There is no evidence that depression is caused by lower levels or reduced activity of serotonin in the brain, according to a recent analysis of 17 previous studies.
The analysis, carried out by Joanna Moncrieff, MD, a professor of psychiatry at University College London, and her colleagues, tells us pretty much what we've known all along. The chemical imbalance marketing myth has been used as an indicator that people need antidepressants.
The response to this analysis, by many psychiatrists at least, has been eye-opening.
The Science Media Centre (SMC), whom I've wrote about before on this blog, were rolling out their 'experts'.
Dr Michael Bloomfield, Consultant Psychiatrist and UKRI Principal Clinical Research Fellow, Translational Psychiatry Research Group Head, UCL, said:
"The findings from this umbrella review are really unsurprising. Depression has lots of different symptoms and I don’t think I’ve met any serious scientists or psychiatrists who think that all causes of depression are caused by a simple chemical imbalance in serotonin."
Bloomfield really needs to brush up on his research skills. Just two years ago, Adrienne Nagy, Board President of the National Alliance on Mental Illness (NAMI), America's largest grassroots mental health organization, had this to say:
"We're continually trying to educate the public to know that mental illness is an illness like any other illness—it's a biochemical imbalance in the brain. It's no different than diabetes or heart failure."
Other examples of psychiatrists promoting the chemical imbalance theory can be viewed here.
Another SMC 'expert', Prof David Nutt, Edmond J Safra Chair and Head of the Centre for Neuropsychopharmacology, Imperial College London, seemed to be digging his heels in when reacting to the Moncrieff analysis with:
"It is only recently that we have developed the technology to measure serotonin release in the living human brain and in the first study of this type (currently under review) we did find decreased serotonin release capacity in people with depression. So, to dismiss the serotonin hypothesis of depression at this point is premature."
Nutt has, in the past, received grants and personal fees from Lundbeck and GSK and personal fees from Lilly, BMS, Otsuka, Servier, and Pfizer, the majority of whom market and manufacture SSRI's, the very same types of drugs promoted to correct a chemical imbalance. I think it's no coincidence that Nutt still wants to hold on to the serotonin hypothesis of depression.
The general consensus (from psychiatry) of this new analysis seems to be, 'So what, we've known all along that it was just a theory'. I think they're either missing the point or being deliberately obtuse.
Samei Huda, author and consultant psychiatrist, Pennine Care NHS Foundation Trust, went one further.
Here's a screenshot of his tweet which implies Moncrieff and her colleagues have "right-wing associations."
I find his above tweet was specifically constructed to be inflammatory. Huda can be followed here. I blocked him a couple of years ago.
The point many psychiatrists, on Twitter at least, seem to be missing is patients have been sold a lie. Not one single psychiatrist has been able to answer the following, Is the patient, taking SSRIs, at risk or is increasing serotonin in the brain deemed safe?
Professor Carmine Pariante, spokesperson for the Royal College of Psychiatrists, said of the Cipriani analysis "This finally puts to bed the controversy on antidepressants, clearly showing that these drugs do work in lifting mood and helping most people with depression."
A year later, Pariante was interviewed by BBC's Angela Rippon. According to Pariante, his team "chemically induce brain cells in test tubes to mirror the state of depression. Antidepressant medication is then added". Furthermore, according to Pariante, "There is no evidence that we are over prescribing antidepressants, yes more antidepressants are prescribed today than 10 years ago but, in fact, most people who need antidepressants are not receiving an antidepressant."
Yes, he really did say this.
You can watch the full show, Truth or Scare, here.
The SMC's 'expert' reaction can be viewed here.
Bob Fiddaman
