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NOTE from Altostrata: Please disregard anything in these articles that state or imply there is low serotonin in the brain of depressed people, or any other kind of neurotransmitter imbalance. That is entirely, absolutely false.

 

 

Wasn't sure where best to put this.

 

This is for anyone curious how the brain works (and also links to depression and anxiety).

 

Just found this wonderful Candian site with lots of info about how the brain works. It's material is 'copyleft' - see site for full descripation, but basically your free to use it elsewhere as you want.

 

The site is developed, researched, and written by Bruno Dubuc with funding from the Canadian Institutes of Health Research: Institute of Neurosciences, Mental Health and Addiction.

 

It includes this interesting information on 'Serotonin and other molecules involved in depression' and also (of course) Antidepressants - including an argument of why it's not appropriate to talk about "chemical imbalance" in depression any more. It has explanations at beginner, intermediate and advanced levels for everything.

To read more you can start here:-

Beginner

http://thebrain.mcgill.ca/flash/d/d_08/d_08_m/d_08_m_dep/d_08_m_dep.html

Intermediate

http://thebrain.mcgill.ca/flash/i/i_08/i_08_m/i_08_m_dep/i_08_m_dep.html

Advanced

http://thebrain.mcgill.ca/flash/a/a_08/a_08_m/a_08_m_dep/a_08_m_dep.html

 

But be warned if you are curious about this stuff you could get lost for hours :)

Citalopram for 6 months

Since then tapering off over last 4 months

20mg -> 15mg -> 10mg -> 5mg (roughly every 3-4 weeks)

Stayed at 2.5mg for approx 6 weeks

As of 9 Sept 2011 off citalopram

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Thanks again for contributing these very interesting pointers, bright.

 

I'm moving it to Media because DIY Editorials is for opinion pieces and rants.

This is not medical advice. Discuss any decisions about your medical care with a knowledgeable medical practitioner.

"It has become appallingly obvious that our technology has surpassed our humanity." -- Albert Einstein

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These articles contain this and similar statements:

 

"But scientists have been able to measure the decline in serotonin levels in the bloodstreams of depressed people only indirectly."

 

Please disregard anything in these articles that state or imply there is low serotonin in the brain of depressed people, or any other kind of neurotransmitter imbalance. That is entirely, absolutely false.

 

I have written the author and asked him to update this material. Mainstream psychiatry now disavows the chemical imbalance theory.

This is not medical advice. Discuss any decisions about your medical care with a knowledgeable medical practitioner.

"It has become appallingly obvious that our technology has surpassed our humanity." -- Albert Einstein

All postings © copyrighted.

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Sorry didn't mean to provide a link to misleading information.

 

Bright

Citalopram for 6 months

Since then tapering off over last 4 months

20mg -> 15mg -> 10mg -> 5mg (roughly every 3-4 weeks)

Stayed at 2.5mg for approx 6 weeks

As of 9 Sept 2011 off citalopram

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That's okay, bright. There's an enormous amount of this material on the Web.

 

The "chemical imbalance" theory was very fashionable for many years, although it was disproven about 20 years ago. But it was a handy way for doctors to persuade patients to take medications as though they had a progressive disease, like diabetes. Promoting this idea was also very profitable for the drug companies.

 

Let's see how Bruno Dubuc responds to my e-mail. The Mayo Clinic actually modified some of their material after I wrote them.

 

I hope you don't mind, if I get no response, I may delete this topic. But carry on with your contributions! We're all learners here.

This is not medical advice. Discuss any decisions about your medical care with a knowledgeable medical practitioner.

"It has become appallingly obvious that our technology has surpassed our humanity." -- Albert Einstein

All postings © copyrighted.

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Alto,

 

If you don't get a response your happy with and want to delete the post, please do I'm ok with that.

 

Alternately, it might be interesting to post whatever response you get here, say what you think, and maybe change the topic title so it becomes a cautionary tale about how to be careful of what you find on the internet.

 

You can decide what's best as far as I am concerned.

