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Kelly Brogan MD: "Depression: It’s Not Your Serotonin"


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I'm not sure if this link has been posted before, but this article on the lack of support for the "chemical imbalance" theory of depression is excellent. A great read!

 

Excerpt from the article:

 

In fact, a meta-analysis of over 14,000 patients and Dr. Insel, head of the NIMH, had this to say:

 

    “Despite high expectations, neither genomics nor imaging has yet impacted the diagnosis or treatment of the 45 million Americans with serious or moderate mental illness each year.”

 

To understand what imbalance is, we must know what balance looks like, and neuroscience, to date, has not characterized the optimal brain state, nor how to even assess for it. In a review of serotonin theories of depression, Andrews et al. turn the paradigm on its head and conclude:

 

    "We propose that depressed states are high serotonin phenomena, which challenges the prominent role the low serotonin hypothesis continues to have in depression research (Albert et al., 2012). We also propose that the direct serotonin-enhancing effects of antidepressants disturb energy homeostasis and worsen symptoms. We argue that symptom reduction, which only occurs over chronic treatment, is attributable to the compensatory responses of the brain attempting to restore energy homeostasis."

 

 

http://kellybroganmd.com/depression-serotonin/ 

 

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  • 2 weeks later...
I followed Dr. Brogan for a bit and still get her emails.  She's offering a free webinar now.  On the whole she is a pioneer in the psychiatry field.  She seems very compassionate and truly offers helpful "cures" for our dependencies.  Thanks for posting the link, Lapis!
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Hi!

Glad you enjoyed the article. I've certainly come across Dr. Brogan's name a few times, but I haven't spent a lot of time going through her website.

 

I was searching for decent articles about the so-called "chemical imbalance theory" because a friend of my mother was told she needed antidepressants due to low serotonin. It's been debunked as a myth, but it seems the myth still gets thrown around as a real possibility. My mom forwarded the info, but the woman still didn't believe it. She still thought she needed the pills. UGH.  :(

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Well, I think why the myth persists is that, like Dr. Breggin says, psych drugs create chemical imbalances where none previously existed, and a lot of people take psych drugs
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The myth exists because the advertisers of the medications created that myth and repeated it many times on TV. When they wanted to sell the meds, they created a need for them. Also, they misinformed doctors, who carried on the myth.

 

It has been dispelled, but not everyone got the message. But it makes sense that taking the meds creates imbalances. The myth is that people NEED the meds BECAUSE they have chemical imbalances, i.e. BEFORE they take them. Some even tried to equate them with the concept of insulin for diabetics. It's NOT true.

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The myth exists because the advertisers of the medications created that myth and repeated it many times on TV. When they wanted to sell the meds, they created a need for them. Also, they misinformed doctors, who carried on the myth.

 

It has been dispelled, but not everyone got the message. But it makes sense that taking the meds creates imbalances. The myth is that people NEED the meds BECAUSE they have chemical imbalances, i.e. BEFORE they take them. Some even tried to equate them with the concept of insulin for diabetics. It's NOT true.

 

:thumbsup:  Yep!  Wish I could dig up the article here, but if memory serves me correctly, wasn't it with the SSRIs that they were deciding what condition to market it for?  As in, based solely on what would make them the most money.  Zippo to do with any science!

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I don't know. I have such mixed feelings about antidepressants. Some SSRI's are quite nasty, but Prozac had minimal side effects on me. From my experience, when that was the only psych med I was taking, my world was quite good, I was functional, had good jobs, friends, etc. I think the trouble may arise when SSRI's is taken in conjunction with a benzo, or if an SSRI is taken after the CNS has already been benzo compromised and injured. Also, going on/off various AD's can cause problems down the road. So, if someone was on an SSRI, stable, leading a decent life, would there be a need for them to taper or stop?  Not recommending SSRI's but just thinking that it may be ok to keep taking an SSRI your body agrees with before the CNS is compromised. Now, after the benzo disaster, I can no longer tolerate any antidepressant. So, from that point, giving an AD to a patient who's tapering benzos, or has been off or is taking them may not be such a good idea. Also, I've tried Zoloft once, and Effexor once and found those extremely stimulating. AD's wiith short half-lives can be trouble.....
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I don't know. I have such mixed feelings about antidepressants. Some SSRI's are quite nasty, but Prozac had minimal side effects on me. From my experience, when that was the only psych med I was taking, my world was quite good, I was functional, had good jobs, friends, etc. I think the trouble may arise when SSRI's is taken in conjunction with a benzo, or if an SSRI is taken after the CNS has already been benzo compromised and injured. Also, going on/off various AD's can cause problems down the road. So, if someone was on an SSRI, stable, leading a decent life, would there be a need for them to taper or stop?  Not recommending SSRI's but just thinking that it may be ok to keep taking an SSRI your body agrees with before the CNS is compromised. Now, after the benzo disaster, I can no longer tolerate any antidepressant. So, from that point, giving an AD to a patient who's tapering benzos, or has been off or is taking them may not be such a good idea. Also, I've tried Zoloft once, and Effexor once and found those extremely stimulating. AD's wiith short half-lives can be trouble.....

