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Little evidence that chemical imbalance causes depression, UCL scientists find - Guardian


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https://www.theguardian.com/society/2022/jul/20/scientists-question-widespread-use-of-antidepressants-after-survey-on-serotonin

 

Scientists have called into question the widespread use of antidepressants after a major review found “no clear evidence” that low serotonin levels are responsible for depression.

 

Prescriptions for antidepressants have risen dramatically since the 1990s, with one in six adults and 2% of teenagers in England now being prescribed them. Millions more people around the world regularly use antidepressants.

 

“Many people take antidepressants because they have been led to believe their depression has a biochemical cause, but this new research suggests this belief is not grounded in evidence,” said the study’s lead author, Joanna Moncrieff, a professor of psychiatry at University College London and consultant psychiatrist at North East London NHS foundation trust.

 

“It is always difficult to prove a negative, but I think we can safely say that after a vast amount of research conducted over several decades, there is no convincing evidence that depression is caused by serotonin abnormalities, particularly by lower levels or reduced activity of serotonin.

 

“Thousands of people suffer from side-effects of antidepressants, including the severe withdrawal effects that can occur when people try to stop them, yet prescription rates continue to rise. We believe this situation has been driven partly by the false belief that depression is due to a chemical imbalance. It is high time to inform the public that this belief is not grounded in science.”

 

The new review of existing studies found that depression is not likely to be caused by a chemical imbalance and said people should be made aware of other options for treating it.

 

However, other experts, including from the Royal College of Psychiatrists, questioned the findings and urged people not to stop taking their medication in light of the study, arguing that antidepressants remained effective.

 

In the new analysis, researchers said 85% to 90% of the public believed depression was caused by low serotonin or a chemical imbalance. 

 

Most antidepressants are selective serotonin reuptake inhibitors (SSRIs), originally said to work by correcting abnormally low serotonin levels.

 

The review, published in the journal Molecular Psychiatry, looked at studies examining serotonin and depression involving tens of thousands of people. One of the findings was that research comparing levels of serotonin and its breakdown products in the blood or brain fluids did not discover any difference between people diagnosed with depression and healthy people.

 

The authors also looked at studies where serotonin levels were artificially lowered in hundreds of people and concluded that lowering serotonin in this way did not produce depression in hundreds of healthy volunteers.

 

Other studies looked at the effects of stressful life events and found that the more stressful life events a person had experienced, the more likely they were to be depressed, showing the importance of external events.

 

According to the research, there is also evidence from other studies that antidepressants may actually induce low serotonin in the long term.

 

“Our view is that patients should not be told that depression is caused by low serotonin or by a chemical imbalance, and they should not be led to believe that antidepressants work by targeting these unproven abnormalities,” said Moncrieff.

 

“We do not understand what antidepressants are doing to the brain exactly, and giving people this sort of misinformation prevents them from making an informed decision about whether to take antidepressants or not.”

 

A spokesperson for the Royal College of Psychiatrists said: “Antidepressants are an effective, Nice-recommended treatment for depression that can also be prescribed for a range of physical and mental health conditions. We would not recommend for anyone to stop taking their antidepressants based on this review, and encourage anyone with concerns about their medication to contact their GP.”

 

Dr Michael Bloomfield, a consultant psychiatrist and principal clinical research fellow at University College London, who was not involved in the study, said: “Many of us know that taking paracetamol can be helpful for headaches, and I don’t think anyone believes that headaches are caused by not enough paracetamol in the brain. The same logic applies to depression and medicines used to treat depression.

 

“There is consistent evidence that antidepressant medicines can be helpful in the treatment of depression and can be life-saving.”

Oct 2018 - Jun 2020: 10 mg per day generic Escitalopram in pill form.

Jul 2020 - Aug 2020: Switched to 9 mg per day of Cipralex drops to aid tapering.

Sep 2020 - Oct 2020: Taper to 8 mg.

Nov 2020 - Dec 2020: Taper to 7 mg.

Jan 2021 - Feb 2021: Taper to 6 mg.

Mar 2021 - Apr 2021: Taper to 5 mg.

May 2021 - Jun 2021: Taper to 4 mg.

Jul 2021 - Sep 2021: Taper to 3 mg.

Sep 2021 - Jan 2022: Taper to 2 mg.

Jan 2022: Stopped taking altogether.

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See also: 

 

 

1996-2018 - misc. polypharmacy, incl. SSRIs, SNRIs, neuroleptics, lithium, benzos, stimulants, antihistamines, etc. (approx. 30+ drugs)

2012-2018 - 10mg lexapro/escitalopram (20mg?)    Jan. 2018 - 10mg -> 5mg, then from 5mg -> 2.5mg, then 0mg  -->  July 2018 - 0mg

2017(?)-2020 - vyvanse/lisdexamfetamine 60-70mg    2020-2021 - 70mg down to 0mg  -->  July 2021 - 0mg

March-April 2021 - vortioxetine 5-10mg (approx. 7 weeks total; CT)  -->  April 28th, 2021 - 0mg

supplements: magnesium powder (dissolved in water) as needed throughout the day; 1 tsp fish oil w/ morning meal; 2mg melatonin 9pm 

August 1, 2022 - 1 mg melatonin, approx. 10:30pm

 

Courage is fear that has said its prayers.  - Karle Wilson Baker

love and justice are not two. without inner change, there can be no outer change; without collective change, no change matters.  - Rev. angel Kyodo williams

Holding multiple truths. Knowing that everyone has their own accurate view of the way things are.  - text on homemade banner at Afiya house

 

I am not a medical professional; this is not medical advice. 

