Over the past couple of days, a class of antidepressant medications, known as SSRIs, have been the subject of much discussion in the media.
But what are SSRIs? How does it work, and is it really effective in treatment depression?
What are SSRIs?
Selective serotonin reuptake inhibitors are a class of medications that are used to treat certain mental health conditions such as depression, Post Traumatic Stress DisorderAnd the Obsessive-compulsive disorder And the anxiety disorders.
Selective serotonin reuptake inhibitors (SSRIs) first came into general use as an antidepressant treatment in the 1980s and are now widely used, usually in combination with speech therapies such as cognitive behavioral therapy.
How do SSRIs work?
SSRIs change the way serotonin works in the brain. Serotonin is a neurotransmitter, which also acts as a hormone, relaying messages between nerve cells in our brains and throughout the body’s nervous systems.
Normally once serotonin carries these “messages” between nerve cells, it is reabsorbed. This is known as “re-absorption,” and this is what SSRIs prevent from happening.
Since SSTIs block serotonin uptake, there is more serotonin available to pass on more messages around the brain and body. Presumably, this is how SSRIs relieve depression, at least in part.
Why are people talking about SSRIs now?
SSRIs have been the topic of discussion recently in the following media publish paper which reviewed 17 studies on serotonin. The authors wanted to see if there was evidence that depression was linked to low serotonin concentrations. They could not find any such evidence.
This paper questioned the role that serotonin plays in depression and, implicitly, the efficacy of SSRIs in this case – but it is important to note that this was not the purpose of the research.
To say that low serotonin levels are the cause of depression is an oversimplification. While many experts agree that serotonin often plays a role in major depressive disorders, the causes of depression are more complex and involve environmental factors, social and economic influences, other physical and medical conditions, and even our personal experiences such as violent events or childhood trauma. .
Professor David Curtis, Professor Emeritus, UCLA Genetics Institute said:
“This paper does not present any new findings but only presents results that have been published elsewhere, and it is certainly not news that depression is not caused by ‘low serotonin levels.’ The notion of depression due to a ‘chemical imbalance’ is outdated,” the college wrote. Royal psychiatrists said this was an oversimplification in a position statement published in 2019. SSRI antidepressants also increase serotonin levels. Their immediate action is to alter the balance between serotonin concentrations in and out of neurons, but it is possible that their antidepressant effect is due to changes in More complex in neuron functions, which subsequently occurs as a result.It is very clear that people with depressive illness have some abnormalities in brain function, even if we do not yet know what this is, and that antidepressants are effective treatments for major depression, Whereas interventions such as exercise and mindfulness are not. It is important that people with major depression are not discouraged from receiving appropriate treatments, which can make a huge difference to them and those around them.”
So, are SSRIs effective?
As with all treatments for physical and mental health conditions, the answer is: It depends.
For some people, SSRIs are very effective. For others, they seem to make little or no difference.
In many cases, SSRIs can help improve symptoms, but only when used in combination with other forms of treatment such as cognitive behavioral therapy.
More research is needed to better understand why SSRIs work for some people but not others.
Dr Michael Bloomfield, Consultant Psychiatrist and Principal Clinical Research Fellow at UKRI, Head of the Transformational Psychiatry Research Group, UCL, said:
“Many of us know that taking paracetamol can be good for headaches, and I don’t think anyone thinks that headaches are caused by insufficient paracetamol in the brain. The same reasoning applies to depression and medications used to treat depression. There is consistent evidence that antidepressant medications can be Useful in treating depression and can save a life.Antidepressant medication is one type of treatment along with other types of treatment such as psychotherapy (talk therapy).Patients should have access to evidence-based treatments for depression, and anyone taking Any treatment for depression and are considering discontinuing treatment discuss this with their doctor first.”
Should I stop taking antidepressants?
It is very important that if your doctor prescribes antidepressants for you, do not suddenly stop taking them. Doing so can lead to symptoms such as dizziness, nausea, mood swings, brain fog and even, in some cases, suicidal thoughts.
Instead, you should talk to your doctor about your treatment options and follow their recommendations.
For more information, there are some helpful resources here:
SSRIs – Information from the NHS
Stopping antidepressants – advice from the Royal College of Physicians
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