SSRIs
Is the “serotonin hypothesis” of depression really dead? Have we spent nearly 40 years heading down one path only to find ourselves no closer to answering the question how and why we become depressed - Siddhartha Mukherjeeapril

image by: The Health-Care Survivor
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30 years after Prozac arrived, we still buy the lie that chemical imbalances cause depression
Some 2,000 years ago, the Ancient Greek scholar Hippocrates argued that all ailments, including mental illnesses such as melancholia, could be explained by imbalances in the four bodily fluids, or “humors.” Today, most of us like to think we know better: Depression—our term for melancholia—is caused by an imbalance, sure, but a chemical imbalance, in the brain.
This explanation, widely cited as empirical truth, is false. It was once a tentatively-posed hypothesis in the sciences, but no evidence for it has been found, and so it has been discarded by physicians and researchers. Yet the idea of chemical imbalances has remained stubbornly embedded in the public understanding of depression.
Prozac,…
Resources
Treating depression takes much more than serotonin
Neurotransmitters can't tell the whole story, no matter what "serotonin culture" says.
A Short History of the SSRI
Before the introduction of Prozac, antidepressants, albeit effective, were accompanied by a plethora of adverse effects. They required closer monitoring and were far more dangerous in the event of an overdose. SSRIs, starting with Prozac, provided psychiatrists with a new tool for the treatment of depression and opened the door for primary care physicians to treat depression and anxiety.
Do Antidepressants Really Work? A New Study Says Yes, With A Caveat
At least for these two SSRIs, it seems the weight of evidence leans toward users benefiting because the drugs are altering neurochemical processes in their brains, as opposed to users just thinking they’re benefiting. The researchers report, “Our results indirectly support the notion that the two drugs under study do display genuine antidepressant effects caused by their pharmacodynamic properties.”
Do SSRI's Even Work? And if so, How?
Perhaps antidepressants like Prozac and Paxil primarily alter behavioral circuits in the brain — particularly the circuits deep in the hippocampus where memories and learned behaviors are stored and organized — and consequently change mood.
Everything You Need to Know About Mixing MDMA and Antidepressants
It's difficult to get high when on SSRIs, but is trying to do so actually doing you any damage?
Five Reasons Not to Take SSRIs
What Should You Do? Think twice, be skeptical, and question a simplistic diagnosis you might receive after discussing your condition for a short time with a rushed practitioner. If each person takes a stand, is willing to engage in therapies beyond drug-taking, we might actually have a responsible and informed public confronting an increasingly powerful medical-pharmalogical establishment. Drugs may not be the answer for you, and now it turns out that some drugs may not be the answer for almost anyone.
How common drugs affect our moral decision-making
After taking the serotonin-enhancing antidepressant citalopram, healthy volunteers were willing to pay twice as much to prevent harm to themselves or others versus those taking placebo drugs. Healthy volunteers taking dopamine-boosting Parkinson's drug levodopa, on the other hand, appeared to shed this altruism...
I thought antidepressants would stop me from finding “true” happiness. I was wrong.
When I began taking SSRIs, my psychiatrist told me that while some patients require medication for only a few months or a few years, others are in it for "the long haul." He told me there isn't a good way to predict how long a patient will need SSRIs, so I have no idea how long I may need to take mine. That worries me: What if I need to take my meds every single day until the day I die?
Learning How SSRI Antidepressants Actually Work Can Pave Way For New Depression Treatment
Antidepressants have been a staple in mental health treatment for decades, but researchers never knew exactly how they worked on a molecular level — until now. A team of scientists has discovered the precise process behind the effectiveness of two popular antidepressants, and broken down an important wall on the road to developing safer, more effective medications in the future.
My experience of Citalopram (SSRI)
Citalopram is well worth a go, and if it proves not to be sitting quite right, your GP can switch you over to something else, until you both find the right SSRI for you. Something like 50-80% of people find the right SSRI first time around, and so totally do stick with it and hopefully you’ll feel more positive soon.
SSRIs (Selective Serotonin Reuptake Inhibitors)
Selective serotonin reuptake inhibitors (SSRIs) are the most frequently prescribed category of antidepressants. These medications have a strong reputation for both safety and effectiveness. Developed in the past 20 years, SSRIs are typically the first choice for physicians when treatment requires the prescription of antidepressants.
SSRIs: It Doesn’t Have To Be This Way
I’m not going to pretend all my troubles are over, but I can now cope with the minutiae of life. And as a result, the big things don’t floor me so much that I am paralysed into doing nothing at all. I regret that it took me to the age of thirty to realise this was how things should be.
The Assault on Antidepressants
Twenty-three years after Listening to Prozac, Peter Kramer comes to the drug’s defense.
The Most Popular SSRI Antidepressants Don’t Work the Way Big Pharma Claims
Fortunately, there are many drug-free alternatives to SSRIs that have been proven to reduce the symptoms of anxiety, depression and phobias in dozens of studies.
The Popular Assumption About SSRI Meds That Could Be Completely Wrong
“SSRIs are effective for anxiety disorders, including social anxiety disorder that we have studied,” Furmark told me. “However, the exact mechanisms whereby SSRIs exert their anxiety reducing effect is still not known. Clearly, it is not a simple matter of too little serotonin being produced when anxious, and more serotonin being produced during SSRI treatment.
The Truth About SSRI Meds, Serotonin and Anxiety
Focusing only on the neurotransmitters and the receptors in the synapse (the space and connection between neurons) is so 1990’s and 2000’s.
Why The Science Behind Anti-Depressants May Be Completely ‘Backwards’
As people and physicians become more aware that antidepressants only work for a limited period of time, and are less safe than they have been supposed, the use of antidepressant medications will decline and the use of psychotherapies will increase.
A Psychiatrist Explains Anxiety Medications
These are very similar to SSRIs; in fact, some SSRIs are more closely related to SNRIs than others. Venlafaxine actually acts as a SSRI at low doses and turns into an SNRI at higher doses. Most of the comments I made above about SSRIs also apply to SNRIs.
Into the medicine cabinet: The benefits and downsides of SSRIs and SNRIs
Unfortunately, the benefits of SSRIs and SNRIs have to be weighed against their risks and side effects. Despite their advantages over older medications, SSRIs and SNRIs still cause side effects, leading over 50% of patients to stop taking them after 4 months.
30 years after Prozac arrived, we still buy the lie that chemical imbalances cause depression
Some 2,000 years ago, the Ancient Greek scholar Hippocrates argued that all ailments, including mental illnesses such as melancholia, could be explained by imbalances in the four bodily fluids, or “humors.” Today, most of us like to think we know better: Depression—our term for melancholia—is caused by an imbalance, sure, but a chemical imbalance, in the brain. This explanation, widely cited as empirical truth, is false.
SSRI Stories
SSRI Stories is a collection of over 6,000 stories that have appeared in the media (newspapers, TV, scientific journals) in which prescription drugs were mentioned and in which the drugs may be linked to a variety of adverse outcomes including violence.
MayoClinic
SSRIs, a popular antidepressant type, can help you overcome depression. Discover how SSRIs boost mood and what side effects they may cause.
Patient
It has long been postulated that a deficiency in CNS serotonergic activity is the cause of, or a predisposing factor for, depression However, the evidence for this association is largely circumstantial and it certainly does not represent an adequate and full model for depression, probably due to there being multiple aetiological factors. Some pharmacological trial data also cast doubt on the efficacy of SSRIs compared with placebo. Despite this, manipulation of the serotonin axis by SSRIs seems to be beneficial in treating patients with moderate-to-severe depression.

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