4 ms·

Problematizing the serotonin hypothesis is nothing new. I'm disappointed that this is not a new study but just a meta review. It does nothing to resolve the iss

by tokai 4y ago

Problematizing the serotonin hypothesis is nothing new. I'm disappointed that this is not a new study but just a meta review. It does nothing to resolve the issue with serotonin levels not causing depression while antidepressants have a proven (slight) positive effect on depressive symptoms. It also doesn't do anything for explaining the effects from antidepressants that affect other things than serotonin. Like sertraline with its dopaminergic effect.

dmix 4y ago
Yeah this type of anti-SSRI stuff is definitely not new but this has been getting major viral traction for some reason. I was given Cipralex temporarily in my early 20s for anxiety w/ a very positive experience (lack of sex drive is a major downside and why everyone I know doesn't use them or stopped): https://en.wikipedia.org/wiki/Escitalopram https://en.wikipedia.org/wiki/Escitalopram I'm curious if anxiety is similarly being targeted here? (didnt read the paper)
- Goronmon 4y ago
  Yeah this type of anti-SSRI stuff is definitely not new but this has been getting major viral traction for some reason. One angle I've seen in certain circles is that people who are against gun legislation in the US are claiming that SSRI use is the real root cause for all the gun violence.
  - nradov 4y ago
    There is some fairly strong evidence that SSRI use can make certain people more violent. And there appears to be a real causal effect: it's not just that people who already have violent tendencies are more likely to take SSRIs. https://www.sciencedirect.com/science/article/pii/S0924977X20301048 https://www.sciencedirect.com/science/article/pii/S0924977X2... We don't know whether this is a significant factor in gun violence.
    - EddieRingle 4y ago
      I'm not sure the study you linked supports that. They found an association between SSRIs and violent crimes, but specifically state they cannot claim a causal link without further study.
    - tokai 4y ago
      Depression in itself increase risk of violence. https://pubmed.ncbi.nlm.nih.gov/26236648/ https://pubmed.ncbi.nlm.nih.gov/26236648/
  - runarberg 4y ago
    Seems like the wrong angle to take, since owning a gun is extremely dangerous for your own safety when you are dealing with severe depression. The risk of successful suicide increases many fold if you have an easy access to a loaded gun.
  - jrsj 4y ago
    SSRIs can cause depersonalization (a form of dissociation) which can lower the barrier to violence (or self harm). It doesn’t make sense to point to this is a root cause for gun violence generally but it could reasonably be a root cause for an unknown number of mass shootings.
  - stjohnswarts 4y ago
    I'm against gun legislation because of the Second Amendment, and it's obvious meaning along with our historic tradition of the right to bear arms. I support common sense legislation like background searched and red flag laws as partial solutions along with education. We are not against all legislation just the ones that say "no more semis" "no more AR15s" because we know as soon as y'all get those that same reason leads down the road to taking all guns. You're not going to take our guns my friend. We aren't Australia or Europe.
    - Goronmon 4y ago
      Sure, but I'm not sure how any of what you said relates to my post?
    - qzx_pierri 4y ago
mistercool 4y ago
> It does nothing to resolve the issue with serotonin levels not causing depression while antidepressants have a proven (slight) positive effect on depressive symptoms. It also doesn't do anything for explaining the effects from antidepressants that affect other things than serotonin. Agreed it doesn't do these things, but there is value in publicizing the fact that "the idea that depression results from a 'chemical imbalance' is hypothetical." Anecdotally, most people I've encountered that are depressed view the chemical imbalance theory as fact. This has consequences in how they approach treatment (medication-centric) and in how they view their situation (inalterable).
- rewq4321 4y ago
  > there is value in publicizing the fact [...] This has consequences in how they approach treatment (medication-centric) If anything (in my experience) people are too biased against medicine. And as others pointed out, this isn't at all evidence that medicines don't work - their efficacy is based on double-blind studies, not on chemical imbalance hypotheses. There are many other possible mechanisms that aren't related to the environment. Publicizing studies like this beyond academia is only likely to cause confusion and unfounded anti-medicine sentiment.
gwn7 4y ago
Analyzing and demonstrating problems with an accepted but potentially ineffective / suboptimal treatment method does something to resolve the issue in terms of illustrating the need for new methods thus making room for new research & development. Not everything needs to be constructive. You sound like you don't appreciate this kind of work. I don't see a problem about this "not being new" nor being "just a meta review". Should scientists "shut up unless they have new or good things to say"?
- tokai 4y ago
  No I don't like it because it doesn't add much new knowledge to the debate about the serotonin hypothesis. And yeah it would be great if scientist didn't had to publish results for the sake of it. Especially in medical sciences meta studies are super popular cause you can do them with library article login and spreadsheets, which end up in a lot of articles with strong conclusions on a mismatch of data. Meta review definitely have their place but they are as far removed from the clinical reality as can be.
  - gwn7 4y ago
    Interesting take for me. Thank you for your answer
- etc-hosts 4y ago
  Moncrieff has been writing about this for years https://link.springer.com/book/10.1007/978-0-230-58944-5 https://link.springer.com/book/10.1007/978-0-230-58944-5 Obviously I have not read every line of the new paper and I have no idea if it has any new research.
WhitneyLand 4y ago
Why use them at all given the side effects and that the benefit is only slight? Why not instead Ketamine every couple weeks? I’m not proposing this, I honestly don’t know the answer since the latter has been put forth as a kind of miracle drug for depression.
- dsr_ 4y ago
  With sample N < 5 acquainances, ketamine works for a few months and then stops.
  - tokai 4y ago
    I can't find the paper I'm thinking off. But as far as I know the newest clinical research concludes that the benefits of ketamine are temporary and aren't helpful as a permanent treatment. They can be very helpful in treating acute depressive symptoms which can help other treatments like CBT to work tho.
- qzx_pierri 4y ago
  Because people in America would rather take a magic pill. Exercise, healthy sleeping schedules, better diet, journaling, meditation, etc - Could all be prescribed by a doctor in some way. But it seems like so many people here in the USA have the tendency to avoid their dealing with their problems directly. I believe this comes from the religious culture in the USA and the core tenet of religion being that God is all powerful and you must relinquish your problems to God while acknowledging your lack of power and remaining in submission. That line of thinking gives a sense of relief, but ultimately causes people to avoid dealing with things directly due to not realizing how powerful their minds really are (as far as being able to make changes on their own without “magic pills” that often leave you feeling worse). Ironically, religion also helps a bit because people often “find God” and turn their lives around for the better due to the benefits of prayer which are often described as peace or serenity. However, prayer is LITERALLY just forgiveness/open heart meditation. That sense of relief people feel after praying and releasing all of their problems to God for 15 minutes? That can be achieved without identifying as powerless without the help of a supreme deity. Sorry about the rant, but this has been on my mind for a while now.