 

I'm finding the chemical imbalance stuff very confusing, and there is so much contradicting stuff on SSRIs on the internet. The site links I posted above have the look of something authorative BUT it doesn't provide any citations to support it's claims. This makes it simpler read but in an area such as SSRIs where so much information is either written by vested interests e.g. the people selling this stuff or the people who are funded by them this may not be good.

 

It'll be interesting to see what response you get.

Citalopram for 6 months

Since then tapering off over last 4 months

20mg -> 15mg -> 10mg -> 5mg (roughly every 3-4 weeks)

Stayed at 2.5mg for approx 6 weeks

As of 9 Sept 2011 off citalopram

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I did get a response. See below.

 

-----Message d'origine-----

De : Altostrata [mailto:altostrata@comcast.net]

Envoyé : 8 septembre 2011 14:36

À : bruno.dubuc at videotron.ca

Objet : Misinformation on your site

 

Hello --

 

You may wish to update the information on your site.

 

There is no evidence whatsoever that there is low serotonin in the brain of depressed people, or any other kind of neurotransmitter imbalance. That is entirely, absolutely false.

 

This has been well-documented. The "chemical imbalance" theory is now widely disavowed by mainstream psychiatry.

 

Thank you.=

 

---------- September 9, 2011 RESPONSE BELOW -----------

 

 

Hi,

 

Thanks for your comments. But I don’t think that I wrote anywhere in that topic that low serotonin levels « cause » depression. If so, tell me where, but I think I used some precautions with this (« there is some correlation », etc. because in some forms of depression, there is).

 

And above all, I have written a special box at page http://thebrain.mcgill.ca/flash/a/a_08/a_08_m/a_08_m_dep/a_08_m_dep.html#2 (the last one in the right column) to explain exactly what you are saying. I have pasted it below.

 

Finally, this website try also to show that science progress by its mistakes, that’s why I took some time and place to talk about the chemical imbalance theory.

 

Hope that it clarifies your point.

 

Cordially,

Bruno Dubuc

 

-

Many researchers now believe that it is not really appropriate to describe the physiological causes of depression as a "chemical imbalance".

 

The hypothesis that depression was caused by a "chemical imbalance" originated in the 1960s. The first antidepressant medications, developed around that time, were tricyclics and monoamine oxidase inhibitors (MAOIs). In addition to alleviating the symptoms of depression in many patients, these molecules were known to increase brain levels of dopamine, norepinephrine, and serotonin in various ways. For this reason, researchers hypothesized that depression might be due to an imbalance in these neurotransmitters. This hypothesis did indeed yield some fairly useful research findings during the last decades of the 20th century. In addition, by emphasizing that mood disorders might be related to a physiological malfunction and not simply to a character defect or a lack of will power, this hypothesis reduced the needless feelings of guilt that often haunted people with depression.

 

However, the results of efforts to identify this "chemical imbalance" more precisely have been rather disappointing and contradictory. Research is now focusing less on the neurotransmitters themselves and more on the receptors for these molecules and on the molecular events involved in regulating genes. But here too, there is room for controversy. Relatively little direct evidence has been found of alterations in receptors or anomalies in gene expression related to these receptors or other enzymes in cases of depression. Moreover, the reason for the two to three week lag between the time when antidepresssants first affect neurotransmitters and the time when they begin to affect mood (see sidebar to the left) is still not well understood. In short, the situation is far more complex than scientists believed in the 1960s when they first formulated the "chemical imbalance" hypothesis.

 

Given these problems in securing any unequivocal data to support this hypothesis, some scientists have begun to ask whether the extensive use that continues to be made of the term "chemical imbalance" might raise some ethical problems, or even political ones. In the United States, for example, where advertisements for antidepressants are allowed in the mass media, the pharmaceutical companies have not always worried about this fine point. Simplistic advertisements tell Americans that when they are depressed, a substance in their brain is out of balance, and that if they take the right antidepressants, the ideal balance will be magically restored. These advertisements may well have something to do with the stunning success of SSRI antidepressants, such as Prozac, Zoloft, and Paxil, in the marketplace, and the billions of dollars that they have earned for the companies that make them.

