(Press-News.org) The widely held belief that depression is due to low levels of serotonin in the brain - and that effective treatments raise these levels - is a myth, argues a leading psychiatrist in The BMJ this week.
David Healy, Professor of Psychiatry at the Hergest psychiatric unit in North Wales, points to a misconception that lowered serotonin levels in depression are an established fact, which he describes as "the marketing of a myth."
The serotonin reuptake inhibiting (SSRI) group of drugs came on stream in the late 1980s, nearly two decades after first being mooted, writes Healy. The delay centred on finding an indication.
After concerns emerged about tranquilliser dependence in the early 1980s, drug companies marketed SSRIs for depression, "even though they were weaker than older tricyclic antidepressants, and sold the idea that depression was the deeper illness behind the superficial manifestations of anxiety," he explains. The approach was an astonishing success, "central to which was the notion that SSRIs restored serotonin levels to normal, a notion that later transmuted into the idea that they remedied a chemical imbalance."
In the 1990s, no one knew if SSRIs raised or lowered serotonin levels, he writes; they still don't know. There was no evidence that treatment corrected anything, he argues.
He suggests that the myth "co-opted" many, including the complementary health market, psychologists, and journals. But above all the myth co-opted doctors and patients, he says. "For doctors it provided an easy short hand for communication with patients. For patients, the idea of correcting an abnormality has a moral force that can be expected to overcome the scruples some might have had about taking a tranquilliser, especially when packaged in the appealing form that distress is not a weakness."
Meanwhile more effective and less costly treatments were marginalised, he says.
He stresses that serotonin "is not irrelevant" but says this history "raises a question about the weight doctors and others put on biological and epidemiological plausibility." Does a plausible (but mythical) account of biology and treatment let everyone put aside clinical trial data that show no evidence of lives saved or restored function, he asks? Do clinical trial data marketed as evidence of effectiveness make it easier to adopt a mythical account of biology?
These questions are important, he says. "In other areas of life the products we use, from computers to microwaves, improve year on year, but this is not the case for medicines, where this year's treatments may achieve blockbuster sales despite being less effective and less safe than yesterday's models."
"The emerging sciences of the brain offer enormous scope to deploy any amount of neurobabble. We need to understand the language we use. Until then, so long, and thanks for all the serotonin," he concludes.
INFORMATION:
The UK government plan to fund and to increase participation in rugby in schools has not been informed by injury data, warn experts in The BMJ this week.
Professor Allyson Pollock and colleagues at Queen Mary University of London say the government "should ensure the safety and effectiveness of (school) sports" and call for injury surveillance and prevention programmes to be established to help reduce injury rates.
The high rates of injury in rugby union and rugby league for professional and amateur players, including children, are well established and a cause for medical ...
As the deadline for the millennium development goals approaches, experts writing in The BMJ this week take stock of the successes, failures, and oversights, and look ahead to the next phase - the sustainable development goals.
The millennium development goals are eight aspirational targets set by the United Nations (UN) in New York in September 2000, explain Dr Mark Beattie and colleagues.
The progress made towards some of the goals has been remarkable, they write. For example, child mortality has effectively halved worldwide, from 90 per 1,000 births in 1990 to 46 ...
WASHINGTON -- Law should be viewed as a major determinant of health and safety and can be utilized as a powerful and innovative tool to address pressing global health concerns, says a newly formed, high-level commission announced today by the O'Neill Institute for National and Global Health Law at Georgetown University in partnership with The Lancet.
In their "Comment" published online in The Lancet, the Commission's co-chairs Lawrence O. Gostin and John T. Monahan, along with the Commission's project coordinator, Mary C. DeBartolo, and Richard Horton, Editor-in-Chief ...
Alcohol and drug misuse are responsible for around a third of all deaths in former male prisoners and half in female ex-prisoners, a new study of almost 48000 ex-prisoners published in The Lancet Psychiatry journal has found. Moreover, the research shows that a substantial proportion of these deaths are from preventable causes, including accidents and suicide (42% in men and 70% in women).
Several studies have reported high death rates after release from prison, but few have looked at potential risk factors for these high rates. Led by Seena Fazel, Professor of Forensic ...
The good relationship between humans and dogs was certainly influenced by domestication. For long, it was assumed that humans preferred particularly tolerant animals for breeding. Thus, cooperative and less aggressive dogs could develop. Recently, however, it was suggested that these qualities were not only specific for human-dog interactions, but characterize also dog-dog interactions. Friederike Range and Zsófia Virányi from the Messerli Research Institute investigated in their study if dogs are in fact less aggressive and more tolerant towards their conspecifics ...
A team of French clinicians has diagnosed the first case of rabies in that country since 2003. Only 20 cases of human rabies had been diagnosed in France between 1970 and 2003. Moreover, the patient was unaware of having been bitten. So it is not surprising that that diagnosis was not suggested until day 12 post admission to the intensive care unit. The case report appeared April 8 in the Journal of Clinical Microbiology, a publication of the American Society for Microbiology.
"Rabies is nowadays extremely rare in the developed world," said Christian Brun-Buisson, head ...
DALLAS, April 21, 2014 -- Among black heart failure patients, moderate depression may increase the risk of heart failure patients being hospitalized or dying, according to research in the American Heart Association journal Circulation: Heart Failure.
Comparing outcomes of 747 blacks to 1,420 whites with heart failure using a patient-reported scale of depressive symptoms, researchers found:
Even moderate depressive symptoms may raise the risk of black heart failure patients being hospitalized or dying.
Blacks with levels of depressive symptoms even below the levels ...
(MEMPHIS, Tenn. - April 21, 2015) Researchers have identified a protein that offers a new focus for developing targeted therapies to tame the severe inflammation associated with multiple sclerosis (MS), colitis and other autoimmune disorders. St. Jude Children's Research Hospital scientists led the study which appears today in the scientific journal Immunity.
Investigators showed that the protein NLRP12 works in T cells to limit production of chemical messengers or cytokines that fuel inflammation. T cells are specialized white blood cells produced to eliminate specific ...
The Energy Department's National Renewable Energy Laboratory (NREL) has released an updated proposal that will establish an international quality standard for photovoltaic (PV) module manufacturing. The document is intended for immediate use by PV manufacturers when producing modules on an industrial scale so they can increase investor, utility, and consumer confidence in PV system performance.
"Our recent research on 50,000 systems found that, during the time period we studied, just 0.1% of all PV systems were affected by damaged or underperforming modules and less than ...
A recent randomized trial that looked at the feasibility of 2013 guidelines issued by the American College of Surgeons Trauma Quality Improvement Project for trauma resuscitation found that delivering universal donor plasma to massively hemorrhaging patients can be accomplished consistently and rapidly and without excessive wastage in high volume trauma centers. The plasma is given in addition to red blood cell transfusions to optimize treatment.
The 2013 guidelines recommend that universal donor products be immediately available on arrival of severely injured patients, ...
