About 1 in 8 adults in the UK, or 8.3 million people, are taking antidepressants, and this number has increased by more than 20% over the past five years. Many would say that the medicine eased their suffering. Joanna Moncrief, a professor of social psychiatry at King’s College London and an NHS psychiatrist, believes she was sold a lie.
Her work last summer, molecular psychiatry It concludes that there is “no evidence” that depression is caused by low serotonin levels. About 80% believe depression is caused by a chemical imbalance.
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Given how little we know about the biology of mental illness, she argues, there are no disease-specific targeted drugs. Antidepressants have properties similar to alcohol. Instead of correcting the underlying brain dysfunction, it changes the way you think and feel. “Those changes are superimposed on what someone thinks or feels at that moment. We even describe this in alcohol. We talk about ‘drowning your sorrow’ “Once you recognize that’s what drugs do, it quickly becomes clear that it’s not a long-term solution and can be harmful.”
Moncrief is a leading figure in critical psychiatry, a movement that rejects the mainstream psychiatrist’s medical approach to mental illness.her book chemotherapy myths (2007) and the most bitter medicine (2013), arguing that erroneous science and corporate greed led to the mismarketing and massive overprescription of psychotropic drugs, is the central text of the movement.
When she sees patients, she sometimes prescribes them. In the short term, sedatives can help those who are agitated and unable to sleep, and antipsychotics may also help. Moncrief told me.
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She says that clinical trials have shown that the efficacy of antidepressants versus placebo is so small that it is clinically insignificant. Even this, she argued, could be explained by an enhanced placebo effect, as it means you can know when you’re in the treatment arm. Long-term aspects of antidepressant use may be overlooked, such as the fact that depression often improves within 6 months.
Does she admit that her views may appear negative to the millions of people who believe antidepressants can help them? That doesn’t mean you have to keep information out of people,” she said. , or not because they’re stupid.” She emphasized that anyone considering stopping antidepressants should only do so with the support and guidance of a doctor.
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Moncrief is 57 years old and has a petite build with wild curls on the mop. She drank peppermint tea and spoke softly, but her point of view was clear. Does it matter how these drugs work? “If a placebo can help people feel better, why not give it to them?” is not good in their recovery.
“guess what [Moncrieff] It is very important to challenge the evidence and ask the key questions of clinical practice. In 2018, Cipriani led the largest-ever review of antidepressant efficacy and found that all 21 of his included drugs were more effective than placebo. “My interpretation is that the active ingredients in antidepressants, as opposed to sugar pills, do not have a great effect, and I agree,” he said, but clinically significant. (experiencing significant symptom relief), but 35-40% respond to placebo.
Cipriani disputes the notion that antidepressants are ineffective in the long term, pointing to a 2021 study. New England Journal of Medicine The results showed that patients who gradually stopped taking the drug after a long period of time were more likely to relapse than those who continued to take the drug. said it was necessary. One reason for this is that the debate over the effectiveness of psychiatric treatment has become so ideological and so heated. I was.
Moncrief is accustomed to strong criticism from her colleagues, but says that has changed in recent years. ), she believes the pandemic has created a new atmosphere of intolerance for scientists with heretical views. I was abused and slandered,” she said. She noticed a similar climate in the wake of her study of serotonin. [limits] “To criticize antidepressants, this is an area of scientific debate and should not be allowed,” she said. ”
Moncrief has been an opponent her entire career. A student in the 90s, she saw mental illness as a political and social construct more than her colleagues, who believed advances in brain science would lead to new treatments, such as RD Rain and Thomas Saas. I felt a sense of closeness with early figures such as. While working at her London Psychiatric Institute, she joined a reading group with her like-minded peers. “We were all pretty left-wing and a little rebellious.” Co-chaired by Moncrief, the network now has over 400 members.
“For decades, the pharmaceutical industry and medical professionals have instructed the public that there are medical solutions to life’s crises, but it’s just not true and people need to be set free. “I think there is,” Moncrief said. “We need to find more non-medical ways to help people through the crisis.” , wants people to see it as a “mood state”. in their environment. By definition, depression is a state that someone doesn’t want to be in, something going wrong in someone’s life, or a reaction to a stressful situation. ”
Critics of Moncrief have noted that her views are popular with far-right and Scientologists in America. There is,” said Moncrief. “Just because Scientologists … have these views on mental health doesn’t mean I should stop them.”
Another group that resonates with her views is the growing community of people who claim they have been harmed by psychiatry and want change. Their perspective is “stronger” than hers and she is “hopeful” for the future, she said. It is necessary and it will be very difficult,” she added.
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