Understanding the Serotonin Theory of Depression
In the 1960s, researchers put forward an idea that depression might be caused by a lack of serotonin in the brain. So (understandably) they thought that if they could somehow increase serotonin level in be brain with medication, then symptoms of depression could be reduced. This became known as the serotonin hypothesis of depression. This theory became highly influential over the following decades, especially after the introduction of SSRI antidepressants.
Fast-forward 50 years after the serotonin hypothesis was first proposed...
In 2022 an umbrella review of the evidence concluded that there is no evidence that depression is associated with, or caused by, lower serotonin concentrations or activity. The review was published in 2022 in the scientific journal called “Molecular Psychiatry” under the title “The serotonin theory of depression: a systematic umbrella review of the evidence”.
The review looked at decades of research around whether depression is in fact linked to low serotonin levels or reduced serotonin activity. The review was led by Professor Joanna Moncrieff (a consultant psychiatrist and Professor of Critical and Social Psychiatry at University College London), and co-authored by Mark Horowitz (a Australian doctor and researcher with a PhD in the neurobiology of depression and antidepressant pharmacology from King's College London), along with a team of highly skilled psychologists, psychiatrists and mental health researchers who have expertise in evidence synthesis, epidemiology and psychopharmacology (click for information).
They looked at all the evidence from brain imaging studies, genetic studies, serotonin metabolite research, serotonin receptor and transporter studies, and experiments designed to temporarily lower serotonin levels. After evaluating the findings from all these different areas of research, the authors concluded that the available evidence does not support the theory that depression is caused by low serotonin.
This absolutely does not mean that experiences of depression aren't real. And it certainly doesn't mean that antidepressants don't help some people. Because they do. For some people, these medications have been life-changing and, in some cases, life-saving.
What it does mean, though, is that a very important question is now being asked: if depression is caused by low serotonin, where is the evidence for that? And another very important question follows: if antidepressants work by correcting an underlying serotonin deficiency, why do so many people who take antidepressant medications continue to experience depression?
These are the questions that researchers have increasingly been exploring. More than 50 years after the serotonin hypothesis was first proposed, the authors of “The serotonin theory of depression: a systematic umbrella review of the evidence” concluded that the available evidence does not support the idea that depression is caused by low serotonin or a simple chemical imbalance in the brain.
Fast-forward 50 years after the serotonin hypothesis was first proposed...
In 2022 an umbrella review of the evidence concluded that there is no evidence that depression is associated with, or caused by, lower serotonin concentrations or activity. The review was published in 2022 in the scientific journal called “Molecular Psychiatry” under the title “The serotonin theory of depression: a systematic umbrella review of the evidence”.
The review looked at decades of research around whether depression is in fact linked to low serotonin levels or reduced serotonin activity. The review was led by Professor Joanna Moncrieff (a consultant psychiatrist and Professor of Critical and Social Psychiatry at University College London), and co-authored by Mark Horowitz (a Australian doctor and researcher with a PhD in the neurobiology of depression and antidepressant pharmacology from King's College London), along with a team of highly skilled psychologists, psychiatrists and mental health researchers who have expertise in evidence synthesis, epidemiology and psychopharmacology (click for information).
They looked at all the evidence from brain imaging studies, genetic studies, serotonin metabolite research, serotonin receptor and transporter studies, and experiments designed to temporarily lower serotonin levels. After evaluating the findings from all these different areas of research, the authors concluded that the available evidence does not support the theory that depression is caused by low serotonin.
This absolutely does not mean that experiences of depression aren't real. And it certainly doesn't mean that antidepressants don't help some people. Because they do. For some people, these medications have been life-changing and, in some cases, life-saving.
What it does mean, though, is that a very important question is now being asked: if depression is caused by low serotonin, where is the evidence for that? And another very important question follows: if antidepressants work by correcting an underlying serotonin deficiency, why do so many people who take antidepressant medications continue to experience depression?
These are the questions that researchers have increasingly been exploring. More than 50 years after the serotonin hypothesis was first proposed, the authors of “The serotonin theory of depression: a systematic umbrella review of the evidence” concluded that the available evidence does not support the idea that depression is caused by low serotonin or a simple chemical imbalance in the brain.
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