Antidepressants work, insist top doctors as they hit back at explosive study
Top psychiatrists have rounded on the authors of a bombshell study that cast doubt on the effectiveness of antidepressants, calling the results “absurd” and “grossly exaggerated.”
Last week, researchers at University College London said they had refuted a theory from the 1960s that depression was caused by low levels of serotonin, a chemical in the brain believed to control mood. .
Led by Professor Joanna Moncrieff, a respected consultant psychiatrist, the study analyzed decades of research, involving tens of thousands of patients with the disease, and found “no convincing evidence” of a link between the mental illness and serotonin levels.
Professor Joanna Moncrieff, pictured, a consultant psychiatrist at University College London, led a team of researchers who disproved the long-standing link between low serotonin levels and depression
The findings were deemed significant because most antidepressants – taken by more than eight million Britons – are designed to boost serotonin levels.
“Thousands of people suffer from the side effects of antidepressants, including the severe withdrawal effects that can occur when you try to stop them, but prescription rates continue to rise,” Professor Moncrieff said. “We believe this was motivated by the false belief that depression is due to a chemical imbalance. It’s time to inform the public that this belief is not based on science.
However, leading brain experts have criticized Professor Moncrieff, who has written best-selling books that shed a negative light on antidepressants. They argue that it is wrong to say that scientists believe depression is caused by low levels of serotonin. Instead, they say, the prevailing theory is that depression is caused by many factors and that antidepressants are clinically proven to help.
Dr Michael Bloomfield, a consultant psychiatrist and colleague of Professor Moncrieff at University College London, said his conclusion “doesn’t make sense”.
“Depression has many different symptoms and I don’t think I’ve come across any serious scientists or psychiatrists who believe that all causes of depression are due to a simple chemical imbalance of serotonin.”
He added: ‘[This paper] grouped depression together as one disorder, which biologically makes no sense.
David Curtis, Honorary Professor, UCL Genetics Institute, agreed: “The notion of depression due to chemical imbalance is outdated, and the Royal College of Psychiatrists wrote that this was an oversimplification in a statement published in 2019.” Phil Cowen, professor of psychopharmacology at Oxford University, appeared to accuse Professor Moncrieff of selecting data based on his hypothesis.
Doctors in the 1960s first found a link between low serotonin levels and depression, later providing general practitioners with a weapon to target the disease.
He pointed out that the review omitted a pivotal study that suggested depressed patients had lower levels of compounds integral to serotonin production in their blood.
“The possible role of serotonin in depression is a separate issue from the antidepressant effects of [antidepressants],’ he said.
Other experts point to several studies that show that taking antidepressants can relieve depression, regardless of their effect on serotonin levels.
“Thanks to years of research, we know that antidepressants work and save lives,” says Professor David Nutt, director of the Center for Neuropsychopharmacology at Imperial College London.
“The conclusions of this article are absurd. The authors grossly exaggerated the importance of serotonin levels. Nobody ever said that a serotonin imbalance was the only cause of depression.
He adds that more recent studies, not included in Professor Moncrieff’s review, which used more precise testing methods, had found a “decreased capacity to release serotonin” in people with depression. “To reject the serotonin hypothesis in depression at this stage is premature,” he said.
Psychiatrists say the exact reason why antidepressants work isn’t unusual, but it isn’t. ‘It is difficult to be absolutely sure of the cause of a drug’s action in the brain,’ says Professor Nutt. “In the case of antidepressants, it could have an effect on things other than serotonin receptors.”
Basically, they argue that while depression isn’t caused by a serotonin imbalance, that doesn’t mean it can’t be effectively treated by increasing levels of the brain chemical.
Responding to criticism, Prof Moncrieff said the aim of the study was not to claim that antidepressants don’t work, but to ask whether the pills should be prescribed in the first place.
“People are told that the reason they feel depressed is that there is something wrong with their brain chemistry and antidepressants might fix it. But if there’s no evidence that something is wrong with brain chemistry, then that doesn’t seem like a sensible solution. This profession has misled people for so long about the need for antidepressants and now doctors don’t want to admit they were wrong.
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