“There are no objective tests in psychiatry – no X-ray, laboratory, or exam finding that says definitively that someone does or does not have a mental disorder.” “It’s bull—. I mean, you just can’t define it.” — Allen Frances, Psychiatrist and former DSM-IV Task Force Chairman [DSM = Diagnostic and Statistical Manual of Mental Disorders]
“Virtually anyone at any given time can meet the criteria for bipolar disorder or ADHD. Anyone. And the problem is everyone diagnosed with even one of these illnesses triggers the pill dispenser.” — Dr. Stefan Kruszewski, Psychiatrist
For decades it has been stated by a few. For the same stretch of time, it has been ignored by many. As of recent (2022), it has been confirmed by independent science: there is no such thing as a chemical imbalance in the brain. In a systematic review of existing evidence published in Molecular Psychiatry, Joanna Moncrieff, Professor of Critical and Social Psychiatry at University College London and a leading figure in the Critical Psychiatry Network, concluded that there is “no consistent evidence of there being an association between serotonin and depression, and no support for the hypothesis that depression is caused by lowered serotonin activity or concentrations.”
Serotonin and Marketing
Since the late 80s, the marketing of pharmaceutical companies has been centered around the serotonin hypothesis of depression. Serotonin is a neurotransmitter, a substance that transmits nerve impulses from one nerve to another. The hypothesis claimed that depression was associated with lowered serotonin concentration. Low serotonin levels would cause a chemical imbalance in the brain. Medication, the so-called selective serotonin reuptake inhibitors (SSRIs), would be able to handle that imbalance. And that would have a positive effect on depression. The story sounded great and was presented with scientific-looking studies. Many a psychiatrist and general practitioner fell for it, and SSRIs became an overnight best seller. To this day, they are even the most commonly prescribed antidepressants.
Professor Moncrieff’s team has demonstrated that the marketing story was on par with Hans Christian Andersen’s swindlers who weaved invisible but ‘magnificent’ clothes for the emperor. No one, not even the emperor himself, wanted to appear inept or stupid by saying there were no clothes; those who did venture to say something were ridiculed.
Why Did Doctors Believe the Chemical Imbalance Theory?
People in marketing departments of the pharmaceutical industry are smart. They can convince doctors to prescribe their paymaster’s products with evidence-based data. This is done with clinical trials, scientific studies that help determine if and how a medicine works in people. Such studies can, however, be manipulated. As early as 2008, John Ioannidis, the most cited physician-scientist, writer and Stanford University professor who has made contributions to evidence-based medicine, epidemiology, and clinical research, signaled the use of “many small randomized trials with clinically non-relevant outcomes, improper interpretation of statistical significance, manipulated study design, biased selection of study populations, short follow-up, and selective and distorted reporting of results” leading up to “a seemingly evidence-based myth on antidepressant effectiveness.”
SSRIs, Aggression and Suicide
Apart from their underlying theory being faulty and now debunked, SSRIs are not harmless drugs to take. Particularly in children and adolescents, Danish researchers reported a doubling of the risk of suicidality and aggression. They found “limitations in the study design and discrepancies in reporting, which may have led to serious under-reporting of harms.” Other researchers have performed a reanalysis of a drug trial (SmithKline Beecham’s Study 329). Whereas the ads of this drug manufacturer (now GlaxoSmithKline) purported that its SSRI paroxetine (Seroxat, Paxil) in combination with imipramine (an antidepressant sold under the brand name Tofranil) was safe and effective for use by adolescents, the reanalysis of the study’s raw data found that “neither paroxetine nor high-dose imipramine showed efficacy for major depression in adolescents, and there was an increase in harms with both drugs.”
In the below video clip, Peter Gøtzsche, Danish physician, medical researcher, and former leader of the Nordic Cochrane Center at Rigshospitalet in Copenhagen, was quite clear about the risks of antidepressants.
SSRIs in Ireland
SSRIs are the most frequently prescribed antidepressants in Ireland. The first of its kind was fluoxetine, which was sold under the brand name Prozac. Other SSRIs in Ireland include citalopram (Cipramil), paroxetine (Seroxat) and sertraline (Lustral). Over time, the use of antidepressants has dramatically increased. In 2018, the Irish Times estimated that between 10 and 12 percent of all Irish adults were being prescribed antidepressants. In 2019, RTÉ found worse figures that doubled this estimate. No less than 221 out of 1000 people on the publicly funded drug schemes (the General Medical Services, the Drugs Payment Scheme, and the Long-Term Illness Scheme) were using antidepressants in 2017. Longford/Westmeath had the worst figures with a yearly average rate of 265 people (per 1,000) prescribed antidepressants on the public drug schemes, from 2012-17. Although these numbers are for all antidepressants, the majority of them will be SSRIs.
These numbers show that the chemical imbalance theory has had an impact in Ireland as well and that too few doctors have been calling out that the emperor is wearing nothing at all.
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