This is not medical advice. Discuss any decisions about your medical care with a knowledgeable medical practitioner.

"It has become appallingly obvious that our technology has surpassed our humanity." -- Albert Einstein

All postings © copyrighted.

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From: Altostrata <altostrata@comcast.net>

Subject: Re: Misinformation on your site

Date: September 10, 2011 11:50:26 AM PDT

To: Bruno Dubuc <Bruno.Dubuc at videotron.ca>

 

Dr. Dubuc:

 

Thank you for your prompt response and obvious concern about the accuracy of material on your site.

 

If it is not too much trouble for you to respond, I would like to know in which forms of depression a correlation has been found with low levels of serotonin or any neurotransmitter, as you mentioned in your mail.

 

It would be very easy for a reader to miss your disclaimer box isolated on http://thebrain.mcgill.ca/flash/a/a_08/a_08_m/a_08_m_dep/a_08_m_dep.html#2 Sampling and skimming are the usual practices in Web reading. The corrections should be woven into the entire site. There are still errors on other pages.

 

Here are some examples descended from the discredited "chemical imbalance" theory:

 

http://thebrain.mcgill.ca/flash/d/d_08/d_08_m/d_08_m_dep/d_08_m_dep.html

"A decline in the activity of these neurons is believed to be associated with various forms of depression, in particular those that lead to suicide."

 

"Depression has been linked to imbalances in certain chemical messengers in the body, such as serotonin, norepinephrine, and dopamine."

 

http://thebrain.mcgill.ca/flash/d/d_08/d_08_cl/d_08_cl_dep/d_08_cl_dep.html Sidebar

"Depression does not appear to be due solely to an imbalance between certain chemical messengers in the brain."

 

"these substances not only re-establish the equilibrium of certain neurotransmitters"

 

http://thebrain.mcgill.ca/flash/d/d_08/d_08_s/d_08_s_dep/d_08_s_dep.html

"We now know that certain molecules in the brain, such as serotonin, play a role in depression and therefore probably in suicide as well."

 

 

Although in your disclaimer you rightly note self-serving pharmaceutical company promotion is responsible for the emphasis on the chemical imbalance theory in mass media, it permeated the thinking of many psychiatric researchers as well.

 

 

On other subjects, I also take exception to:

 

http://thebrain.mcgill.ca/flash/d/d_08/d_08_m/d_08_m_dep/d_08_m_dep.html

"Thus these diseases must be regarded as the result of disturbances in the communications between neurons."

There are no disturbances in the communications between neurons -- those communications are working well. It is the content of the thought that causes depression.

 

 

http://thebrain.mcgill.ca/flash/d/d_03/d_03_m/d_03_m_par/d_03_m_par.html

"So researchers have not been surprised to discover that practically all of the drugs that cause dependencies increase the amount of dopamine in the reward circuit."

Researchers may be further surprised to discover that drugs affecting other systems, such as SSRIs also cause physical dependency -- without much pleasure, unfortunately for the millions of SSRI users in the world.

 

 

http://thebrain.mcgill.ca/flash/d/d_08/d_08_cl/d_08_cl_dep/d_08_cl_dep.html

"antidepressants such as Prozac appear to cause an actual positive personality change in many people who take them."

 

"these drugs can improve the mental condition of people who are not clinically depressed, but simply shy or compulsive."

Surely this is in the eye of the beholder? A minority of people respond positively to antidepressants. Others respond adversely, and others not at all. Are you suggesting antidepressants be prescribed simply to change personality traits?

 

 

http://thebrain.mcgill.ca/flash/d/d_08/d_08_cl/d_08_cl_dep/d_08_cl_dep.html Sidebar

"Recurrent depressions may be more like a degenerative disease in which some nerve cells and neural connections are damaged or destroyed."

