Depression is caused by too little serotonin between the brain cell synapses. Sustained selective reuptake inhibiting (SSRI) medications cause the serotonin levels to go back to a pre-depressed state in effect healing the brain.
Numerous studies have shown that SSRI’s help about 50-70% of those with depression.
Of those who are not helped, another 50-70% are helped by switching to another medication or one that also works on norepinephrine called serotonin and norepinephrine reuptake inhibitors (SNRI’s.)
This is a helpful bit of text compliments of our friends at WebMD:
“If you’re being treated for depression, taking an antidepressant may be part of your treatment plan.
“Antidepressants work by balancing chemicals in your brain called neurotransmitters that affect mood and emotions. These depression medicines can help improve your mood, help you sleep better, and increase your appetite and concentration.
“Antidepressants can help jump-start mood and give people the boost they need to get over the symptoms of their depression,” says Eric Endlich, Ph.D., a clinical psychologist based in Boston.
“This often allows them to start doing the things they enjoy again and make better choices for themselves, which also helps contribute to a more positive mood37.”
Unfortunately, as simple and as tidy as this story is, none of it is true.
- Low serotonin does not cause depression
- SSRI medications are not more effective than placebos
Those are some strong statements. Let me back them up and explain why I do not consider SSRI or SNRI medications as first-line treatments for depression.
Failed Serotonin Hypothesis
The theory that low levels of neurotransmitters were the cause of depression first came from Joseph Schlidkraut in 196538. Serotonin became the molecule of focus within the next two years39.
Numerous attempts were made to prove the hypothesis. Researchers measured serotonin by-products in the cerebrospinal fluid in those with severe depression.
They also tried to cause depression by depleting serotonin. Other attempts were made to reverse depression by giving massive doses of L-tryptophan, a precursor of serotonin.
None of these efforts worked40.