Could drug treatment for depression be a myth?

A recent study found that low serotonin levels did not cause depression. But has the research been misinterpreted?

A study that found that depression is not caused by low levels of serotonin, the “happiness hormone”, has become one of the most talked about and shared medical articles in recent months.

The conclusion sparked a wave of misinformation about antidepressant drugs, many of which increase the amount of serotonin in the brain.

Research, however, does not point out that these drugs are not effective or fail to help patients.

On the other hand, it has also provoked some genuine questions about how people treat mental illness.

After the British woman Sarah had her first serious psychiatric problem in her early 20s, doctors told her the drug prescribed was like “insulin for diabetics”.

For them it was essential: they said the drug would correct a chemical problem in their brain and should be used for life.

Her mother had type 1 diabetes, so she took it very seriously.

Sarah continued to use the drugs, even though they made her feel worse. Eventually, she “heard threatening voices” urging her to kill herself. She also had electroconvulsive therapy (ECT).

However, the claim that Sarah needed the drug like a diabetic needs insulin was not based on any scientific evidence.

“I felt betrayed by the people I trusted,” she says.

His negative reaction to drugs has been extreme, but the argument “chemical imbalance” as a cause of depression is not uncommon.

Many psychiatrists have said they have long known that low serotonin levels are not the main cause of depression. Therefore, the recent article would bring nothing new.

However, the large repercussions of the research indicate that this was new to many people.

The problem is that using the article to argue that antidepressants don’t work is an inaccurate leap.

And doctors fear that, in the confusion, people may abruptly stop taking their medications and risk severe withdrawal effects.

The UK’s National Institute for Health and Care Excellence (Nice) states that the use of these drugs should not be stopped abruptly, except in a medical emergency. Slowly reducing the dose can minimize withdrawal symptoms, he says.

What did the research show?

This latest research looked at 17 studies and found that patients with depression did not have different levels of serotonin in their brains than people who did not.

The discovery helps rule out a possible way the drugs might work by correcting a deficiency.

London-based psychiatrist Michael Bloomfield makes a comparison:

“Many of us know that taking acetaminophen can be helpful for headaches, but I don’t think anyone believes headaches are caused by insufficient acetaminophen in the brain,” he points out.

So do antidepressants work?

Research shows that antidepressants work only slightly better than placebos. There are debates among researchers about how significant this difference is.

Within that average there is a group of people who experience much better results with antidepressants. The problem is that doctors simply have no way of knowing if their patient is one of those people.

Some people who take antidepressants claim that the drugs help a lot with a mental health crisis or allow them to better manage the symptoms of depression in everyday life.

Professor Linda Gask, of the Royal College of Psychiatrists (a professional body of psychiatrists in the UK), says antidepressants are “something that helps many people feel better quickly”, especially during a crisis.

However, one of the authors of the article on serotonin, Professor Joanna Moncrieff, points out that most of the research done by pharmaceutical companies is short-term. So, according to her, little is known about the performance of patients after the first few months of using the drug.

“You have to analyze the results of the treatment and not let the patient take the drug longer than necessary, which is often not the case,” says Gask.

While there are risks of not treating depression, some people will experience severe side effects from antidepressants: the authors of the serotonin study say these harms need to be communicated more clearly by the industry.

Effects can include suicidal thoughts and attempts, sexual dysfunction, emotional numbness, and insomnia, according to Nice.

A few months ago, UK doctors were told to prescribe therapy, exercise and meditation for patients with less severe depression.

What has been said about the research?

Reactions to the study on the relationship between serotonin and depression said the research showed that antidepressant prescribing was “built on a myth.”

But it’s not true.

The problem with this argument is that the study did not look at the use of antidepressants.

Serotonin plays a role in mood, so regulating it can make people feel happier, at least in the short term, even if they don’t have abnormally low levels of the hormone. It can also help the brain make new connections.

Others have said that research shows that depression was never a disease in people’s brains, but a reaction to the environment.

“Obviously they are both,” says Mark Horowitz, one of the authors of the article. “Your genetics affect your sensitivity and stress, for example.”

But some people may be better treated with “relationship counseling, financial counseling, or job change” than medication.

However, Zoe, who lives in southeastern Australia and suffers from severe depression and psychosis, says that even redefining depression as “an anguish that would go away if we solved all social problems” is too simplistic.

For her, this concept neglects people with more severe problems than mental illness.

Psychosis runs in his family, but his episodes are often triggered by stressful events.

Zoe says she found drugs, including antidepressants, that changed her life.

For her, “the side effects of drugs are worth addressing”, as they prevent severe episodes.

And this is a consensus among the experts who spoke to BBC News: Patients need more information to be able to make the right decision for them.

– This text has been published originally in https://www.bbc.com/portuguese/geral-62584210

Source: Terra

Benjamin

Benjamin Smith is a fashion journalist and author at Gossipify, known for his coverage of the latest fashion trends and industry insights. He writes about clothing, shoes, accessories, and runway shows, providing in-depth analysis and unique perspectives. He’s respected for his ability to spot emerging designers and trends, and for providing practical fashion advice to readers.