In brief

• Professor of psychiatry Joanna Moncrieff challenges the popular explanation of depression as caused by a serotonin deficiency.
• According to her 2022 analysis, there is a lack of convincing evidence for such a mechanism.
• The researcher believes treatment should take into account factors that have so far been treated as secondary.

A moment of revelation

British professor of psychiatry Joanna Moncrieff, who has been conducting research on psychiatric drugs for more than two decades, describes her findings as a moment of revelation. According to her account, antidepressants may help patients, but not in the way that was presented for years in textbooks and clinics. ("To był moment olśnienia". Od 30 lat pomaga chorym na depresję. Obala popularny mit. "Działanie znieczulające" – Onet)

Evidence concerning serotonin

In 2022, Moncrieff and her research team published an analysis according to which there is no reliable evidence linking depression to disturbances in serotonin levels. The claim of a so-called serotonin deficiency was one of the most frequently repeated explanations of how antidepressants work.

Consequences for treatment

If serotonin is not the cause of the illness, many of the existing assumptions about why drugs improve mood require re-examination. Some specialists believe that the explanation based on biochemical action was too simplistic. Moncrieff points out that its popularity stemmed more from marketing than from scientific evidence.

A new view of pharmacotherapy

The researcher herself emphasizes that the point is to revise the way pharmacotherapy is explained to patients. In her view, the key to treating depression lies in factors that have so far been treated as secondary, rather than in brain chemistry itself. The details of these factors are not elaborated in the material.

Clinical experience

Moncrieff works in a clinic within the British public NHS system that helps people discontinue antidepressants. According to her, experience with patients who want to end therapy shows that the issue requires a more cautious approach.