by tokai 4y ago

dmix 4y ago

Yeah this type of anti-SSRI stuff is definitely not new but this has been getting major viral traction for some reason. I was given Cipralex temporarily in my early 20s for anxiety w/ a very positive experience (lack of sex drive is a major downside and why everyone I know doesn't use them or stopped): https://en.wikipedia.org/wiki/Escitalopram https://en.wikipedia.org/wiki/Escitalopram I'm curious if anxiety is similarly being targeted here? (didnt read the paper)

Goronmon 4y ago
Yeah this type of anti-SSRI stuff is definitely not new but this has been getting major viral traction for some reason. One angle I've seen in certain circles is that people who are against gun legislation in the US are claiming that SSRI use is the real root cause for all the gun violence.
- nradov 4y ago
  There is some fairly strong evidence that SSRI use can make certain people more violent. And there appears to be a real causal effect: it's not just that people who already have violent tendencies are more likely to take SSRIs. https://www.sciencedirect.com/science/article/pii/S0924977X20301048 https://www.sciencedirect.com/science/article/pii/S0924977X2... We don't know whether this is a significant factor in gun violence.
  - EddieRingle 4y ago
    I'm not sure the study you linked supports that. They found an association between SSRIs and violent crimes, but specifically state they cannot claim a causal link without further study.
  - tokai 4y ago
    Depression in itself increase risk of violence. https://pubmed.ncbi.nlm.nih.gov/26236648/ https://pubmed.ncbi.nlm.nih.gov/26236648/
- runarberg 4y ago
  Seems like the wrong angle to take, since owning a gun is extremely dangerous for your own safety when you are dealing with severe depression. The risk of successful suicide increases many fold if you have an easy access to a loaded gun.
- jrsj 4y ago
  SSRIs can cause depersonalization (a form of dissociation) which can lower the barrier to violence (or self harm). It doesn’t make sense to point to this is a root cause for gun violence generally but it could reasonably be a root cause for an unknown number of mass shootings.
- stjohnswarts 4y ago
  I'm against gun legislation because of the Second Amendment, and it's obvious meaning along with our historic tradition of the right to bear arms. I support common sense legislation like background searched and red flag laws as partial solutions along with education. We are not against all legislation just the ones that say "no more semis" "no more AR15s" because we know as soon as y'all get those that same reason leads down the road to taking all guns. You're not going to take our guns my friend. We aren't Australia or Europe.
  - Goronmon 4y ago
    Sure, but I'm not sure how any of what you said relates to my post?
  - qzx_pierri 4y ago

