Sunday, July 24, 2022

Debunking the serotonin theory of depression

Moncrieff et (2022) undertook a systematic umbrella review of the evidence for the serotonin theory of depression (see eg. previous post). Their conclusion that the main areas of serotonin research provide no consistent evidence of an association between serotonin and depression, and no support for the hypothesis that depression is caused by lowered serotonin activity or concentrations, has been taken up by the media (see eg. discussion between Joanna Moncrieff, the main author of the review, and Dr Ellie - see previous post - on This Morning TV programme).

Psychiatrists have been using the chemical imbalance theory as a means of persuading patients to take their medication. True, the role of psychiatry is to give hope to depressed people. But it is also to be honest with them about the cause of their problems and the appropriate treatment. It is understandable that patients who receive antidepressant treatment are readily persuaded that they are having appropriate therapy. The trouble is that doctors, too, may be deluded into believing that their prescribing is having specific antidepressant effects. 

Patients are able to understand that the 'chemical imbalance theory' has only ever been a theory. What they find more difficult to appreciate is why they have been told that this theory has been proven, when this is clearly not the case. The doctor–patient relationship needs to become more open, so that doctors are not deceiving their patients about antidepressants. This has to start with doctors becoming more aware of their own bias.

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