A new perspective on depression

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A new study has been released that challenges the widely accepted use of anti-depressants in the treatment of depression. Paul Andrews, an assistant professor of Psychology, Neuroscience and Behaviour at McMaster, has reviewed existing research and has concluded that the focus should shift instead to counseling.

In the review paper published in Neuroscience & Behavioural Reviews, Paul Andrews and his co-authors analyzed 15 papers using different animal models of depression to find that 13 of them supported a left-field hypothesis in the study of depression. Contrary to past literature, Andrews attributes depression to high, not low, levels of serotonin in the space between brain cells.

The issue then arises when considering that a common form of anti-depressants called selective serotonin re-uptake inhibitors, or SSRIs, increase serotonin between cells by blocking serotonin transport channels to prevent reabsorption into cells. These drugs are based on the well-established notion that depression is related to low serotonin levels in the space between cells, making the high-serotonin hypothesis a paradigm shift that, if substantiated, would suggest a change in treatment of depression.

“Anti-depressants seem to make people feel worse before they make them feel better,” argued Andrews, comparing the body’s homeostatic system to a spring. Homeostasis is the biological concept of maintaining stable conditions, or equilibrium, in the body.

“Taking an SSRI is like compressing the spring. The very first thing that happens is that you feel worse,” said Andrews. “It usually takes about three or four weeks for people to start experiencing an elevation of depressive symptoms… but as people continue to take these drugs for a longer period of time, they will experience a return of these depressive symptoms.”

The rate of relapse has also been found to be higher in patients who recovered from depression while taking a drug, as opposed to those who got better on their own. What is more, the slew of side effects associated with anti-depressants need to be given the attention they deserve.

“The reason why I am not a big fan of these drugs is because serotonin is not only as a neurotransmitter, but it is also important in just about every process in the body [such as] growth, development, reproductive functioning, digestive functioning, electrolyte balance and a host of others… Serotonin is found everywhere in the body, and the transporter, which anti-depressants are usually designed to block, is also found everywhere in the body. When you take an SSRI to treat your depression, you are also blocking other cells and interfering with other biological processes.”

Although Andrews’ research presents an interesting hypothesis, his review is not a comprehensive look at the field. Andrews’ work may be the beginning of a shift away from anti-depressants; however, more research is needed to determine the usefulness of anti-depressants and alternative treatments.

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