There is no evidence for this fear-mongering, but it does support psychiatry's wish that patients need perpetual treatment.

 

"Thus these substances not only re-establish the equilibrium of certain neurotransmitters but also probably produce changes in the structure of numerous neural networks."

The substances may indeed "produce changes in the structure of numerous neural networks" but these changes, possibly due to chronic neuroreceptor downregulation, may not be benign -- see El-Mallakh et al 2011.

 

(Personally, I think the theory of antidepressant-induced neurogenesis as an improver of disposition will also prove to be invalid.)

 

 

http://thebrain.mcgill.ca/flash/d/d_08/d_08_cr/d_08_cr_dep/d_08_cr_dep.html

"But major depression does not represent a malfunction in a single part of the brain. It is more likely due to a variety of brain abnormalities."

Completely unproven that any brain abnormality exists in major depression, or any kind of depression.

 

 

http://thebrain.mcgill.ca/flash/d/d_08/d_08_s/d_08_s_dep/d_08_s_dep.html

"An estimated 9 out of 10 cases of suicide are associated with some form of mental disorder, generally depression."

Unproven, unless you retroactively diagnose suicidal inclination as depression. Tautologies are not unknown in psychiatry. Your own statistics on this page show the Canadian suicide rate as .0125%. What is psychiatry's estimated rate of depression -- 10% - 50%? Clearly, depression is not predictive of suicide -- even given that these estimates of depression are wildly exaggerated.

 

 

I understand how hard it must be for the psychiatric profession to relinquish theories that seem so neatly to explain human emotions, and that reconceptualizing the information on your site must be quite time-consuming. But thousands of people may be visiting your site and being misinformed, which can affect their own decisions about their health.

 

(I do appreciate your trenchant observations in the Social silo.)

 

I am sure you and the Canadian Institutes of Health Research and the Canadian Institute of Neurosciences, Mental Health and Addiction share my concern. We must all work together to take this erroneous information off the Web.

 

Thank you,

 

Altostrata

 

 

PS You may wish to make your site easier to navigate in terms of topic hierarchy. For example, on http://thebrain.mcgill.ca/flash/d/d_08/d_08_m/d_08_m_dep/d_08_m_dep.html, make the three balloons at the top of the page clickable, so a user might be able to go to the Mental Disorders page. Also, it would be helpful if the site map in English was also accessible from each page.

 

PPS You may be interested in my Web site, http://survivingantidepressants.org, a peer support site for people who have difficulty withdrawing from antidepressants because they cause physical dependency.

This is not medical advice. Discuss any decisions about your medical care with a knowledgeable medical practitioner.

"It has become appallingly obvious that our technology has surpassed our humanity." -- Albert Einstein

All postings © copyrighted.

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Thanks Alto

Citalopram for 6 months

Since then tapering off over last 4 months

20mg -> 15mg -> 10mg -> 5mg (roughly every 3-4 weeks)

Stayed at 2.5mg for approx 6 weeks

As of 9 Sept 2011 off citalopram

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Well, let's see how this goes over, bright!

This is not medical advice. Discuss any decisions about your medical care with a knowledgeable medical practitioner.

"It has become appallingly obvious that our technology has surpassed our humanity." -- Albert Einstein

All postings © copyrighted.

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From: Bruno Dubuc <Bruno.Dubuc at videotron.ca>

Subject: RE: Misinformation on your site

Date: September 12, 2011 7:31:55 AM PDT

To: Altostrata <altostrata@comcast.net>

 

Dear « Altostrata »,

 

First I know it’s your right to hide behind a nickname, but it makes it difficult for me to find out « from where » you speak, because everybody speak from somewhere, and there is not absolute truth, right ? Because I found that the arguments in you email are formulated in a way that YOU know what depression is (or is not, in that case) and I, and a lot of researchers, do not know (at all, to use your kind of emphasis). So those two things makes it very difficult for me to find the motivation to answer directly to your questions.

