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dangil t1_iv75nnu wrote

Reply to comment by DucksNQuackers in BRAIN SEROTONIN RELEASE IS REDUCED IN PATIENTS WITH DEPRESSION: A [11C]Cimbi-36 PET STUDY WITH A D-AMPHETAMINE CHALLENGE. - Biological Psychiatry by chilladipa

The serotonin model is dead. Probably a symptom.

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dude2dudette t1_iv80mfh wrote

The Serotonin Model is probably only accurate for a subset of those with depression.

Depression itself may be a symptom, with multiple possible causes (a bit like how severe stomach pain could be caused by IBS, Crohn's, Endometriosis etc.)

There might be various neurochemical imbalances that each can cause the behavioural/cognitive outcome of 'Depression' (especially given the different subtypes of depression that exist)

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Able-Emotion4416 t1_ivb0b7k wrote

There are now tons of studies showing that it isn't necessarily an individual problem for the vast majority of people suffering from mental health. But a huge systemic and societal one. Studies after studies demonstrate that air quality is crucial to prevent depression and anxiety, that most homes and buildings have neurotoxic offgasing, that out-door air qualities in cities is even worse. And that the probability to suffer from depression and anxiety in this environment strongly increases. Same thing with artificial lighting, junk food, and lack of physical exercises...

It's time to work and intervene like animal biologists do. It's time to fix our environment and food. And make them suitable for human mental and neurological health, among others.

Time to choose building materials, food ingredients, and artificial lighting that enhance human health, not harm it. And really time to strongly improve outdoor air quality in cities... We can't continue to make individual people carry the costs and burden of grave societal mistakes...

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dude2dudette t1_ivb3d62 wrote

Behavioural/environmental mechanisms are certainly important. However, that doesn't exclude neurotransmitter mechanisms.

It could be that the environment causes neurotransmitter receptor activation changes (e.g., lived environment (work stress/poor living space/lack of exercise, etc.) modifying one's immune system could lead to opioid activation dysfunction, which could then lead to depressive symptoms - see Charles, Farias and Dunbar, 2020)

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dangil t1_iv80u4c wrote

Pro tip. It’s epilepsy

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40ozSmasher t1_iv76651 wrote

Could you elaborate?

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dangil t1_iv76vw5 wrote

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5299662/

https://www.psychologytoday.com/us/blog/charting-the-depths/201007/the-serotonin-theory-depression-is-collapsing

https://science.thewire.in/the-sciences/serotonin-model-depression-repeal/

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Grisward t1_iv7ozfc wrote

These articles are valuable components of the overall research still ongoing to understand mental health and related pharmacotherapies. They have value. They are not showing serotonin is unrelated to depression.

First “major depressive disorder” is substantially stronger diagnosis than more commonly diagnosed depression.

Second, even among this subset of patients, “SSRIs significantly reduced the Hamilton Depression Rating Scale.” Their initial overall finding was significant decrease in depression (on multiple measurement scales).

They also found increase in adverse episodes (30/1000 in treated versus 22/1000 placebo), which is a known risk with serotonin-related treatments. This risk should not be ignored, for sure. However that risk doesn’t erase the benefit of treatment in some patients, it adds a secondary factor. It is certainly valid for the authors (and other scientists and physicians) to have the opinion that the risks do not outweigh the benefits, however that isn’t the subject of the study, nor is that type of opinion factual. The risks of adverse events is higher in “major depressive disorder”, and so their opinion is based upon a very focused study that only includes the stronger depressive disorder.

The serotonin model is not dead, nor is new data showing it to be dead. The serotonin model is as yet incomplete. The benefits of treatment is not fully understood in concert with risks to each patient.

Edit: fixed typo “sowing” to “showing”. Oops.

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ampanmdagaba t1_iv7n1aw wrote

This study: n=37 with p=0.04 turning to something like 0.5 after removal of one outlier.

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