Over the past few months, I’ve received a lot of questions about the effectiveness of certain types of medications for the treatment of depression. Depression is a multi-layered health condition with a variety of causes and contributing factors. However, one of the key pieces has been considered to be the levels of neurotransmitters (chemicals in the brain) such as serotonin. Serotonin has been shown to have an influence on mood and is specifically associated with feelings of happiness. Because of this, specific medications (e.g. Prozac, Paxil, Zoloft, Celexa, Lexapro, etc.) have been developed called Serotonin Reuptake Inhibitors (SSRIs) that are frequently prescribed as a treatment for symptoms of depression by maintaining or increasing serotonin levels in the brain.

In July, a research paper was published in the medical journal, “Molecular Psychiatry”, titled “The Serotonin Theory of Depression: A Systematic Umbrella Review of the Evidence” which purported to put the link between low serotonin levels and depression into question. The research paper is a systematic review which looks at the results of existing research on serotonin and then draws conclusions from an overview of all of those studies. The conclusion of the review asserted that “there is no convincing evidence that depression is associated with, or caused by, lower serotonin concentrations or activity”, potentially putting into doubt the effectiveness of SSRI medication and depression. Because of this noteworthy position, this particular study was widely reported by the media and understandably, left many people confused about what this might mean for people with depression.

While the research paper itself reaches strong conclusions, I caution anyone against jumping to any specific conclusions based on this study. As well, no one should discontinue the use of any anti-depressant medication without consulting with a medical professional first. We know that depression is a very individual experience that can have multiple contributing factors (e.g. genetics, situational stressors, trauma, etc.) and that symptoms can vary from person to person. What is also clear is that there is no one-sized-fits-all approach. Some people respond very positively to medication, others may find certain medications are less effective or ineffective for them or their medication may cause undesirable side effects. Many individuals experiencing depression will also find other forms of treatment helpful (whether as an alternative to or in conjunction with prescription medications) such as psychological support (e.g. cognitive behavioural therapy, talk therapy, support groups, etc.), stress management support, physical activity, dietary modifications, and complementary therapies (e.g. naturopathic medicine, acupuncture, etc.). Everyone experiencing depression is a unique individual and will require an individualized approach that is tailored to their needs, health concerns, and goals. As a naturopathic doctor, I can perform a thorough assessment, meet you where you are, and provide support to help get you to where you wish to be, whatever that might mean for you.

– Dr. Jennifer Yee, ND.