According to surveys, more than 4 in 5 people believe that depression stems from imbalanced brain chemicals and, specifically, to low levels of the neurotransmitter serotonin. This explanation of depression has a corresponding treatment -- antidepressants known as SSRIs that are designed to boost serotonin levels and correct the so-called imbalance.
Psychiatric experts, however, say that this understanding of depression was disproven long ago. The theory was first proposed in the 1960s and was promoted heavily in the 1990s when pharmaceutical companies started developing and marketing this new class of antidepressants tailored to this theory.
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The dissonance between the public's understanding of depression and the psychiatric literature came to a head recently when British psychiatrist Dr. Joanna Moncrieff, co-author Mark Horowitz and colleagues published an extensive review of existing studies in July and put the final nail in the coffin on the serotonin theory. The review was packaged as a revelation, one that debunks the common understanding of depression and its associated treatment.
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The study generated extensive media coverage and controversy, with Moncrieff and her co-authors showering broad critiques on the depression treatment landscape. Other psychiatrists have stressed the difference between how a drug works and whether it works.
"We don't really understand fully how statins work for lowering cholesterol -- we're learning more about it. But the reason we use them is because of clinical trials," said Dr. Srijan Sen, director of the depression center at the University of Michigan.