Serotonergic antidepressants: where are we at in 2023? The link between serotonin and depression

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In 2023, the understanding of serotonergic antidepressants and their connection to depression stands at a crossroads. Serotonin, often dubbed the "happy substance," functions as a crucial neurotransmitter in regulating various bodily functions, including mood. The historical linkage between serotonin and depression emerged from observations in the 1950s, leading to the monoamine hypothesis of depression. Despite being theorized well after the introduction of antidepressant medications, the serotonin theory gained traction as these drugs, such as iproniazid and imipramine, were found to increase serotonin levels in the brain. The advent of selective serotonin reuptake inhibitors (SSRIs) in the 1980s further solidified this connection.

However, recent developments have cast doubt on the serotonin theory. A comprehensive umbrella systematic review in 2022 questioned its validity, challenging long-held beliefs. Yet, a groundbreaking study in the same year provided direct evidence of reduced brain serotonin release in individuals with depression, reigniting the debate. Amidst this controversy, healthcare professionals, particularly nurses, face challenges in managing patients with mood disorders who rely on serotonin-boosting medications.

Despite the uncertainty, antidepressant medications demonstrate efficacy, albeit not universally. Randomised controlled trials support their effectiveness over placebo, although response rates vary. Clinical guidelines recommend their use in moderate to severe depression, emphasising the importance of psychosocial support alongside pharmacotherapy. Psychological interventions, ranging from simple techniques to formal therapies, play a crucial role in treatment. Shared decision-making between healthcare providers and patients is advocated to navigate treatment options effectively.

Furthermore, the risk of suicide underscores the importance of ongoing education and support for patients and their caregivers. Considering the recurrent nature of mood disorders, treatment cessation warrants careful evaluation, with some individuals requiring lifelong medication. This article encapsulates the complexities surrounding serotonergic antidepressants in 2023, highlighting the need for continued research and holistic patient care approaches.
Original languageEnglish
Pages (from-to)18-19
Number of pages2
JournalThe Hive
Issue number41
Publication statusPublished - 2023


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