Dr Joanna Moncrieff
@joannamoncrieff
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Critical psychiatrist, author and researcher
UK
Joined October 2013
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Our new review is the first to systematic overview of all the main areas of research and concludes there is no evidence of a link between low serotonin and depression THREAD
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This was probably the most important slide I showed in my talk at RCPsych congress yesterday
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Matthew Perry is a victim of an industry that exploits desperation. There is no evidence ketamine benefits mental health beyond placebo effects and the drug-induced high. It is a potentially dangerous anaesthetic. An avoidable tragedy!
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'If a plant were wilting we wouldn’t diagnose it with “wilting-plant-syndrome” – we would change its conditions. Yet when humans are suffering under unliveable conditions, we’re told something is wrong with us, and expected to keep pushing through'
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Proud to have been awarded a prize by the Journal of Contemporary Psychotherapy for the serotonin umbrella review for helping to 'refute many outdated but commonly held beliefs about the biochemical basis of depression'
@markhoro
@HengartnerMP
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Royal College of Psychiatrists discusses the 'antidepressant wars' with only one side in the room (again). What's wrong with letting psychiatrists hear the other side and make up their own minds?
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Surely 3 decades of no progress should prompt us to reject the reductionist paradigm that seeks to locate mental health problems in the brain instead of in the world
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This article perpetuates the myth of a connection between serotonin and depression which is highly misleading and prevents people from appreciating that antidepressants do not rectify anything but change normal brain chemistry with unforeseen consequences
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I will be a Professor at last! Strange after years in the wilderness, but the battle to get the truth out there goes on!
Delighted to announce that no fewer than four
@UCLPsychiatry
academics have been promoted to full professor this year!
We are very proud of Prof Liz Sampson
@DrLizSampson
, Prof Joanna Moncrieff
@joannamoncrieff
, Prof Andrew McQuillin
@mcquillin9
and Prof Zuzana Walker!
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‘First they ignore you. Then they ridicule you. And then they attack you …’*
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The serotonin theory of depression: 'a multibillion dollar error'
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I am just going to receive a prize from the
@rcpsych
publishing for the most downloaded paper in the Psychiatric Bulletin called 'Why antidepressants are not antidepressants'. Good to know psychiatrists are thinking about this.
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Doctors and the public still don't know about this devastating effect of SSRIs and they need to
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Childhood trauma makes us vulnerable - you don't need fancy theories about epigenetics or frightening proposals about meddling with genes or brains - just social measures to make life easier for families
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Study finds increased risk of suicidal behaviour in younger people starting antidepressants. No effect either way in older people. Consistent with RCTs. There is no evidence that antidepressants prevent suicide.
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Absolutely brilliant and very funny video about our serotonin study by
@rustyrockets
showing how the chemical imbalance myth was all about profit. What other Pharma products are we being misled about he asks?
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Leading biological psychiatrist, E. Fuller Torrey concludes schizophrenia 'does not appear to be a genetic disorder' and genetic research has been a waste of resources
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People need to be properly informed about the effects of antidepressants. These include emotional blunting and sexual dysfunction
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The public have been misled by Pharma and sections of the medical profession into believing depression has an established biological cause. Our serotonin paper exposed this, but Jauhar & co want the situation to continue.
@Mad_In_America
@markhoro
@HengartnerMP
@PloederlM
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Call to reduce antidepressant prescribing. 20% of people in England are prescribed them, and 50% take them long-term, resulting in huge exposure to unnecessary harm
#beyondpills
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The ongoing rise in antidepressant use is not a welcome sign that people are willing to seek help, but a sign that we are trying to paper over social problems with medical solutions
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'It is much easier to reduce depression to a biochemical phenomenon in the brain than to analyze how the social relations prevalent in the capitalist mode of life create the conditions for [its] emergence'
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Thanks to
@NewStatesman
and
@SEMcBain
for enabling me to make some complex points on the 'bigger and more controversial point about how antidepressants do, and don’t, work' that some psychiatrists don't want people to hear
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High antidepressant use 'clear example of over-medicalisation, where patients are often prescribed unnecessary and potentially harmful drugs instead of tackling the root causes of their suffering, such as loneliness, poverty or poor housing.'
