreasing neuroinflammation [in the brain] through a variety of mechanisms, including the reduction of blood or tissue cytokines or the regulation of complex inflammatory pathways."

Whatever the explanation, it is true that other methods of treating depression, including cognitive behavioral therapy and physical therapy, have proven effective with added benefits and no side effects.

one last irony

Despite destroying the premise millions of Americans were given psychoactive drugs by, raising questions about the intersection of health care and fraudulent drug marketing, some media outlets attempted to politicize the accident.

Many media outlets lashed out after Fox News anchor Tucker Carlson said, “We were first told that SSRIs would save lives. Now we learn that they are not working as expected. In fact, the whole idea behind the drug was totally wrong. And yet, best of all, people ignore this news and the drugs are still being prescribed."

Rolling Stone magazine published a successful article that portrayed Moncrieff as a conspiracy fanatic who had criticized overmedication for mental illnesses in the past and blamed some psychoactive drugs for mass shootings. The article Who is the psychiatrist behind the study on antidepressants that is dominating the right-wing media? and the opioid scourge created by drug manufacturers to demonize competitors.

Millions of people taking SSRI antidepressants now face the prospect of stopping.