Serotonin

The serotonin reuptake inhibiting (SSRI) group of drugs came on stream in the late 1980s, nearly two decades after first being mooted. The delay centred on finding an indication. They did not have hoped for lucrative antihypertensive or antiobesity profiles. A 1960s idea that serotonin concentrations might be lowered in depression1 had been rejected,2 and in clinical trials the SSRIs lost out to the older tricyclic antidepressants as a treatment for severe depression (melancholia).3 4 5  

While serotonin is an important brain chemical, 90% of it is made outside the brain, in the gut. Now, a study of mice suggests gut bacteria play a key role.  

The commercial success of SSRI antidepressants is based on a ‘myth’ that has been a 'costly distraction' from better treatment approaches, suggests one expert.  

Although serotonin is well known as a brain neurotransmitter, it is estimated that 90 percent of the body's serotonin is made in the digestive tract. In fact, altered levels of this peripheral serotonin has been linked to diseases such as irritable bowel syndrome, cardiovascular disease, and osteoporosis. New research shows that certain bacteria in the gut are important for the production of peripheral serotonin.  

I wrote an almost identical editorial in 1991.1 2 Covering the marketing of serotonin in 1997,3 I cited Jerome Gaub’s 1767 opinion of Leibniz’s views on the relations between mind and body—it is a “fable whose novelty has recommended it, whose recommendation has spread it, whose spread has polished it, refined and adorned it with . . . a pleasing look …  

Healy does a great disservice to jobbing psychiatrists with his editorial on serotonin and depression, the marketing of a myth.1 By portraying them as “co-opted into a myth” about low levels of serotonin being the sole cause of depression he paints them as gullible. And by stating that this theory is “an easy shorthand …  

If a pharmacologist has to name one of the finest medical marvels in the history of Neuro-pharmacology then Selective Serotonin Reuptake Inhibitors or SSRIs  

Dextromethorphan is the antitussive found in many OTC cough and cold medicines (mucinex, robitussin, nyquil, dimetapp, coricidin, delsym, theraflu, and others).  It was originally engineered as a codeine replacement.  It is structurally related to codeine but has a chemical structure similar to PCP.  In addition to therapeutic usage, recreational use is common.  

Use of the selective serotonin reuptake inhibitor paroxetine during pregnancy may increase the risk of congenital and cardiac malformations in children, new research shows.  

An easy-to-use algorithm can help predict response to treatment with a selective serotonin reuptake inhibitor.  

Serotonin-norepinephrine reuptake inhibitor exposure in the last 4 weeks of pregnancy increased postpartum hemorrhage odds in multiple analyses before and after adjustment.  

The selective serotonin reuptake inhibitor citalopram may reduce agitation in patients with Alzheimer's disease, but only at high doses, which are not recommended by the FDA.  

Adults with depression who do not respond to treatment with a selective serotonin reuptake inhibitor may have undetected ADHD and not treatment-resistant depression, new research suggests.