 

The whole issue is that there's no proof that the SSRIs have any positive effect that's greater than the placebo. But the side effects and long-term effects are very real. They can adversely affect bone density, sodium levels, sex drive and possibly cause effects on unborn children if taken during pregnancy. They have withdrawal effects. They can interact in unknown and adverse ways with other substances.

 

We each have our individual genetics which determine how we will metabolize these meds. Sometimes there can be an okay or neutral effect from an SSRI, but these meds have also been associated with suicidal and homicidal tendencies. That's pretty serous stuff. Genetic testing might be able to catch some issues in advance, but few have access to these tests. It's a crap shoot, really.

 

So, my take is that it's better and safer to focus on non-drug interventions for depression. Personally, I only have regrets about having taken Prozac. It is undoubtedly a big factor in why I continue to suffer with withdrawal symptoms for so long. I think people should be informed about ALL of the possible effects of these meds before taking them. I was not.

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The myth exists because the advertisers of the medications created that myth and repeated it many times on TV. When they wanted to sell the meds, they created a need for them. Also, they misinformed doctors, who carried on the myth.

 

It has been dispelled, but not everyone got the message. But it makes sense that taking the meds creates imbalances. The myth is that people NEED the meds BECAUSE they have chemical imbalances, i.e. BEFORE they take them. Some even tried to equate them with the concept of insulin for diabetics. It's NOT true.

 

So well said Lapis, including your above post.  You are so eloquent.  I tried to convey the same information to a neighbour/aquaintance (I was hoping, friend) but it didn't go over well.  She did credit me with informing her of the importance of tapering off ADs.  She was already planning to stop them and thankfully I got the tapering message to her in time (and last I heard she was still suffering w/d).  However, she did not come off because she understood they did not correct a chemical imbalance etc. and may go back on them again.  Later when I talked to her about how AD's don't do what we are led to believe, she said something jokingly about "conspiracy" and "Scientology".  I later emailed her a couple articles and I haven't heard from her since.  In fact she looked right through and past me when I saw her while out for a walk.  That was months ago.  I see your efforts for your Mom's friend went similarly.  UGH! is right.  I'm getting used to this, sadly.  :( 

 

Thank you for this article.  It's a good one.  Very thorough.

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Hi benzohno,

I figure that sharing the info -- as long as it's not done in a rude or obnoxious way -- could have some good effects down the road, even if it's not well-received initially. There's the concept of "cognitive dissonance", meaning that a person can't hold two conflicting ideas in his/her head. So, perhaps the person continues to believe that the SSRIs are good and that they correct a chemical imbalance, but over time, and with more information, the person might say, "Hey, I remember reading about that and now I see this other information, and maybe, just maybe, there's something to it. Perhaps I should investigate further. Perhaps my lovely and talented neighbour benzohno was right!"

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Shortly after I came off Prozac, I ordered a book called, "The Antidepressant Solution", by Dr. Joseph Glenmullen. I had just come across it, and even though it was post-taper for me, I still found it useful and informative. I would recommend it without hesitation to anyone who is considering going off an SSRI. It's quite balanced, and it provides useful tips for those who want to get off SSRIs safely. Glenmullen is a Harvard professor and a practising psychiatrist, so he's got the credentials to back up what he says.

 

http://www.goodreads.com/book/show/1837507.The_Antidepressant_Solution 

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I can only concur with everything Lapis has said. I appreciate that many people feel they benefit from taking SSRIs. Antidepressants are pretty effective at blunting emotion but in the words of Dr Joanna Moncrieff this altered state may be preferred but it isn't normal.

 

My very first antidepressant was one of the older tricyclic antidepressants Anafranil which gave me such a dry mouth and blurred vision that I considered getting specs in my early 20s. I should have had the gumption to read the leaflet on side effects. I suspect that my age and length of time on these drugs - at one stage I was also on Seroxat - probably worked against me when I came to taper off Effexor in 2010 and into early 2011 but within a week of stopping I was in a dire situation. I spent a year and a half existing on my sofa in abject terror and this lead to the terrifically bad decision to take benzodiazepines. In the decades of antidepressant use I had noticed that anytime I missed a dose of my "medication" I would get extremely jittery.

