“Lexapro appears to relieve symptoms of depression and anxiety by increasing serotonin”, reads an ad on the Bonkers Institute, a website that archives drug ads and also lampoons pharmaceutical claims and shaky science.
“Zoloft works to correct a chemical imbalance in the brain that may be related to symptoms of depression”, reads another ad.
“Paxil CR prevents serotonin from being reabsorbed back into the sending nerve cell. This process increases the availability of serotonin to the receiving nerve cell and may help bring the transmission of [depression] messages back on track”, reads a third ad.
The serotonin “chemical imbalance” theory of depression was recently dismissed by a group of University College London scientists in the journal Molecular Psychiatry. After reviewing decades of research, there is no evidence that serotonin levels or serotonin activity are responsible for depression, they concluded.
In other words, the theory behind the selective serotonin reuptake inhibitor (SSRI) antidepressants was false (Citalopram (Celexa), Escitalopram (Lexapro), Fluoxetine (Prozac), Paroxetine (Paxil, Pexeva), Sertraline ( Zoloft)). While the theory has been disputed by scientists for decades, molecular psychiatry research appears to be the final nail in the theory’s coffin: a technical knockout.
Joanna Moncrieff, Professor of Psychiatry at University College London, lead author of the study said: “The popularity of the ‘chemical imbalance’ theory of depression has coincided with a large increase in the use of antidepressants. Antidepressant prescriptions have increased dramatically since the 1990s. Thousands of people suffer from the side effects of antidepressants, including the severe withdrawal effects that can occur when people try to stop them, but prescription rates continue to rise. We believe this situation has been driven, in part, by the false belief that depression is due to a chemical imbalance. It is time to inform the public that this belief is not based on science”.
It is hard to overestimate the medical, financial, and sociological consequences of the chemical imbalance theory, which prompted the approval of the SSRI antidepressant Prozac by the US Food and Drug Administration (FDA) in 1987, and which still continues today, go on. Several years ago, Harvard Health Publishing estimated that about 1 in 4 American women ages 40 to 50 were taking antidepressants. Thanks to direct-to-consumer marketing about depression, people with life problems or occasional bad moods absorbed the message of chemical imbalance, were diagnosed with depression, and presented themselves at doctors’ offices.
Problems with family, work, health, money or housing were no longer a reason to feel depressed or defeated, aggressive SSRI advertising campaigns suggested. If you were depressed, you had a chemical imbalance, regardless of anything else that may have explained your depression (such as the loss of meaning and social connection often seen in modern society). While the antidepressants that preceded the SSRIs, some called monoamine oxidase inhibitors, were linked to neurotransmitters in the brain like serotonin, dopamine, and norepinephrine, the SSRIs reduced the chemistry to a simple problem-solution equation, which the public easily accepted.
Thanks to the new chemical imbalance of serotonin depression theory, drug makers had a formidable new franchise; doctors, a ready-to-use tool that pleases the patient; the media, new reliable advertisers; and Wall Street, hot new stocks, all almost overnight. Global SSRI sales are estimated to skyrocket to US$18.29 billion by 2027.
Response of traditional medicine
Psychiatrists and the American Psychiatric Association (APA) were among the first to reject the Molecular Psychiatry article. The APA is highly funded by drug manufacturers, in fact 70% of the authors of the APA Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, were funded by drug manufacturers, according to ABC News. Chief among the protests was “we never promoted the ‘chemical imbalance’ theory and no one really understands why or how antidepressants work”.
The “third rail” for physicians funded by drug manufacturers is the suggestion that mental illness may not be due to physical conditions at all. As Mark Horowitz, co-author of the Molecular Psychiatry paper, put it: “An interesting aspect of the studies we examined was how strong the effect of adverse life events was on depression, suggesting that low mood is a response to people’s lives and cannot be boiled down to a simple chemical equation. If depression stems from stress, trauma, pain, loneliness, and social conditions such as poverty, as Horowitz suggests, it would not be amenable to drug treatment. Worse, if it weren’t a permanent chemical imbalance as the serotonin depression theory implies, it wouldn’t turn into lifelong drug prescriptions, which are sought after and treasured most by drug manufacturers”.
For Moncrieff: “While viewing depression as a biological disorder may seem like it would reduce stigma, in fact, research has shown the opposite, and also that people who believe their own depression is due to a chemical imbalance are more pessimistic about your chances of recovery”.
Psychiatrist Peter Breggin, who has been called the Conscience of Psychiatry, wrote for The Epoc Times: “Since the ancient Greeks, physicians have wanted to believe that mental and emotional distress must have biological origins. That allowed them to include ‘mental illnesses’ within their specialty. With the development of the massive involvement of pharmaceutical companies in routine psychiatric practice during the advent of antipsychotic drugs in 1954, pharmaceutical companies also began to push the biochemical and biological bases of human experiences such as anxiety, depression, manic-depressive (now bipolar disorder) and schizophrenia. Then, in the late 1980s, in anticipation of the FDA’s approval of Prozac for depression, the Eli Lilly Co. ran an international advertising campaign claiming that depression is caused by a biochemical imbalance in serotonin. It was apparent from the start that this was pure fantasy. In my books and scientific articles, since 1983, I have pointed out the constant truth that biochemical imbalances in the brains of mental patients are not known until the neurotoxic effects of all psychiatric drugs cause them”.
Now a review article by British psychiatrist Johanna Moncrieff has reconfirmed that research fails to show any connection between depression and abnormalities in serotonin metabolism in the brain. It is not known that the so-called ‘mental illnesses’ are of genetic or biochemical origin; it’s all hype from medical and pharmaceutical companies.
Do not stop SSRIs abruptly, both parties warn
Whether they believe SSRIs are misleading and overprescribed treatments or valuable, doctors warn patients not to stop the drugs abruptly. In 2018, The New York Times exposed that SSRI antidepressants can be hard to quit and downright addictive (although manufacturers prefer to call the effects of addiction “withdrawal syndrome”).
Some patients say their doctors did not warn them that they could be on the drugs indefinitely because of side effects such as dizziness, nausea, headache and cerebral shock that they experience when trying to stop the drugs, the newspaper reported. Brian, a 29-year-old Chicago resident who asked not to give his last name, said he has continued to take an SSRI antidepressant for years despite his desire to stop: Every time I try to stop, I feel something that feels like an electric current in my head and I cannot do it.
