A major international study has found no clear evidence that low serotonin levels are responsible for depression.
Researchers are now questioning New Zealand’s reliance on serotonin-targeting anti-depressants, with prescriptions for the medication rising dramatically in recent decades while other forms of mental health services became ever more sparse.
For many doctors, antidepressants are the primary tool for treating depressive disorders, with most forms of the medication targeting serotonin, often dubbed the ‘happiness’ neurotransmitter.
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But new research, looking at multiple studies across tens of thousands of people has as yet found no evidence linking depression and low serotonin.
Clinical psychologist Dougal Sutherland says the results don’t come as a complete shock.
“In some ways, it was a surprise like, 'man there's no evidence at all', and in other ways, it was kind of confirming what we knew already.
"People with depression, lots have happened in their lives and to try and simplify it to a chemical imbalance in the brain seems an oversimplification.
"You're taking antidepressants now and they're working for you I'd say keep taking them... but the problem with that is we know that antidepressants only work for some."
General practitioner Dr Bruce Arroll says these medications aren’t always effective and are often used as the first line of treatment by doctors, instead of the last resort.
"Antidepressants really only work in the severe end of the spectrum… about 12% to 13% of New Zealanders are on antidepressants, but only 2% to 3% are getting a chemical benefit.
"Traditionally antidepressants have been used a lot... I think for some prescribers it can be seen as an easy solution and it gets the patient out of the door quickly.
"They should not be given it in the first visit, basically you should be giving people exercising, contacting friends and doing something pleasurable."
"If that doesn't work after 2 or 3 weeks then you might want to talk about medication."
The dispensing of antidepressants in New Zealand is on the rise, Ministry of Health data shows prescriptions are up 20% in 2020 compared to 2010.
Arroll says the new research doesn't mean ditching the pills, rather the health system should make a range of alternative treatments such as talk therapy available.
"This is a longer-term thing about where do we redirect resources and how do we actually help... and it may not be about pushing more money into medication.”
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