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Apr 15 • 8 tweets • 5 min read
FACT: “Chemical imbalance” or "neurotransmitter deficiency theory" was deployed by pharmaceutical companies to advertise their #psychiatric psychotropics. Never been scientifically proven, debunked many years ago, still circulating as rumor 20+ years later.
See sources below. /1
Source #1:
cepuk.org/unrecogni.../m…
Source #2:
psychiatrictimes.com/.../debunking-…...
Source #3:
researchgate.net/.../315533279_…...
Source #4:
healthline.com/.../chemical-i…...
Source #5:
psychologytoday.com/.../dont-say-d…...
Source #6:
madinamerica.com/.../chemical-i…
Source #7:
joannamoncrieff.com/.../the-chemic… /2
Source #8:
medpagetoday.com/psyc.../genera…
Source #9:
health.harvard.edu/min.../what-ca…
Source #10:
ncbi.nlm.nih.gov/pmc/articles/P…
Source #11:
m.youtube.com/watch...
Source #12:
refinery29.com/en-gb/what-is-…
Source #13:
ncbi.nlm.nih.gov/pmc/articles/P… /3
No "chemical imbalance" or "neurotransmitter deficiency" has been found in depression, anxiety, schizophrenia, ADHD, bipolar disorder, autism, PTSD, or any other #psychiatric disorder (excluding organic neurological conditions). /4
However, some doctors still tell patients that #psychiatric drugs "top up" their neurotransmitters to compensate for deficiencies, like insulin for diabetes. This is incorrect medical advice & unethical as a manipulation to get people to comply with taking the drugs. /5
The simple beauty of the "chemical imbalance" or "neurotransmitter deficiency" legend causes people to repeat it widely on social media. It has the status of an Internet myth, one of those things "everybody knows" -- & may still hear from their doctors -- that is dead wrong. /6
#Psychiatric prescribers don't bother educating people that "chemical imbalance" or "neurotransmitter deficiency" is not correct in understanding their conditions. It's more convenient for patients to believe the drugs they prescribe address deficiencies scientifically . /7
Understanding one's #psycohiatric issues as "chemical imbalance" or "neurotransmitter deficiency" makes a patient cooperative, docile, & in suggestible to thinking the drug treatment is beneficial, despite many uncomfortable adverse effects that might diminish quality of life. /8

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More from @Altostrata

Kindly #deprescribe -- taper psychiatric drugs Profile picture
Mar 24
@_pem_pem Why this is nonsensical: "Jeffrey Lieberman, a professor of #psychiatry at Columbia University...“The problems that they’ve been criticized for have more to do [with] the way they’re used by doctors & the heterogeneity of the condition that they’re indicated for.” /1
@_pem_pem What Lieberman is saying is that if #antidepressants were prescribed to a population for which they are known to work well, they would have a much better track record. This is true, because it is a tautology. /2
@_pem_pem The reasoning is circular, if #antidepressants were prescribed for those people for whom the drugs worked, they would work. /3
Read 38 tweets
Kindly #deprescribe -- taper psychiatric drugs Profile picture
Jan 28
Monoamine hypothesis aka "chemical imbalance" & other synonyms, arose circa 1965, but was known to only #psychiatrists, who were unhappily prescribing TCAs and MAOIs to a niche market. Patients hated the many adverse effects of the drugs. /1
Until mid-1990s, monoamine hypothesis (aka "chemical imbalance", "serotonin deficiency" etc.) was not circulating as a "folk model", not in medicine or in the general public. 1990 is ~center of this chart, when #psychiatrists, many paid by pharma, started churning out papers. /2
As a meme or "folk model", monoamine hypothesis (aka "chemical imbalance", "serotonin deficiency", "neurohormone imbalance", etc.) was diligently planted by dozens of #psychiatrists -- not a few -- many paid by pharma. Not something that arose organically out of nowhere. /3
Read 15 tweets
Kindly #deprescribe -- taper psychiatric drugs Profile picture
Jan 1
Lewis, et al. respond to letters to the NEJM editor, demonstrating they do not understand basic concepts of #antidepressant withdrawal @ANTLERtrial

Maintenance or Discontinuation of Antidepressants in Primary Care | NEJM nejm.org/doi/full/10.10…
@ANTLERtrial Some in non-discontinuation group were taking their drugs inconsistently. Lewis, et al. missed potential withdrawal symptoms in that group: "but participants reported some new & worsening symptoms while continuing to take #antidepressants"
@ANTLERtrial Lewis, et al. claim "an increase in depressive symptoms might lead to an increase in “new & worsening” symptoms that are recorded as withdrawal symptoms" EXCEPT they also recorded physical withdrawal symptoms, failed to identify who had both, & did not exclude them from "relapse"
Read 4 tweets
Kindly #deprescribe -- taper psychiatric drugs Profile picture
Nov 4, 2021
@sanilrege @markhoro @SenadHasanagic1 Not at all, Sanil. Among my site members, many people come off #antidepressants & other drugs with slight or no withdrawal symptoms except an emotional anesthesia, which they may describe as depression, anhedonia, various kinds of malaise, even "relapse" but.... /1
@sanilrege @markhoro @SenadHasanagic1 ....it's a "relapse" unlike anything they've experienced before. While they may use #psychiatry's vocabulary, because that's all they've got, this emotional anesthesia is actually a result of long-term psychotropic exposure, not "relapse"..../2
@sanilrege @markhoro @SenadHasanagic1 Post-drug emotional anesthesia is well known among those who have gone off psychotropics classified as addictive & considered a feature of those protracted withdrawal syndromes. There is no reason to think chronic #psychiatric psychotropics are exempt..../3
Read 10 tweets
Kindly #deprescribe -- taper psychiatric drugs Profile picture
Oct 6, 2021
With all due respect to the fine @awaisaftab, these are the varieties of #antidepressant withdrawal syndrome:

1) WS with only physical, no emotional symptoms
2) WS with both physical & emotional symptoms
3) WS with only emotional symptoms
4) WS manifested as emotional anesthesia
@awaisaftab Of the above, types 1 & 2 are WS, not "relapse", even if "depression" is present. Emotions such as those that compose "depression" do not exist apart from experience. Emotional reaction to feeling neurobiologically out of control should not be diagnosed as "depression".
@awaisaftab Type 3 may include the waves of intense anxiety, fear, & "black holes" characteristic of WS. Characterized by intense sensations with interludes of relative calm. Typically, these very gradually abate over months.
Read 14 tweets
Kindly #deprescribe -- taper psychiatric drugs Profile picture
Oct 6, 2021
$10K cost per patient: "In late 2012, when the team finally had 6 months of data on 90 patients, the depression-score reductions....[were] essentially matched by the control group, who after 6 months with inactive devices had 17% hitting the improvement target & 7% in remission."
"As expected, it failed to help many....1st year, 10/90 patients left the study (& 4 had their devices removed), for reasons ranging from worsening depression to a suicide attempt. Eventually, of the 90 patients, 37—most of those who’d felt no benefit—had the devices removed."
"Also as expected for a surgical intervention in so depressed a population, some experienced side effects & complications....at least 9 ppl reported increased depression, 6 got infections, & several more suffered side effects such as headaches or postoperative discomfort or pain"
Read 7 tweets

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