What If Everything We Know About Treating Depression Is Wrong?

[madokie]

Scientific studies indicate that current medications target the wrong parts of the brain.

A new study is challenging the relationship between depression and an imbalance of serotonin levels in the brain, and brings into doubt how depression has been treated in the U.S. over the past 20 years.

Researchers at the John D. Dingell VA Medical Center and Wayne State University School of Medicine in Detroit have bred mice who cannot produce serotonin in their brains, which should theoretically make them chronically depressed. But researchers instead found that the mice showed no signs of depression, but instead acted aggressively and exhibited compulsive personality traits.

This study backs recent research indicating that selective serotonin reuptake inhibitors, or SSRIs, may not be effective in lifting people out of depression. These commonly used antidepressants such as Prozac, Paxil, Celexa, Zoloft, and Lexapro, are taken by some 10% of the U.S. population and nearly 25% of women between 40 and 60 years of age. More than 350 million people suffer from depression, according to the World Health Organization, and it is the leading cause of disability across the globe.

The study was published in the journal ACS Chemical Neuroscience. Donald Kuhn, the lead author of the study, set out to find what role, if any, serotonin played in depression. To do this, Kuhn and his associates bred mice who lacked the ability to produce serotonin in their brains, and ran a battery of behavioral tests on them. In addition to being compulsive and extremely aggressive, the mice who could not produce serotonin showed no signs of depression-like symptoms. The researchers also found, to their surprise, that under stressful conditions, the serotonin-deficient mice behaved normally.

http://www.alternet.org/news-amp-politics/what-if-everything-we-know-about-treating-depression-wrong

[BainsBane]

1. recent trials have shown ketamine enormously effective in treating depression

within hours, and for those with treatment resistant depression. The theory is it acts on glutamate receptors.

The fact is psychiatry (which is now about prescribing medication) is a matter of trial and error. Their theories about the causes of depression are really just theories. They can see it in brain scans but they don't know for sure what causes it, and recent research such as you point to above is challenging existing understanding.

[truedelphi]

12. I'd like to know more about this.

Do you have any links?

I know that HTP 5 works very well on mild depression, that has to do with serontonin expression, but I don't know if it helps people whose depression is severe.

Ketamine woud be interesting to read more about.

[Control-Z]

13. I want to try ketamine.

I looked for clinical trials a few years ago and found very little. I want that "within hours" relief. I have had an extended period in my life when I was not depressed. It was amazing. I want that again.

[REP]

19. I can tell you that it's amazing

I've had it twice - legally, in a hospital - and while it didn't cure my depression (nor was it intended to; it was used during surgeries), it was exceedingly pleasant and it was the only time I've had complete relief from nerve pain. Only lasted a couple days, but they were great days.

[Control-Z]

25. What I wouldn't give to feel well and good.

Not high, mind you, just relieved and normal. No pain. No black pit of fear and hell. Sigh.

[BainsBane]

21. There are none currently in my area

But NIH does list a series of trials throughout the country. Ketamine is hallucinogenic, so treatment is all inpatient. There is work being done to develop drugs that could be used on an out-patient basis. One of the problems with the trials has been patients know if they are on a placebo because they do not hallucinate. So I read something about studies being planned that would substitute another hallucinogenic for the placebo.

[Control-Z]

24. What area are you in?

I just did a search and found someone in San Diego. I think he's at UCSD. Looks promising but... Always a scary prospect to even get involved in these things.

[lovemydog]

17. Thank you for this info

BainsBane.

[antigop]

2. interesting... thanks. nt

[elleng]

3. Please cross-post this

at Mental Health Information and Mental Health Support.

[madokie]

5. Would you please do that

[elleng]

9. OK

[Octafish]

4. Big Pharma's not gonna like this.

Nor its supporters who count on the check.

[pinboy3niner]

6. By the time they understand us, brother...

...well, you know.

I wish we could live long enough to see the marvelous discoveries that will be made in the future about the brain. It's a fascinating subject, especially for those affected by things like depression and PTSD.

[Kalidurga]

7. I tried a drug for depression once

I didn't think I was depressed. Doctors did and they said it would help my insomnia well that I do know I have and probably more than one type. Any way it did nothing, unless you count the nightmares it induced. I don't think of depression as a bad thing though and I think instead of treating it we should channel it, people get depressed for a reason in some cases it might just be the best way to deal with toxic people in their lives. For other people they just might recognize how horrid life is and not see a real reason to pretend otherwise. Other people become more focused on problem solving when they are in a "depressed" state. If you can figure out what function the "depression" has that might provide a clue for dealing with it.

[HereSince1628]

8. Lots of other studies say similar things...

Chemical Imbalance are key words to open up various reports of the same.

[Rod Beauvex]

10. Anti-depressents are only a band-aid anyway.

They cannot fix the underlying causes of depression, which are mental, psychological in origin.

[blue neen]

16. Sorry. I disagree with that assertion.

The treatment of depression and other brain illnesses is starting to become more scientific, but we have a long way to go:

http://www.nytimes.com/2013/03/01/health/study-finds-genetic-risk-factors-shared-by-5-psychiatric-disorders.html?_r=0

[Live and Learn]

23. +1 nt

[JayhawkSD]

22. No.

[Brickbat]

34. In some cases. In others, not so much.

[AceWheeler]

11. It's complicated

As a trained clinical psychologist and retired college professor, I can tell you that all so-called "mental disorders" are complex interactions between the individual and his, or her environment. And most "causal" models do NOT rely on single cause-and-effect relationships, such as a lack of serotonin.

