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Wednesday, November 09, 2005
PLoS on the Serotonin Hypothesis
I missed this article before, but it is worth reading. October's PLoS Medicine suggests direct to consumer advertising for SSRI antidepressents is false and misleading.
I had never read a review of the serotonin hypothesis before and it makes me think that doctors too are probably heavily influenced by the drug companies' push of the serotonin hypothesis. I would be willing to bet that a majority of psychiatrists probably buy into it, simply because the drugs are effective (the article doesn't really dispute that, just the scientific basis for how they work). I don't remember being taught this hypothesis as fact in Medschool, but I think it was suggested. Anyone else remember being taught the serotonin hypothesis? |
3 Comments:
"The Serotonin Hypothesis" sounds vaguely spooky. It would be a good title for a medical thriller. Maybe you could be the John Grisham of Doctors.
2:48 PM, November 09, 2005
I think that the 'chemical imbalance' message is just for the consumer, much in the way we call diuretics 'water pills' or aspirin a 'blood thinner'. It's just a marketing hook to help people remember and give them some vague assurances that we know what we're doing.
I don't remember being taught a 'serotonin hypothesis' per se; in fact I distinctly remember some of the profs saying "yeah, we actually have no idea how these work." The fact that the 'dirtier' drugs (i.e. those with broader receptor specificity) work as well or better than the SSRIs suggests that there's more to it. And the fact that serotonin reuptake is inhibited almost immediately while the effects of SSRI treatment take 3 weeks or more suggests that this is all a giant black box. Which is about what the profs said.
3:02 PM, November 09, 2005
Well, I feel reassured. I've had many years since my basic science days in medschool, and the DTC drug adds may have had more affect on my mind than they should have. I simply didn't recall the mechanism that they explained to us so I subconsciously substituted the drug company one.
5:33 PM, November 09, 2005
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