Thread by @tylerblack32

While the "serotonin hypothesis" of depression is no longer taught, #SSRIs delay the reuptake of serotonin @ neurotransmitters. We also now know they have a host of other effects (σ1, BDNF, CREB, cytokines, on top of a slew of differences on the various subtypes of serotonin)

/1

The key difference, is that today, we know that the brain changes seen in depression are impairing, and we know that SSRIs work. Instead of drawing a straight line between "serotonin regulation" and efficacy, the honest psychiatrist doesn't understand the current mechanism.

/2

We now suspect that there are a host of effects, second, third, & even tertiary effects, and the complex way in which the brain is interconnected plays a role.

But yes, SSRIs DO block the reuptake of serotonin. It's why we have to be careful about withdrawal and tolerance.

/3

It turns out that the brain is really really really complex. And these medications are important for improving the symptoms of depression for many people.

So no, depression isn't "lack of serotonin," but it certainly can be treated by SSRIs.

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Lazy antipsychiatry-people railing against "chemical imbalance theory" of depression are beating a dead horse. The current psychiatric position is that "We aren't sure how SSRIs work but they work phenomenally well for depression and anxiety and a host of other conditions."