Antidepressants are effective, top doctors insist their response to the bomb study
Leading psychiatrists rounded up the authors of a surprising study that cast doubt on the effectiveness of antidepressants, calling the findings “ridiculous” and “grossly exaggerated.”
Last week, researchers at University College London said they had disproved a theory dating back to the 1960s that depression was caused by low levels of serotonin, a brain chemical believed to control mood.
Led by Professor Joanna Moncrieff, a respected consultant psychiatrist, the study analyzed decades of research, involving tens of thousands of patients with the condition, and found ‘no convincing evidence’ of a link between mental illness and serotonin levels.
Professor Joanna Moncrieff, pictured, a consultant psychiatrist at University College London, led a team of researchers who disproved the popular belief that there was a link between low serotonin levels and depression.
The findings are significant because most antidepressants – which have been taken by more than eight million Britons – are designed to increase serotonin levels.
Professor Moncrieff said: “Thousands suffer from the side effects of antidepressants, including severe withdrawal effects that can occur when trying to stop them, and yet prescription rates continue to rise.” We believe this is motivated by the misconception that depression is caused by a chemical imbalance. It’s time to inform the public that this belief is not based on science.
However, prominent brain experts have criticized Professor Moncrieff, who has written popular books that take antidepressants in a negative light. They argue that it is incorrect to say that scientists believe depression is caused by low levels of serotonin. Instead, they say, the prevailing theory is that depression is caused by many factors, and that antidepressants are clinically shown to help.
Dr Michael Bloomfield, a consultant psychiatrist and fellow of Professor Moncrieff at University College London, said her conclusion was “illogical”.
Depression has many different symptoms and I don’t think I’ve met any serious scientists or psychiatrists who believe that all depression is due to a simple chemical imbalance in serotonin.
he added: ‘[This paper] I grouped depression together as if it were a single disorder, which makes no sense from a biological perspective.
David Curtis, Professor Emeritus, Institute of Genetics at UCLA, agreed: “The idea of depression due to chemical imbalances is outdated, and the Royal College of Psychiatrists wrote that this was an oversimplification in a statement published in 2019.” It appears that Phil Quinn, professor of psychopharmacology at the University of Oxford, accuses Professor Moncrieff of cherry-picking data to fit her hypothesis.
Paramedics in the 1960s found a link between low serotonin levels and depression, and later provided doctors with a weapon to target the condition.
He noted that the review had omitted a pivotal study that indicated depressed patients had lower levels of compounds that are integral to serotonin production in their blood.
The potential role of serotonin in depression is a separate question from antidepressant effects [antidepressants],’ He said.
Other experts point to multiple studies showing that taking antidepressants can elevate depression, regardless of their effect on serotonin levels.
“Through years of research, we know that antidepressants work and save lives,” says Professor David Natt, Head of the Center for Psychopharmacology and Neuropsychology at Imperial College London.
The conclusions of this paper are absurd. The authors have severely exaggerated the importance of serotonin levels. No one has ever said that a serotonin imbalance is the only cause of depression.
He adds that more recent studies, not included in Professor Moncrieff’s review, and which used more accurate testing methods, found “lower serotonin releasing capacity” in people with depression. “It is premature to rule out the serotonin hypothesis for depression at this point,” he said.
Psychiatrists say the exact reason antidepressants work is not understood, but this is not unusual. “It’s hard to be absolutely sure why a drug works in the brain,” says Professor Knott. In the case of antidepressants, it can have an effect on things other than serotonin receptors.
Crucially, they argue that even if depression is not caused by an imbalance of serotonin, this does not mean that it cannot be effectively treated by increasing levels of the chemical in the brain.
Responding to the criticism, Professor Moncrieff said the aim of the study was not to argue that antidepressants don’t work, but rather to ask whether the pills should be prescribed in the first place.
People are told that the reason they feel depressed is that there is something wrong with the chemistry in their brains and that antidepressants can correct it. But if there is no evidence that there is anything wrong with brain chemistry, this would not seem like a reasonable solution. The profession has misled people for a long time about the need for antidepressants and now doctors don’t want to admit they got it wrong.
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