Given this, all studies, particularly those with non-humans, are at best suggestive. Researchers attempt to objectify "depression," for example, but they don't really know what a "depressed" mouse looks like. The fact that the mice became aggressive may simply be a sign of what is called "agitated" depression in humans.

SSRs do not work for all people, and I don't know any mental health folks who think serotonin is, in and of itself, the issue. It may be a contributing factor for some, but not everyone.

I think this is an important study, but multivariate analysis using multiple variables correlating with observed and self-reported "depression" in humans will have the best potential predictive validity and guide toward treatment.

Having good heuristics helps the practitioner, but each person must be understood and treated within the context of what and how he, or she, alone thinks and feels and behaves.

[Recursion]

27. But for clinicians, you need a diagnosis to get paid

And that diagnosis needs to fit in a DSM box. Though IIRC even today SSRI for depression is "off-label", though it's far and away the most common use.

[TM99]

29. I agree.

I am also in the field and all disorders are much more complex than the internet discussion forums and main steam media really understands.

I have seen patients that responded well to medications. I have seen patients that have not. I have seen patients that could overcome or mitigate long-standing depression through non-pharmaceutical means. I have seen patients that could not.

Bioindividuality and psychic individuality is still a missing component in any holistic treatment of mental health in the western disease model.

[nolabear]

33. I'm in the field too. Nice to hear that acknowledged.

[cantbeserious]

14. Thank You For Sharing

eom

[jeff47]

15. There isn't one disease "depression".

There's a whole lot of conditions where depression is a symptom. For some SSRIs help. For others, they don't. In both cases, you need to treat the underlying cause. For the people where they work, SSRIs are a stop-gap until that treatment.

If you're getting an SSRI from your primary care doctor, you really need to go see a mental health professional to treat the real problem.

[lovemydog]

20. In my own subjective experience, I agree

with you jeff47. Hope you enjoy a nice short week. All weeks should be only 4-day work weeks, imho!

[Jim Lane]

31. SSRI's helped me.

I was in a clinical trial of Wellbutrin for mild or moderate depression. (It had already been approved for severe depression.) For the first few weeks I thought I was probably on the placebo, because I felt nothing. They start you off with a dosage that's below what they're testing, so that they can gradually up it and make sure you don't have any bad reactions. As the trial progressed to the higher dosage, I definitely felt the difference. I wasn't at all surprised, at the unblinding, to learn that I'd been on the drug.

I agree with you that there's probably no one "depression" with one diagnosis and treatment. I don't think one animal study is sufficient to throw out all the evidence of human experience, including double-blind trials, showing that at least some people do benefit from SSRI's.

[lovemydog]

18. Thanks madokie.

This is really fascinating information.

[TexasTowelie]

26. Please tell me that I can go back to smoking weed.

I haven't felt right since I quit nearly six months ago.

[daredtowork]

28. I'm a bit grumpy lately because

some recent diagnoses and some new meds I'm taking all relate to the "dopamine" side of the equation. If I understand things correctly, serotonin is in a sort of seesaw relationship with dopamine, and upping serotonin will decrease dopamine. I sought out support for "stress" when I had a very important decision to make years ago, and SSRIs were thrown at me (without even the benefit of therapy). I got nothing but side effects out of them. Now I understand why: whether or not my stress at the time qualified as any sort of serious depression, I had underlying conditions that needed dopamine support, not serotonin enhancement. I went through my first spate of serious physical symptoms at that time, and I may have made the life-determining decision to leave graduate school just short of turning in my dissertation if I had not been shovel-fed SSRIs.

Thank you, Prozac Nation.

Ironically I lost access to medical insurance as soon as I left grad school, so I was off of SSRIs immediately after that. My health immediately improved and I was a working, productive member of society for some years after that.

By the way, this has made me wonder about Robin Williams: he had Parkinson's Disease (also dopamine-side depression, and, which, curiously, can also drive drug addiction because of that dopamine cycle). I wonder if early treatment of depression with SSRIs conflicted with or exacerbated that underlying problem? Or is it possible to have problems on both sides that can't be reconciled?

[davidpdx]

30. The study is interesting, but I will tell you I'm skeptical of secondary reporting like this

It looks like the article is not available without paying for it. Here is the citation:

Angoa, M.A., Kane, M.J., Briggs, D.I., Herrera-Mundo, N., Sykes, C.E., Francescutti, D.M., & Kuhn, D.M. (2014). Mice genetically depleted of brain serotonin do not display a depression-like behavioral phenotype. ACS Chemical Neuroscience. (n/a) doi:10.1021/cn500096g

[hifiguy]

32. Fascinating info.

I have dealt with several major depressive episodes, usually brought on by life circumstances, and SSRIs have been helpful, at least the right ones. Currently I take one 30 mg Cymbalta a day and it is just a very mild anti depressant and, for me, a mild mood-stabilizer.

[BootinUp]

35. 350 million and 1.

I hope someone figures it out.

[Mildred S]

37. I Agree.

Last edited Sun Dec 6, 2015, 06:04 AM - Edit history (1)

I agree with you. Because one of my mother's friend had depression, when I saw her pain, I hope someone or some medicines can help her.

[Mildred S]

36. My personal view

Maybe，Serotonin played an important role of treating depression. I hope so!