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There's a similar article in the Times (UK) today.

 

Unfortunately they've also run an opinion piece right next to it, saying that doctors 'don't give them out lightly'.

 

Which in my humble opinion, is absolute bollocks. How can 1 out of 6 people be on a drug if doctors aren't giving them out lightly? 🙄

Oct 2018 - Jun 2020: 10 mg per day generic Escitalopram in pill form.

Jul 2020 - Aug 2020: Switched to 9 mg per day of Cipralex drops to aid tapering.

Sep 2020 - Oct 2020: Taper to 8 mg.

Nov 2020 - Dec 2020: Taper to 7 mg.

Jan 2021 - Feb 2021: Taper to 6 mg.

Mar 2021 - Apr 2021: Taper to 5 mg.

May 2021 - Jun 2021: Taper to 4 mg.

Jul 2021 - Sep 2021: Taper to 3 mg.

Sep 2021 - Jan 2022: Taper to 2 mg.

Jan 2022: Stopped taking altogether.

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The Horowitz/Moncrieff-Duo are doing really good work. And this story is making quite a splash in the media. 

 

2004: (apr): Citalopram 20 mg, June 60 mg., dec 20 mg

2004 (dec): Mirtazapine 15 mg.

2014 (Jun): Citalopram stop cold turkey. Began 10 mg Vortioxetine

2017: (dec): Mirtazapine 15 mg ->30 mg (after three day stint on psych ward)

2020: (aug): Vortioxetine 10 mg stopped cold turkey. 

2020 (dec): Mirtazapine 30 mg -> 15 mg (GPs instructions)

2021 (feb): Mirtazapine reinstatement 26,25 mg

2022 (Jan): Mirtazapine (5% taper): 14. Jan 24,9 mg, 6. feb 23,7 mg, 1. marts 22,5 mg, 15. marts 21,3 mg, 2. april 20 mg, 26. april 19. mg, 25. may 18.1 mg, 26 jun 17 mg - HOLD UNTIL I AM IN PHYSICAL SHAPE.

 

Have always taken fish oil capsules. Do not drink alcohol when tapering. 1 multivitamin pill a day. Try to eat healthy, but impossible on mirtazapine.

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This has been bubbling away for a while

 

Very curious as to how my next conversation goes with my Dr

Jan 2016 - Autumn/Dec 2016 CLOMIPRAMINE

Oct 2017 CITALOPRAM (accidental updose)

Oct 2017 - Dec 2020 MIRTAZAPINE 15mg

Dec 2020 - May 2021 MIRTAZAPINE Liquid taper to 6.75mg

May 2021 - diet change caused the taper to fail - MIRTAZAPINE pill 15mg reinstated

May 2021 - present MIRTAZAPINE 15mg

 

Will continue to stabilse at 15mg before proceeding with a slow taper

 

 

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Absolutely, hopefully the momentum will keep building.

Oct 2018 - Jun 2020: 10 mg per day generic Escitalopram in pill form.

Jul 2020 - Aug 2020: Switched to 9 mg per day of Cipralex drops to aid tapering.

Sep 2020 - Oct 2020: Taper to 8 mg.

Nov 2020 - Dec 2020: Taper to 7 mg.

Jan 2021 - Feb 2021: Taper to 6 mg.

Mar 2021 - Apr 2021: Taper to 5 mg.

May 2021 - Jun 2021: Taper to 4 mg.

Jul 2021 - Sep 2021: Taper to 3 mg.

Sep 2021 - Jan 2022: Taper to 2 mg.

Jan 2022: Stopped taking altogether.

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  • Administrator

I just posted this about the Guardian's article from 1999:

 

The Guardian - They Said It Was Safe - Prozac trials and akathisia, an article from 1999

 

I wish they had brought this earlier research into their current conversation. Not only do the drugs not solve a problem, they cause akathisia that have led many people to suicide and that article even mentions violence to others. 

Drug free May 22, 2015 after 30 years of neuroleptics, benzos, z-drugs, so-called "anti"-depressants, and amphetamines 

 

My Success Story:  Shep's Success: "Leaving Plato's Cave"

 

And what is good, Phaedrus, and what is not good — need we ask anyone to tell us these things? ~ Zen and the Art of Motorcycle Maintenance


I am not a medical professional and this is not medical advice, but simply information based on my own experience, as well as other members who have survived these drugs.

 

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