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A team of scientists is questioning the theory that too low a level of serotonin in the brain is the cause of depression. Which indirectly questions the real effects of antidepressants.
It is a questioning which agitates the world of psychiatry and is not approved by all… While depression has been attributed for 60 years to a too low level of serotonin in the brain (a chemical messenger of the central nervous system), a team of researchers from University College London calls this assumption into question. She analyzed 17 studies including several hundred thousand people with or without depression. And their conclusions published on July 20 in the journal Molecular Psychiatry is that there is no evidence that low serotonin activity or levels cause depression.
Placebo effect antidepressants?
As a direct consequence of this announcement, the analysis directly targets the treatments of people suffering from depression: what would be the use of taking antidepressants, when their operating principle is based on the selective inhibition and reuptake of serotonin, in order to increase the availability in the brain, if this level of serotonin is not in question?
According to Joana Moncrieff, author of the study, the answer falls like a cleaver: “The conclusion of our article is that we don’t know what SSRI antidepressants are for. One of the possibilities would be that they act through a placebo effect”.
For the psychiatric community, however, the conclusions of this new analysis have limits: the analyzes undertaken do not distinguish between people suffering from chronic depression and those who present depressive episodes, whereas it would be necessary to be able to evaluate this level of serotonin on the same person at several times.
Moreover, it does not take into account the interaction of several factors such as biological, psychological and environmental factors, nor the contribution of other systems, such as dopamine.
A research that needs to be continued
Asked about the subject, Joachim Müllner, psychiatrist, evokes the two conclusions that this analysis suggests to him: a concern and the continuation of research. “Above all, the consequence of this single scientific article must not be the cessation of antidepressant treatment prescribed by a doctor. This study absolutely does not show that antidepressants are ineffective. It’s not even about that. It focuses on the neurobiological mechanisms that underlie depressive symptomatology. Even if depression is not only linked to a serotonin deficiency, this single study is insufficient to reach this conclusion..” he insists.
In addition, this study reminds us how much, in science, everything is true “until proven otherwise” he recalls. “It is imperative that research in psychiatry continues and intensifies as this specialty remains the poor relation of medicine. If only on a clinical level, it seems difficult to link all the symptomatology to the only supposed deficiency in serotonin. ” he concludes, hoping for more research.