 

But I will a little bit, even is English is not my mother tongue (I write the website in French and it is then translated in Englis), and because I do not want to be disrespecful to you (and even if I have a couple of email a day to answer, that I do not usually make double answers, that I am alone and only part time to do the research, writing and coordination of all this website).

 

So you are an activist. You should have put your website adress at the beginning of your email, thing would have been clearer more quickly. I have nothing against this. I am myself an activist in other fields. So I speak to you as a « camarade » as we say in French. I suspect that you, or probably someone near you, had suffered from AD addiction. Activism always start from a very emotional stand point. And for me too, I am no exception. But the difficulty is to not become dogmatic. Dogmatism do not goes well with science. Science have to « stay with the open question ». And science is a path, an history, some models and theories, not dogmatic truth. Some model might have more and more evidence agaist it ? We have to say it, and act in consequence for sure. And the work you are doing goes well in this sens. But we won’t deny the path scientific research has gone through, because science IS the path, and denying the path is denying science. (and I won’t talk about the strange and absolute sens that you seem to give to the proof in science…)

 

So I won’t change what I wrote about depression, which is conform with what I just said, when I write for example, in my box (which is not a « disclaimer » but a simple informative box like the others) : « Many researchers now believe that it is not really appropriate to describe the physiological causes of depression as a "chemical imbalance". » And the same thing with the sentences you report in this email : all have sufficient precautions, and no one says that depression IS CAUSED by chemical imbalance.

 

Finally, you might also be interested in reading this other box that I wrote at page http://thebrain.mcgill.ca/flash/a/a_03/a_03_p/a_03_p_dou/a_03_p_dou.html#2

 

The brain is a complexe organ, the most complexe of the known univers. And we, human, try to do our best to understand it in its complexity.

 

Respectfully,

Bruno Dubuc

 

[the other box at http://thebrain.mcgill.ca/flash/a/a_03/a_03_p/a_03_p_dou/a_03_p_dou.html#2]

 

Many medical sources indicate that over 10% of all men and over 20% of all women will experience depression at some time in their lives, so it is no surprise that antidepressants are among the most-prescribed types of medications. But the real effectiveness of their active ingredients, compared with the placebo effect, is the subject of ongoing debate.

 

In 1998, after analyzing 38 previously published studies on antidepressants, psychologists Irving Kirsch and Guy Sapirstein concluded that the placebos used in these studies produced about 75% as much improvement as the antidepressants themselves. The authors added that even the remaining 25% of the improvement that was exclusive to the antidepressants might have been attributable to an increased placebo response to the side effects caused by their active ingredient, or to other non-specific effects (see box to right).

 

In 2000, another meta-analysis of previously published results found a 30% reduction in suicide attempts among subjects who had received placebos compared with a 40% reduction among subjects who had received real antidepressants.

 

In 2008, in another analysis of several studies on antidepressants, Kirsch and his team showed that 12 weeks after trials lasting 6 to 8 weeks, 79% of the patients who had received placebos were still doing well, compared with 93% of the patients who had been treated with antidepressants.

 

Some researchers have even hypothesized that the reappearance of symptoms that is often observed after patients have been taking antidepressants for some time, and that is generally attributed to a growing tolerance for the antidepressant, might be explained largely by the fading of the placebo effect.

 

The most amazing finding in all of these analyses is just how powerful the placebo effect can be for treating depression. It should be noted, however, that the more severe the depression, the more effective that antidepressants seem to be, compared with placebos.

 

The lively debates on this subject have been going on for years and continue to this day. Scientists now seem to agree that, in certain circumstances, antidepressants do have a greater effect than placebos. But this effect often seems to be smaller than the pharmaceutical companies would have us believe. The difference between the effect of antidepressants and that of a simple sugar pill is not always very great, and may sometimes even be close to zero. The debate continues.

This is not medical advice. Discuss any decisions about your medical care with a knowledgeable medical practitioner.

"It has become appallingly obvious that our technology has surpassed our humanity." -- Albert Einstein

All postings © copyrighted.

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