More “stop taking your meds” from the media

Dr Joanna Moncrieff from UCL writes for the BBC today on the horrors of psychiatric medication. This is starting to be a recurring theme.

If you’ve seen a doctor about emotional problems some time over the past 20 years, you may have been told that you had a chemical imbalance, and that you needed tablets to correct it… In my view it remains more plausible that they “work” by producing drug-induced states which suppress or mask emotional problems (Dr Moncrieff, BBC News)

Ok, so that’s her view. So in the case of depression, SSRIs don’t work because they increase levels of the neurotransmitter serotonin, they just make you feel different. Surely thats the aim? And can’t one cause the other? But wait, serotonin has no link to depression!

Scientific research has not detected any reliable abnormalities of the serotonin system in people who are depressed

Really? As a doctor, I’d have thought  she’d have been able to do something as simple as use Google Scholar? In fact, let me google that for you…

My core problem with this argument is the idea that a pyschoactive drug causes a change in mood as if by magic. Sure, something like an SSRI could cause a change in mood. It’s designed to be psychoactive, by being designed to increase serotonin levels in the synapses of the brain, hence changing mood. It’s like she’s ignoring the inbetween step of all pyschoactive drugs, that they have to do something to have the effect they do on the brain. There’s a link between low serotonin levels and depression. SSRIs are designed to increase serotonin levels. There’s a link between SSRIs and a decrease in depression. Employ Occam’s Razor and what conclusion do you reach?

However, I wouldn’t be all this ranty about the article if it wasn’t for what follows…

At the moment people are being encouraged to believe that taking a pill will make them feel better by reversing some defective brain process… If, on the other hand, we gave people a clearer picture, drug treatment might not always be so appealing. If you told people that we have no idea what is going on in their brain, but that they could take a drug that would make them feel different and might help to suppress their thoughts and feelings, then many people might choose to avoid taking drugs if they could

Again, this seems to me to be missing a fundamental step in the argument. It is known, to an extent, what’s going on in the brain. Something is going wrong. Chances are, it has something to do with crazy levels of particular neurotransmitters, given this is what makes the brain function. In the case of depression, plenty of evidence (see no evil?) is there to suggest that this could be linked to low levels serotonin, or norepinephrine. Hence, giving you a drug that may increase these levels will surely have a chance of making you better. The patient knows that the drug is going to make them “feel different” – that’s why they went to the doctor in the first place!

And talk of giving people a clearer picture? Pot, kettle… The article is in no way clear! It’s a very one sided take on the matter, with no suplimentary evidence provided. She’s an “expert”, so we, the public, should listen to what she says and take it as gospel. The article gives the impression that we’re not supposed to think, just do as we’re told. Way to buy into the media control over the public… and way to sell your book, for that matter.