Not a surprise given their general method of action. Messing with seratonin pathways is always tricky.
The issue here I feel is that sometimes depression is a symptom that one needs to change something in their life. So I dont think we should try to blunt all suffering.
>True, but the thought is that the feelings of worthlessness, hopelessness, even suicide are seratonin related.
Not necessarily true. People on SSRIs can still want to commit suicide after serotonin rebounds and is at a stable level.
I think complex feelings like despair and self-hatred can't be explained by just a single neurotransmitter. Serotonin likely plays a role here, but it's not the only component.
There are also lots of people being killed by drugs prescribed to help treat depression, many of them are suicides as well. These are not long-term solutions.
The parent comment seems to be suggesting that people with depression need to take control of their own life by recognizing what makes them unhappy in order to overcome it. There is nothing harmful about that.
One thing to note is that the study population consisted entirely of severely depressed people. As far as I've read about it, the current consensus seems to be that the more severe the depression is, the more likely it is to respond to medical interventions as opposed to psychological/behavioral ones. This ties in to a broader understanding that depressive disorders are considerably heterogeneous and no single theory or treatment target is relevant to all cases.
So while this may be a genuine breakthrough, I hope people don't get the idea that it's the cure for depression generally.
That's why it's shocking and exciting to see it be used to successfully treat depression, a chemical where very much the dose makes the poison I suppose
> People who want to fight against the idea that these modern miracles (drugs that treat depression) are effective treatments for this debilitating, but curable disease,
The modern miracle drugs that effectively treat and cure debilitating depression are not SSRI's. Whatever benefits SSRIs have are probably a result of their influence on neurosteroids:
>> Certain antidepressant drugs such as fluoxetine and fluvoxamine, which are generally thought to affect depression by acting as selective serotonin reuptake inhibitors (SSRIs), have also been found to normalize the levels of certain neurosteroids (which are frequently deficient in depressed patients) at doses that are inactive in affecting the reuptake of serotonin. This suggests that other actions involving neurosteroids may also be at play in the effectiveness of these drugs against depression [0]
Other miracle drugs are also helpful for addressing the cause. Big Pharma doesn't care about cause/effect, they just want patients on maintenance treatments.
Depressed people usually have some sort of metabolic problem, caused by thyroid problems, inadequate diet, etc. Emotional stress is usually a major factor too.
> belong in the same category as flat earth era, anti-vaxxers and now, apparently, "raw water" fans/advocates.
Where do you belong? Are you a tireless advocate for the status quo?
> I don't think any of that can be captured by whatever neuro-binding effect is being mimicked by these designed molecules
Agreed, it sound like they do not cause any hallucinations, so you would likely not "see the face of evil".
> it was diet and exercise and commitment to changing my life and talking to a therapist that was what helped;
Speaking from my armchair, from what I understand about clinical depression, these are the things that someone who is not depressed can do because they "crave" them. For people who are depressed, there is a (possibly intermittent) neurological imbalance that is preventing them from craving these things which would otherwise keep them functioning normally. While it may be possible to power through the depression, and do these things until the imbalance is resolved, I would argue that this is only due to a temporary break or recession of their depressive symptoms, something that an effective antidepressant should aim to do.
I'm not claiming my view is true, I'm looking for feedback on how correct/incorrect my view is.
So many people (including doctors) seem to be set on the idea that serotonin makes you happy and therefore is the solution to depression. This is only half true, and not in the way that most think. Serotonin (if high) makes you numb [1]. But that might be the lesser of two evils when it comes to depression [2], which is why it’s become popular as a mechanism to treat it. It not a solution, it’s just masking the underlying problem by replacing one set of symptoms with another.
That's very interesting, I've never heard of that. Apparently it's a tricyclic, but doesn't have the same side effects that have caused most tricyclics to fall out of use. Never approved in the US, either, though current research suggests it works in different ways than the most common drugs.
I'm hopeful that as drugs unrelated to seratonin, norepinephrine, and dopamine start to show promise with depression, that we'll have a better picture of what's going on in the brain when people get depressed. IMO one of the missing pieces in severe depression treatment is what to do in the weeks it takes medications to take effect, if they even do; the current strategy seems to be "wait it out and if they're at risk of hurting themselves put them in a rubber room."
2. The linked result shows that directly manipulating serotonin levels in animals doesn't produce depression.
Guess what effect this will have on the worldwide, multi-billion dollar market in SSRI-based and related drugs? If psychology was a medical field, clinicians would be ordered to stop prescribing these ineffective drugs. But don't hold your breath for that outcome.
Depression is a tough thing to treat. The amount of treatments that show promise, but essentially don't make a meaningful difference in RCT's is very, very large.
(Perhaps not coincidentally, placebo effects in depression are known to be large).
It's far more likely they're referring to vitamin D supplements and SAD lamps than antidepressants, though I'm sure antidepressants are used when other things don't work.
Agreed. This article doesn't address "how they work" - whether they "work" in the first place isn't at all clear, given how often they appear to either harm their users or simply do nothing - it's just elucidating "what they do" a little further. Two very different questions.
No small task, of course, and the paper's pretty interesting, but it's not clear this has anything to do with what we call depression.
That's an important consequence to consider. One that often gets omitted. Many drugs - like blood pressure drugs - often have depression as a side effect but it gets overlooked.
The issue here I feel is that sometimes depression is a symptom that one needs to change something in their life. So I dont think we should try to blunt all suffering.
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