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Opinions On Pharmacological Depression Treatment

By: Marcus Maybourne

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A diagnosis of major depressive disorder is one of the most common modern psychiatric diagnoses. The diagnosis is most commonly made my primary care physicians, and these are also the doctors who most typically provide treatment for depression. The usual treatment that patients receive for their depression symptoms are pharmacological ones.

Antidepressant medications are relatively well-established as psychiatric treatments. They are, however, also poorly understood and still remain controversial. For example, a recent meta-analysis of published and unpublished studies found that psychiatric depression treatments were no more effective than placebo, overall. This has been a major challenge to the longstanding acceptance of antidepressant medications as a respected and effective treatment, because the published literature had shown significant results from their use.

This effect is known as publication bias. It simply means that studies which show positive results are more likely to be selected for publication. It is usually more interesting to find that something works than to find that someting doesn't work, so many papers showing poor results have simply not been printed in the peer reviewed journals that doctors and scientists rely on for scientific information. Even after the publication of the meta-analysis showing that overall the drugs have no significant clinical results, they are so entrenched in psychiatric culture that most doctors still use them unflinchingly when a patient presents with depression symptoms.

Antidepressant drugs work by increasing the availability of specific neurotransmitters in your body and brain. The earliest (and still most popular) antidepressants target serotonin, a neurotransmitter that seems to be related to mood, sleep patterns, appetite, and energy levels. The problem with targetting serotonin is that nobody really knows for sure what this brain chemical does. It's presence or absence are related to all the factors that I have listed, but do they cause those factors? No one can say for sure, but the research suggests it is much more complicated than that.

Even the use of traditional antidepressants has indicated a fundamental misunderstanding of the way that neurotransmitters affect mood and mental health. If low levels of serotonin caused depression, then increasing serotonin levels would rapidly alleviate depression. This is not the case. Prozac, for example, will elevate serotonin availability within just a few hours, but no changes are typically seen in depression symptoms for several weeks.

It is hypothesized that this time delay is caused by an internal variability within the neurons which release serotonin. You see, each neuron can send a number of chemical signals to its neighbors, and the mechanisms for this are only partially understood. When a neuron has utilized a particular neurotransmitter for an extended period of time, it may begin to release a secondary signal. This signal and the chemicals which comprise it can vary widely by neuron, so it is more difficult to study than primary serotonin signaling networks. But these secondary signals are thought to account for the effectiveness of serotonergic depression medications.

Newer antidepressants target different neurotransmitters and often multiple neurotransmitters, but the basic problem of these drugs remains the same: we don't really know how they work. And that is because, at the most basic level, we do not yet know the true causes of depression.

Article Source: http://depositarticles.com/

Marcus Maybourne is a psychotherapist with a tremendous personal interest in making sure patients have access to safe, effective treatment of depression, and that they understand their mental health options.

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