#beyondpills
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My article explaining how the chemical imbalance myth supports professional interests and drug company profits, and what they don't want you to know about antidepressants
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How to take the news that depression has not been shown to be caused by a chemical imbalance
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A piece about why more and more treatment of mental health problems (by medication or therapy) only seems to be making things worse
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My 2014 paper on bipolar disorder: 'The expansion of bipolar disorder, like depression before it, medicalises personal and social difficulties, and profoundly affects the way people in Western nations conceive of what it means to be human'
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Here is the clip of my interview on This Morning on our study showing no evidence of a serotonin abnormality in depression
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I hope doctors will watch this video about this devastating complication of SSRIs and some other antidepressants.
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It is incredible that the medicalisation of loneliness can be discussed so uncritically - I wonder what Pharma money might be stoking this in the background
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On the serotonin theory: 'in order to change people's natural inclination to understand moods as a response to what happens to us, it was necessary to .. give the impression that the science was settled'. It wasn't, as we revealed
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Psychiatric diagnoses 'do not cause anything.. They are agreed-upon labels - a kind of shorthand' that often fails to capture the essence of the problem t
https://www.psychologytoday.com/us/blog/psychologically-minded/201907/a-psychiatric-diagnosis-is-not-a-disease
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The prolonged suffering some people experience following antidepressant withdrawal will now be recognised, even if belated. Now we need PSSD to be given a code
SNOMED has today added code 1285639002 'Protracted antidepressant withdrawal syndrome (disorder)' to its system. GP practices I believe need to activate this code locally to use it. It also means that precisely 0 cases of protracted withdrawal have so far been recorded by NHS.
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@SteveBakerHW
Thanks for highlighting this. As a doctor I am very concerned about the impact - many colleagues share my concerns and we have outlined the case against the mandate in the BMJ today
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'Brain changes in response to antidepressants can persist for years.'
@markhoro
in
@TheConversation
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'Psychiatry will not find it easy to abandon its biomedical framework but it needs to do so in the interests of patients.'
Relational psychiatry: Psychiatry needs to abandon its biomedical framework
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Worrying when the media decides what science people should hear about and what they shouldn't.
Disturbingly, Australia’s national broadcaster, ABC cut key scenes from the BBC Panorama Documentary. Namely
@joannamoncrieff
debunking of the chemical imbalance myth
@markhoro
@JDaviesPhD
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Rose Cartwright was told 'the root cause of mental illnesses are biological abnormalities in the brain' but realised this was not true and not helpful
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While SSRIs 'might seem a sensible approach to a condition caused by a serotonin deficiency, we might reasonably be concerned about the effects of modifying the complex, poorly understood serotonin system in the absence of clear evidence of a specific underlying abnormality'
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Panorama tonight covers some harmful effects of antidepressants and debates about their efficacy and mechanism of action
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Guardian piece on our new study of serotonin research
@markhoro
@HengartnerMP
@ReadReadj
@ClinpsychLucy
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Today sees the launch of the UK's All Party Parliamentary Group, Beyond Pills, aiming to reduce epidemic prescribing of antidepressants. Now the job of counteracting years of drug company propaganda and medical collusion
#beyondpills
#informedconsent
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Long-term use of antidepressants is not harmless and many people continue taking them because withdrawal sympotms are esaily confused with relapse. Good piece on importance of withdrawal and how to manage it
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A few years ago pregabalin was the next new wonder drug that relieved anxiety and pain without causing dependence. It soon became apparent this was not true. How did the medical profession fall for this again?
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Antidepressants use associated with increased risk of type 2 diabetes, with a dose effect: risk 4x higher in those with highest dose, long-term exposure
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Well done and thank you to
@markhoro
for producing these Guidelines. They will be invaluable for people trying to come off these prescribed drugs and for those trying to help them
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PHQ-9 (common questionnaire used by GPs) over-estimates (doubles) the rate of depression compared with a proper clinical interview
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So many things wrong with this - but mainly that it encourages even more people to start and stay on antidepressants, and promotes the mythical idea that they 'only stop the bad feelings'
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Good to see this issue covered- 'Legacy effects' of drugs like benzodiazepines and also antidepressants (eg persistent sexual dysfunction & prolonged withdrawal) need to be better recognised
@DrDavidHealy
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Really worrying that antidepressants are being prescribed following very brief telephone consultations to people whose lives and moods have understandably been affected by the pandemic
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Our BMJ letter highlights how people harmed by antidepressants and other prescribed drugs have no support from health services
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its really important people realise this is not a direct measure of brain serotonin, but an indirect measure that is 'conceptualised' as a measure of serotonin release
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the fact that antidepressants can produce severe and protracted withdrawal indicates they are changing the brain in unpredictable and potentially harmful ways, and we should be much more wary of starting them
"A gradual dose reduction at an individualised pace is likely to minimise the risk of withdrawal symptoms for those who are stopping
#antidepressants
."
