Could Link Between Low Serotonin and Depression Be a Myth?

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the Psychiatry Advisor take:

A prominent psychiatrist in Wales who in the past has questioned the marketing of antidepressants by pharmaceutical companies now says that the widespread use of selective serotonin reuptake inhibitors (SSRIs) is based on the “marketing of a myth” that depression is caused by low levels of the neurotransmitter serotonin.

In an opinion in the journal the BMJ, David Healy, MD, a psychiatry professor at Bangor University argues that drug companies have pushed SSRIs — which work by boosting levels of serotonin in the brain — even though older tricyclic antidepressants were more efficacious.

“The approach was an astonishing success, central to which was the notion that SSRIs restored serotonin levels to normal, a notion that later transmuted into the idea that they remedied a chemical imbalance,” Healy wrote. “The tricyclics did not have a comparable narrative.”

Healy also noted that there is no research substantiating whether SSRIs even restore serotonin levels, and if this even helps with depression. But, the myth has persisted, he added, as it provides an way for clinicians to explain the treatment to patients.

“For patients, the idea of correcting an abnormality has a moral force that can be expected to overcome the scruples some might have had about taking a tranquilliser, especially when packaged in the appealing form that distress is not a weakness,” Healy wrote.

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On Tuesday, David Healy, a professor of psychiatry at Bangor University in Wales and author of Let Them Eat Prozac, published an opinion piece in the journal The BMJ writing that the link between serotonin and depression is a “myth” that continues to be perpetrated by the pharmaceutical industry. Specifically, Healy says the marketing of selective serotonin re-uptake inhibitors —better known as SSRIs — has been problematic.

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