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What If Everything We Know About Treating Depression Is Wrong?
Photo Credit: Michael Kowalski/Shutterstock
September 1, 2014
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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.
A subset of the mice who couldn’t produce serotonin were
given antidepressant medications and they responded in a similar manner
to the drugs as did normal mice. Altogether, the study found that
serotonin is not a major player in depression, and science should look
elsewhere to identify other factors that might be involved. These
results could greatly reshape depression research, the authors say, and
shift the focus of the search for depression treatments.
The study joins others in directly challenging the notion
that depression is related to lower levels of serotonin in the brain.
One study has shown that some two-thirds of those who take SSRIs remain
depressed, while another study has even found them clinically insignificant.
Critics of common antidepressants claim they’re not much better than a placebo, yet may still have unwanted side effects.
SSRIs started to become widely used in the 1980s. Their
introduction was heralded by the psychiatric community as a new era
where safer drugs that directly targeted the causes of depression would
become the standard. While SSRIs aren’t more effective than the older
antidepressants, such as tricyclics and monoamine oxidase inhibitors, they are less toxic.
An earlier study by the National Institute of Mental Health
found that two out of three patients with depression don’t fully
recover using modern antidepressants.
These results “are important because previously it was
unclear just how effective (or ineffective) antidepressant medications
are in patients seeking treatment in real-world settings,” said James Murrough, a research fellow at the Mount Sinai School of Medicine Mood and Anxiety Disorders Program.