@markhoro
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The Radar study results are just published. It was disappointing in some ways, but important to have done it and people now have evidence on the 2-year outcomes of the gradual reduction of antipsychotics to inform treatment decisions 1/7
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Psychiatric diagnosis 'shapes the people it describes. It models social identities. It offers scripts for how to behave and explanations for one’s interior life.' Excellent essay/book review from
@NewYorker
.
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This important paper exposes the commonly promoted misunderstanding that makes depression sound like a brain condition (an explanation) when it is, in fact, only a description of the individual's situation
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I am looking forward to giving the UCL lunchtime lecture this Thursday 18th May (1pm UK time) on our serotonin research and its implications for antidepressants. You can sign up here for free:
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Mental disorder needs to be understood at the level of the person - not the brain (nor some abstract idea of 'mind'). This is why mainstream psychiatry is Luddite and cannot move forward
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A worrying suggestion: who will ensure that people are properly informed about the risks of dependence and severe and prolonged withdrawal and persistent sexual dysfunction
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Umbrella review finds little evidence that antidepressants are effective in the elderly, while adverse effects are common
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Shame the press coverage is not highlighting the limitations of this review, esp. that most studies short-term and done by drug companies with every incentive to minimise withdrawal
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Our survey of people in online support groups shows antidepressant withdrawal can be severe and protracted and that longer use predicts worse withdrawal effects
@markhoro
@ReadReadj
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Thoughtful piece from about how taking antidepressants can have profound and worrying effects on one's sense of oneself
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My reflections on what I have learnt from the RADAR trial, including on the various reasons why it is so difficult to stop medications that people have taken for a long time
@Mad_In_America
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'we need a radical overhaul of the way poor mental health is managed in the UK: a move away from its over-reliance on the biomedical model and psychiatric drugs'
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Another brave testimony about PSSD and 'the brutal effect that antidepressants can have on someone’s mental health when they nullify your emotional and sensual self'
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The study cited is no basis for judging the dependence potential of antidepressants. It is based on poor quality, short-term, mostly drug-company funded studies, most of which made no systematic effort to detect withdrawal. See our critique in
@markhoro
My new article in the
@guardian
is out: The myth that
#antidepressants
are addictive has been debunked – they are a vital tool in psychiatry
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From them: antidepressants work, chemicals 'determine' behaviour and depression may be related to a chemical called TrkB. From me: 'We are medicalising the consequences of social and economic policies'
There's a feisty dispute over antidepressants between researchers who see depression primarily as having biochemical causes and those who see it as a consequence of a broken society.
Thanks to
@HashemiLab
@joannamoncrieff
and
@castren_eero
!
Read more at:
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Our meta-analysis shows there is no evidence for the longstanding idea that lithium prevents suicide. Another myth that should be put to bed
@PloederlM
@JackiStansfeld
@woodylisa
@UCLPsychiatry
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Its really important that the press are covering this tragic side effect of antidepressants, especially as many doctors still not aware of it
We became 'asexual' after taking antidepressants for just a few WEEKS - now our genitals have shrunk and we're worried we'll never have sex again
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So many inaccuracies in this piece. There is no evidence that antidepressants 'normalise' mood ranges, and there is evidence they numb emotions. Also many people do get stuck on them for a long time
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Our response to letters on our serotonin review 'It seems the situation is the same as when David Healy described the monoamine hypothesis of depression as a failed Kuhnian paradigm. No one believes it, but no one wants to let it go either.'
