Low serotonin theory questioned

[birchswing]

http://www.huffingtonpost.com/2015/02/28/how-anti-depressants-work_n_6707272.html

I know that some of this isn't new information, but some of it was new to me, at least. It almost sounds as if the brain's adaptation to SSRIs (perhaps an attempt to reach homeostasis?) is what has some beneficial effect.

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[shan564]

http://www.huffingtonpost.com/2015/02/28/how-anti-depressants-work_n_6707272.html

I know that some of this isn't new information, but some of it was new to me, at least. It almost sounds as if the brain's adaptation to SSRIs (perhaps an attempt to reach homeostasis?) is what has some beneficial effect.

That's been a mainstream belief for quite some time now.

 

[Ceke2002]

The so called 'Serotonin Theory', as far as I understand it, is an extremely dumbed down view point of how brain chemistry in depression is actually believed to work - you have low serotonin levels, you're depressed, except it's not as simple as that (at least not according to the rather fascinating lecture on the science of brain chemistry and depression that I got from my Psychiatrist, absolutely none of which I can remember at 10 am on a Sunday morning).

 

[y0ung312]

As Ceke2002 has stated, depression pathophysiology is much more complicated than stating certain things go down or up, so we should adjust accordingly. The monoamine hypothesis has been around for a while now, but we're finding out many new things about mood disorders and possibly new targets for therapeutic formulations that certainly indicates that monoamine metabolism is not the only factor that goes into what happens when someone becomes depressed. The dysregulated HPA axis, inflammatory and oxidative stress, neurotrophic factors, and a host of genetic/genomic changes in depression are a few of the theories that are being postulated to be intricately involved in those with severe depression pathology, especially in treatment resistant patients. I am by no means an expert, but I find this stuff rather fascinating and I believe recent technological advances (e.g. using miRNA to characterize genetic irregularities) will definitely give us a clearer picture of what's going on in our heads =). One thing to note, though, is that depressive disorders are highly heterogeneous, and for this reason, you can't view depression as having a singular pathology but rather a syndrome with a variety of etiologies.

 

[skunky386]

Nice response yOung...one point I wanted to add...SSRI's have been shown to promote increased neuroplasticity of certain regions of the brain bringing it to a more juvenile and malleable cellular state. Couple this more malleable brain with sessions of psychotherapy to more easily tweak the malladaptive thoughts and behaviors and one is cured. This is just a very simplified neuologic correlate to why therapy + meds >either alone