 

Antidepressants have horrible side effects. I had a long list: as mentioned above, blurred vision, weight gain, hot flashes, irregular heartbeats, cognitive impairment, lack of motivation and drive. My gut hated SSRIs and I couldn't have a belt anywhere near my abdomen because of the discomfort. I had photo sensitive skin and a terrible itch that required antihistamines. At the end of the day I was taking a pharmacist's shop worth of drugs to cope with the side effects. I have read that SSRIs have amphetamine like effects but for me I could barely function due chronic exhaustion.

 

There is so much research out there to show that perhaps I should be concerned about my cumulative exposure to antidepressants. They certainly don't seem to help people in the long term. A 2011 meta analysis of 46 studies showed the relapse rate for antidepressant treated patients (44.6%) was much higher than for placebo treated patients (24.7%). Research carried out by the Society for the Study of Addiction found that benzodiazepine and SSRI dependence and withdrawal are similar in 37 of 42 identified reactions which appears to vindicate my own experience of both antidepressant and benzo withdrawal. The suicide risk cannot be down played either. In a 2005 meta-analysis of published trials of 87650 patients independent researchers found that in all ages suicide attempts doubled on antidepressants than on placebo.

 

I know my own experience does not necessarily equate to the experience of everyone else but I have read sufficient about the difficulties encountered by others on-line and in the media to realise that I'm not unique. This is why we really need "informed" consent.

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Hi benzohno,

I figure that sharing the info -- as long as it's not done in a rude or obnoxious way -- could have some good effects down the road, even if it's not well-received initially. There's the concept of "cognitive dissonance", meaning that a person can't hold two conflicting ideas in his/her head. So, perhaps the person continues to believe that the SSRIs are good and that they correct a chemical imbalance, but over time, and with more information, the person might say, "Hey, I remember reading about that and now I see this other information, and maybe, just maybe, there's something to it. Perhaps I should investigate further. Perhaps my lovely and talented neighbour benzohno was right!"

 

:thumbsup:  ;D  :-*

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Hi benzohno,

I figure that sharing the info -- as long as it's not done in a rude or obnoxious way -- could have some good effects down the road, even if it's not well-received initially. There's the concept of "cognitive dissonance", meaning that a person can't hold two conflicting ideas in his/her head. So, perhaps the person continues to believe that the SSRIs are good and that they correct a chemical imbalance, but over time, and with more information, the person might say, "Hey, I remember reading about that and now I see this other information, and maybe, just maybe, there's something to it. Perhaps I should investigate further. Perhaps my lovely and talented neighbour benzohno was right!"

 

:thumbsup:  ;D  :-*

 

I KNOW your neighbour will use that exact phrase!  ;D

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pris,

It's so interesting to hear about your experience with antidepressants. When you mentioned the long list of side effects, I was cringing. It reminded me of some of the things I experienced, including fainting and diarrhea. I'm so sorry you had a horrible time on the meds, but you're obviously MUCH wiser now. We've all got 20/20 hindsight vision (which is way better than the blurry vision you had while taking those horrible pills!).

 

 

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The myth exists because the advertisers of the medications created that myth and repeated it many times on TV. When they wanted to sell the meds, they created a need for them. Also, they misinformed doctors, who carried on the myth.

 

It has been dispelled, but not everyone got the message. But it makes sense that taking the meds creates imbalances. The myth is that people NEED the meds BECAUSE they have chemical imbalances, i.e. BEFORE they take them. Some even tried to equate them with the concept of insulin for diabetics. It's NOT true.

 

:thumbsup:  Yep!  Wish I could dig up the article here, but if memory serves me correctly, wasn't it with the SSRIs that they were deciding what condition to market it for?  As in, based solely on what would make them the most money.  Zippo to do with any science!

 

 

Here it is, it was Eli Lilly and Prozac that started it all.  :-\

 

Wow, I was really expecting to be doing a lot of sighing and eye rolling listening to this, but I was very pleasantly surprised!  He gives a VERY critical and cynical overview of the history and development of ADs, including the psycho-pharmacological movement, the complete lack of science, and drug company marketing and deceit, etc. 

 

Something I didn't know. Apparently Eli Lilly actually produced Prozac in 1974 but it only went to market as an SSRI in 1988/89.  Why?  Partly because they had also produced other supposed ADs and couldn't decide which one to market and, also, because they couldn't decide *how* to market it, as in *what* it was supposed to treat!? :o  Obesity, hypertension, or depression - Which condition would make them the most money.  ::)  Sighs.

 

Very good lecture, well worth the listen!

 

Introduction to the methodology of (medical) science. Lecture for 4th year medical students at the Third Faculty of Medicine, Charles University in Prague.

 

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