Summary: Researchers have criticized recent findings on serotonin’s role in depression, saying people should continue their current therapies to help control depression symptoms.
A source: University of Michigan
More than 1 in 10 Americans currently take antidepressants — a number that has increased during the pandemic.
But how do those drugs work – and why don’t they work for everyone? And why do people get depressed?
Experts still do not know all the answers to these questions. After all, the brain is a complicated place. But they know that depression has its roots in everything from the genes we were born with, to events in our early years, to events happening in our lives now.
Meanwhile, they know that many people with depression can benefit from antidepressant medications and talk therapy, better sleep, exercise, more social interaction, and, in severe cases, treatments like ketamine and ECT.
The important thing is that people with symptoms of depression should seek help and try until they find something that works for them.
That’s why Dr. Sreejan Sen, Ph.D., director of the nation’s first depression center, is concerned about the implications of a new study on serotonin’s role in depression that’s getting a lot of attention.
He worries that overly simplistic news and social media messages may make some people question whether they should continue taking antidepressants that target the brain’s serotonin system.
Such drugs, called SSRIs, aren’t perfect, he says. But there is plenty of evidence that they work for many people.
Basic recommendations for people with depression
For more than 20 years, Sen has directed the Eisenberg Family Depression Center, which has brought together researchers at the University of Michigan. His personal research has been investigating the roots of depression for over two decades. He is a depression scientist and psychiatrist who has treated many people for depression.
“Do we need to understand exactly how a drug or non-drug treatment works to use it? “No, if that were true, we wouldn’t have treatments for depression like drugs like SSRIs, psychotherapy like cognitive therapy, or lifestyle changes like consistent sleep patterns,” he says.
“The biology of the brain and how the brain changes when we are depressed is incredibly complex and our current understanding is limited.”
There is no doubt that basic science, including research on serotonin and genetic variation among people with depression, is critical to our future search for better treatments and personalized treatments. EFDC members from many areas of UM are helping to conduct this search.
However, Sen says, “Information from clinical trials should guide care for people currently struggling with depression. And clinical studies have shown that SSRIs are moderately effective and can play an important role in the treatment of depression in combination with other medications and psychotherapy.”
In other words, “If a treatment or combination of treatments that your health care provider prescribes or recommends is working for you, that’s great—stick with it. Your personal experience with the treatment is more relevant than this study. If you’re dealing with depression Talk to your doctor if you’re using medication or other therapy and your depression symptoms aren’t getting better.”
State of Serotonin Science
Sen points out that mental health experts certainly don’t believe that a simple “chemical imbalance” is the root cause of depression.
Serotonin is one of the main brain chemicals called neurotransmitters, which help brain cells “talk” to each other by attaching to receptors on the outer surfaces of the cells.
A new, high-profile study looks at a lot of older research on serotonin and tries to pull it together to draw conclusions.
The study did not conduct new experiments or even combine previous studies in a meta-analysis. But instead, the researchers conducted an “umbrella review” of some, but not all, serotonin-related meta-analyses.
Coincidentally, another “study” on serotonin and depression was published a week before it was in the news. He concluded that variations in the serotonin transporter gene, along with stressful life events, play a key role in the risk of depression. But this research has received little attention.
In other words, Sen, the science of serotonin’s exact role is not settled.
Sen and his colleagues hope the new research will accelerate progress in treating depression by using modern tools that allow scientists to look at far more data from far more patients than those older studies.
“In the brain, we have much better tools to look directly at how neurotransmitters work and how neural circuits change than we did 20 to 30 years ago, when a lot of the original research was done under the umbrella,” he notes. . “Furthermore, computationally, we can now integrate information from many levels of research and many patients in ways that were not possible before.”
Sen and his colleagues are working to determine, for example, how different combinations of genetic differences, life events, and current lifestyles, combined with sleep patterns, affect depression or response to treatment.
By studying people who live with intense stress and varied schedules—for example, the thousands of new doctors in the Intern Health Study you lead—they’re learning more about how these factors interact.
Meanwhile, researchers at UM and beyond are studying psychedelic drugs like ketamine, esketamine, ECT, talk therapy and even the mushroom-derived psilocybin to see what effects they have and who is most responsive to them. They are looking for people with depression, anxiety and other conditions to participate in carefully controlled studies.
“Basic science is critical to identifying new targets and understanding what’s going on in the brain when we’re depressed or anxious, and could ultimately lead to the development of new treatments that work better and better for more patients,” says Sen. “But we don’t need to know the exact molecular mechanisms to rely on clinical trial data showing positive effects of interventions like better sleep, cognitive behavioral therapy, or SSRIs.”
The future of depression treatment, like cancer treatment, may be more personalized to the individual patient.
“We need new drugs that work better, and we need to understand how to give the right treatment to the right patient at the right time,” Sen said. “We all have different weaknesses and sensitivities.”
This is about depression research news
Author: Look Gavin
A source: University of Michigan
The connection: Kara Gavin – University of Michigan
Photo: Image is in the public domain