Posted by Larry Hoover on January 27, 2009, at 10:18:45
In reply to Review Article Trashing Serotonin Hypothesis + Adv, posted by psychobot5000 on January 25, 2009, at 21:37:18
I finally had time to read the paper, and if I was grading it, I'd give it at most a B-.
The big problem is the recurrent conflation between two separate concepts, serotonin deficiency and chemical imbalance. They're not interchangeable concepts, and yet they treat them as if they are. In some cases, they appear in sequential sentences. By the time you're finished reading the paper, this deliberate blurring of meaning allows for conclusions not supported by the evidence provided.
Now, I'm not supporting the pharmaceutical advertisements literally, but given that mental illness remains heavily stigmatized, and that only 30% of depressed individuals obtain treatment for it, I think that anything that gets people to see their doctors is a good thing. A doctor prescribes not because a patient claims chemical imbalance, but because an examination and medical history yields a clinical diagnosis that may benefit from treatment.
The selective use of evidence also struck me. For example, reference 46 is supplied to show that patients are reporting that they have a chemical imbalance, when the article actually discusses the evolution of conceptual modelling about pharmaceutical treatment of depression. To quote therefrom:
"What these drugs do is affect receptors. Instead of being concerned about the effect of norepinephrine and serotonin, we really need to redefine our concept of psychopharmacology as receptor drugs. Saying, for example, that selective serotonin reuptake inhibitors (SSRIs) treat depression by increasing serotonin is like saying that a boat sinking on the ocean needs to have reduced water levels. The water is there and all around. To fix the boat you need to plug the holes. That will be a great deal more effective than worrying about decreasing the overall amount of water in the system.... Once we begin to conceive of drugs as affecting receptors, things generally seem to make more sense."Lar
poster:Larry Hoover
thread:876214
URL: http://www.dr-bob.org/babble/20090104/msgs/876528.html