mistercool 4y ago

> It does nothing to resolve the issue with serotonin levels not causing depression while antidepressants have a proven (slight) positive effect on depressive symptoms. It also doesn't do anything for explaining the effects from antidepressants that affect other things than serotonin. Agreed it doesn't do these things, but there is value in publicizing the fact that "the idea that depression results from a 'chemical imbalance' is hypothetical." Anecdotally, most people I've encountered that are depressed view the chemical imbalance theory as fact. This has consequences in how they approach treatment (medication-centric) and in how they view their situation (inalterable).

rewq4321 4y ago
> there is value in publicizing the fact [...] This has consequences in how they approach treatment (medication-centric) If anything (in my experience) people are too biased against medicine. And as others pointed out, this isn't at all evidence that medicines don't work - their efficacy is based on double-blind studies, not on chemical imbalance hypotheses. There are many other possible mechanisms that aren't related to the environment. Publicizing studies like this beyond academia is only likely to cause confusion and unfounded anti-medicine sentiment.

gwn7 4y ago

Analyzing and demonstrating problems with an accepted but potentially ineffective / suboptimal treatment method does something to resolve the issue in terms of illustrating the need for new methods thus making room for new research & development. Not everything needs to be constructive. You sound like you don't appreciate this kind of work. I don't see a problem about this "not being new" nor being "just a meta review". Should scientists "shut up unless they have new or good things to say"?

tokai 4y ago
No I don't like it because it doesn't add much new knowledge to the debate about the serotonin hypothesis. And yeah it would be great if scientist didn't had to publish results for the sake of it. Especially in medical sciences meta studies are super popular cause you can do them with library article login and spreadsheets, which end up in a lot of articles with strong conclusions on a mismatch of data. Meta review definitely have their place but they are as far removed from the clinical reality as can be.
- gwn7 4y ago
  Interesting take for me. Thank you for your answer
etc-hosts 4y ago
Moncrieff has been writing about this for years https://link.springer.com/book/10.1007/978-0-230-58944-5 https://link.springer.com/book/10.1007/978-0-230-58944-5 Obviously I have not read every line of the new paper and I have no idea if it has any new research.

WhitneyLand 4y ago

Why use them at all given the side effects and that the benefit is only slight? Why not instead Ketamine every couple weeks? I’m not proposing this, I honestly don’t know the answer since the latter has been put forth as a kind of miracle drug for depression.

dsr_ 4y ago
With sample N < 5 acquainances, ketamine works for a few months and then stops.
- tokai 4y ago
  I can't find the paper I'm thinking off. But as far as I know the newest clinical research concludes that the benefits of ketamine are temporary and aren't helpful as a permanent treatment. They can be very helpful in treating acute depressive symptoms which can help other treatments like CBT to work tho.
qzx_pierri 4y ago
Because people in America would rather take a magic pill. Exercise, healthy sleeping schedules, better diet, journaling, meditation, etc - Could all be prescribed by a doctor in some way. But it seems like so many people here in the USA have the tendency to avoid their dealing with their problems directly. I believe this comes from the religious culture in the USA and the core tenet of religion being that God is all powerful and you must relinquish your problems to God while acknowledging your lack of power and remaining in submission. That line of thinking gives a sense of relief, but ultimately causes people to avoid dealing with things directly due to not realizing how powerful their minds really are (as far as being able to make changes on their own without “magic pills” that often leave you feeling worse). Ironically, religion also helps a bit because people often “find God” and turn their lives around for the better due to the benefits of prayer which are often described as peace or serenity. However, prayer is LITERALLY just forgiveness/open heart meditation. That sense of relief people feel after praying and releasing all of their problems to God for 15 minutes? That can be achieved without identifying as powerless without the help of a supreme deity. Sorry about the rant, but this has been on my mind for a while now.