“No convincing evidence” that depression is caused by low serotonin levels
&gt; Other clinicians say, however, that the notion of depression being because of a simple chemical imbalance is outmoded anyway, and that antidepressants remain a useful option for patients alongside other approaches including talking therapies.<p>This is the key line in the summary.<p>The concept of attacking an idea no one really believes is really a straw man.<p>More importantly the modern practice of medicine is &quot;evidence based medicine&quot;, not &quot;mechanism based medicine&quot;.
That means treatments are tested as to <i>if</i> they work, not <i>how</i> they work.
Ideally in multiple well run double blinded randomised controlled trials with at least some against treatment as usual.
Unlike the past when we thought more about <i>how</i> they might work, theorising something is off about someone&#x27;s humors and adjusting with leeches.<p>Anyone looking for a truly mind bending result should look at Hjorth et al. 2021 [0], the study recruited people with social phobia and gave them all an SSRI (escitalopram). Half were told they were getting a sham active placebo and &quot;should not expect to get better&quot;, half were told &quot;you&#x27;re getting the known effective treatment&quot;.<p>Headline result being told you are being treated leads to 4x as much response <i>with brain changes</i> in the dopamin networks.<p>In the meanwhile, rather than worry about how antidepressants work, why not take a look at electroconvulsive therapy which has proven time and again to be the most effective treatment for depression. Yet we have no idea how it works, other than knowing a decent seizure in those without epilepsy makes you less sad? What on earth.<p>[0] <a href="https:&#x2F;&#x2F;www.nature.com&#x2F;articles&#x2F;s41398-021-01682-3" rel="nofollow">https:&#x2F;&#x2F;www.nature.com&#x2F;articles&#x2F;s41398-021-01682-3</a>