@DrDavidHealy
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The official pictures from this year's BAP conference demonstrate the money and prestige that flow in from Big Pharma and the continuing corruption of psychiatry
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Fascinating project project that enables people "to ‘study’ their own problems, and to investigate patterns and solutions in the writing and testimonies" of others
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This research is important because many people take antidepressants because they have been told they have a chemical imbalance. It may be difficult news, but people deserve to know there is no evidence to support this idea
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An interesting account challenging what has become 'embedded folk knowledge'. The serotonin myth needs to be challenged more widely and publicly to prevent people internalising 'this idea that you are permanently defective or broken'
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Really interesting review of the implications of our serotonin paper including how the chemical imbalance myth has shaped how people think about themselves
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Good article for highlighting creeping medicalisation of ordinary life experiences, but the idea that 'true' depression or other mental disorders are something different has not been demonstrated and is not helpful
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How profit and professional interests have misled us about antidepressants
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Jauhar and co make a number of inaccurate and inconsequential criticisms of our serotonin review. Our published response to most of these point is here: and summarised in this thread, including responses to further criticisms 1/28
#brokenumbrella
Responding to
@joannamoncrieff
There are lots of mistakes. Will restrict to most heinous if that is ok. More on request.
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Harrowing account of PSSD 'Having your sexual function and range of emotions stripped from you leads to a lot of grief.... PSSD feels like pharmaceutical rape.'
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Article in
@BusinessInsider
quotes
@markhoro
: we 'have needs for community and purpose and safety. I think unless those things are being provided, there's no drug that can solve that problem'
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Our open letter to
@thismorning
to protest about inaccurate and misleading coverage of antidepressants. Thanks to
@psychgeist52
and others for putting it together
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We must call a spade a spade- article on how pharmaceutical industry promoted the term 'discontinuation syndrome' to avoid admitting antidepressants are dependence forming and cause withdrawal
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Study finds benzodiazepine long-term use and withdrawal associated with 'low energy, distractedness, memory loss, nervousness, anxiety, and other symptoms' and symptoms can persist for a year or more after withdrawal
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The recent review of drug-company funded, short-term studies that mostly weren't looking for withdrawal confirms how little attention we have paid to this 'major public health issue'. Our critique in
@TheConversation
@markhoro
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Stop talking of 'mental health problems' as if they are things (nouns). Instead use adjectives and verbs to describe how people are feeling and what they are doing. Its start, anyway.
Thinking about the language that is privileged in mental health training for mh professionals. Isn't it time to rethink the pseudo objective way of writing notes. Any ideas on how we can move this forward
@AnneCooke14
@peterkinderman
@joannamoncrieff
@RobFreudenthal
@FrontlineSW
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Many drugs make you happy or high temporarily - this is not the same thing as helping with depression, but may look the same in trials
In a quest to find ways to relieve treatment-resistant
#depression
, scientists turn to nitrous oxide. However, it's safety over long term use is unknown.
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We also found evidence from some studies that suggested long-term antidepressant use may even lower serotonin levels/activity. This underlines how we do not know what antidepressants are doing to the brain, esp in long-term, and should be more wary of prescribing them
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New review of antidepressant withdrawal is based on mostly short-term industry-funded studies that were not set up to study withdrawal. Results have little value, but are being spun to reassure everyone (again) to keep taking the drugs.
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'Antidepressants should not be used for adults with major depressive disorder before valid evidence has shown that the potential beneficial effects outweigh the harmful effects.' Shocking that this was not established before they were introduced
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"despite billions of dollars in research funding, and thousands of journal articles, biological psychiatry has given doctors and patients little of practical value never mind a cause or a cure"
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In utero exposure to SSRIs disrupted facial bone and cartilage development in mouse pups which 'could disrupt growth'
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Hopefully these guidelines will help reduce the ever rising levels of antidepressant prescribing and associated adverse effects
The updated WHO treatment guidelines for mental disorders (MHGap) is out. I‘m proud to be a member of the guideline development group and an expert advisor for the depression chapter. Find the guidelines here
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Our response to Ghaemi's critique of our lithium review and what it tells us about the desperation of some psychiatrists to shut down debate
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Shocking - what is the point of the PSC if not to address things like PSSD? Is this how they respond to all concerns except for reports about valproate and mesh issues?
Finally I received a response from
@PSCommissioner
regarding
#PSSD
. Sadly they don't think patients being irreversibly chemically castrated and lobotomised is a priority. If their problem truly is that they are under-resourced, here is my offer to work for them for free and help
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'We must stop seeing mental health services as a panacea for society’s difficulties'
@DBDouble
on how expanding mental health services will not address the growing demand
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Misleading information about antidepressants remains rife, especially minimisation of withdrawal effects. Here is a response to some of it with
@markhoro
and
@WallisKatharine
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Study shows prevalence of dementia among people with schizophrenia is a staggering 28% at age 66 vs 1.3% in 'controls'. Antipsychotics and other medications suggested as possible cause
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