Podcast - What Your GP Doesn't Tell You Launches 18 August
The Serotonin Hypothesis and Data Suggesting 50% of SSRI Users Suffer Sexual Side Effects
In the first episode of the completely new podcast What Your GP Doesn’t Tell You, which launches on 18 August, in a wide ranging conversation, I talk to Joanna Moncrieff, Professor of Critical and Social Psychiatry at University College, London. She discusses her research and experience as a psychiatrist working with the antidepressant drugs – the Serotonin Selective Re-uptake Inhibitors (SSRIs).
As Joanna explains in this audio clip, worrying new data suggests that around 50% of patients taking these drugs may suffer sexual side effects, some of which may continue even after they have stopped taking them.
And we discuss how different researchers have looked at the same clinical trial data and come to remarkably different conclusions about SSRI drugs, some claiming this evidence means that antidepressants don’t work and others that they do, so who’s right? The podcast examines exactly what the clinical trial data actually tell us about the effectiveness of these drugs. It’s a complex area which we explore fully in the podcast and I’ll talk about this in more detail in my next Substack article.
Joanna also discusses her recent review study in Molecular Psychiatry 1 examining the evidence for the so-called “Serotonin Hypothesis” – the idea that SSRIs work by boosting serotonin levels in the brain.
When these drugs were first introduced in the late 1980s, it was suggested that they were effective because they increased serotonin in the brain and so the idea began to take root that depression was caused by a chemical imbalance of serotonin. Across the world, both doctors and patients absorbed this message and helped by powerful marketing campaigns, rates of antidepressant use shot up. Today 1 in 6 adults in the UK takes an antidepressant. Joanna believes that many people started taking these drugs because they believed they had some biological fault in their brain that the SSRIs could correct.
Yet, having examined all the major areas of research into depression and serotonin, Joanna and her team found no evidence to support the idea that depression is a result of low serotonin levels. So her study suggests that the idea that SSRIs work by increasing serotonin to correct a serotonin deficiency is simply wrong.
In this audio clip, Joanna argues rather than correcting faulty brain chemistry what the drugs are actually doing is altering normal brain chemistry, which may help explain why some patients find withdrawal so difficult.
When the study was published recently, for the general public the news that depression was not linked to serotonin came as a shock, with many feeling misled and claiming that they had been told by their doctors that these drugs would correct a chemical imbalance in their brain.
However, a lot of health professionals claimed that this was old news, and something that they had been aware of for a long time.
But, if that is the case, it is certainly not reflected in the highly ambiguous information that patients continue to receive. A quick search on the web looking at some of the most trusted medical resources quickly reveals the confusing information that is still being provided.
Currently the NHS’s website2 advises:
“How Antidepressants Work
“It's not known exactly how antidepressants work. It's thought they work by increasing levels of chemicals in the brain called neurotransmitters. Certain neurotransmitters, such as serotonin and noradrenaline, are linked to mood and emotion.”
And two of the US’s most prestigious medical facilities, The Mayo Clinic and Johns Hopkins Medicine, are posting information that still appears to support the “Serotonin Hypothesis”:
The Mayo Clinic3 :
“How SSRIs work
SSRIs treat depression by increasing levels of serotonin in the brain. Serotonin is one of the chemical messengers (neurotransmitters) that carry signals between brain nerve cells (neurons). SSRIs block the reabsorption (reuptake) of serotonin into neurons. This makes more serotonin available to improve transmission of messages between neurons. SSRIs are called selective because they mainly affect serotonin, not other neurotransmitters.”
Johns Hopkins4 :
“Selective Serotonin Reuptake Inhibitors (SSRIs)
SSRI drugs are the most commonly prescribed antidepressants and are often considered the first line of defense against depression. They increase your brain's level of a neurotransmitter (a chemical that transfers messages from brain cell to brain cell) called serotonin. This neurotransmitter is associated with feeling happy and content. SSRI side effects tend to be mild, and depression symptoms improve significantly for about 60% of people with moderate to severe depression”.
So is it any wonder patients are confused? Join me for the first episode of What Your GP Doesn’t Tell You on 18 August to find out more.
I should add, Joanna’s advice to anyone who wants to reduce or come off their antidepressant is that it’s very important not to stop the medication suddenly, as this can lead to withdrawal problems. Patients should think about their decision very carefully and discuss it with their doctor, then if they do decide they want to try and stop taking SSRIs, this should be done very slowly and gradually with the support of medical professionals.
https://www.nature.com/articles/s41380-022-01661-0
https://www.mayoclinic.org/diseases-conditions/depression/in-depth/ssris/art-20044825
Where do we find the podcast? Thanks
I've been suffering from pssd for 8 years. It's caused debilitating cognitive and sexual symptoms. There's never any awareness of the cognitive symptoms of pssd such as emotional bluntness, brain fog, fatigue, and anhedonia. My life was destroyed by these drugs and I have no idea how they are legal.