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The British Medical Journal provides an editorial from Professor David Healy, Head of Psychiatry at the Hergest psychiatry unit in Bangor in which it is stated:
When concerns emerged about tranquilliser dependence in the early 1980s, an attempt was made to supplant benzodiazepines with a serotonergic drug, buspirone, marketed as a non-dependence producing anxiolytic. This flopped. The lessons seemed to be that patients expected tranquillisers to have an immediate effect and doctors expected them to produce dependence. It was not possible to detoxify the tranquilliser brand.
Instead, drug companies marketed SSRIs for depression, even though they were weaker than older tricyclic antidepressants, and sold the idea that depression was the deeper illness behind the superficial manifestations of anxiety. The approach was an astonishing success, central to which was the notion that SSRIs restored serotonin levels to normal, a notion that later transmuted into the idea that they remedied a chemical imbalance. The tricyclics did not have a comparable narrative.
Serotonin myth
In the 1990s, no academic could sell a message about lowered serotonin. There was no correlation between serotonin reuptake inhibiting potency and antidepressant efficacy. No one knew if SSRIs raised or lowered serotonin levels; they still don’t know. There was no evidence that treatment corrected anything.
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This lack of evidence-based practice was apparent to Thomas Insel, Director of the US National Institute Of Mental Health who announced in 2013 that the institute would abandon funding towards the DSM:
While DSM has been described as a "Bible" for the field, it is, at best, a dictionary, creating a set of labels and defining each. The strength of each of the editions of DSM has been "reliability" - each edition has ensured that clinicians use the same terms in the same ways. The weakness is its lack of validity. Unlike our definitions of ischemic heart disease, lymphoma, or AIDS, the DSM diagnoses are based on a consensus about clusters of clinical symptoms, not any objective laboratory measure.
In the rest of medicine, this would be equivalent to creating diagnostic systems based on the nature of chest pain or the quality of fever. Indeed, symptom-based diagnosis, once common in other areas of medicine, has been largely replaced in the past half century as we have understood that symptoms alone rarely indicate the best choice of treatment.
Does this mean that psychiatry is finally moving away from a practice akin to leeches for everything?
(Score: 1, Interesting) by Anonymous Coward on Friday April 24 2015, @04:11AM
I suspect, though I don't have hard evidence, that many cases of depression and other health and mental related issues, are at least partially related to helminthiasis. Doctors seem to be very bad at detecting them and even when they do prescribe treatments they usually underprescribe which temporarily reduces the symptoms and causes the problem to return with immunity requiring the doctors to prescribe much more of a stronger medication to eliminate the problem.
(Score: 0) by Anonymous Coward on Friday April 24 2015, @04:13AM
Dang it, I meant the topic to be suspicion but my stupid phone changed it somehow.
(Score: 2) by Sir Finkus on Friday April 24 2015, @07:41AM
Blame the worms. Anyway, assuming you're the same AC as the parent comment, do you have some more information on this? I've read some other studies about a possible link between depression and gut flora and this sounds similar.
Join our Folding@Home team! [stanford.edu]
(Score: 2) by tibman on Friday April 24 2015, @01:45PM
1/3 of the cells in your body must count for something more than waste processing. (imo, of course)
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(Score: 0) by Anonymous Coward on Saturday April 25 2015, @02:00AM
Scroll to the section entitled cognitive abilities
http://en.m.wikipedia.org/wiki/Helminthiasis [wikipedia.org]
(Score: 2) by sjames on Saturday April 25 2015, @04:37AM
I had no idea Pink Floyd meant that literally! :-)