The Truth Hurts…BIG Pharma –  

July 19, 2022 – “There is no such thing as a scientifically established correct ‘balance’ of serotonin,” Lacasse and Leo cautioned more than a decade ago, joining numerous other experts then and now. Additionally, both aspirational claims rest on a hypothesis that follow-up studies would end up contradicting repeatedly. In short, both the hypothesis and the expensive marketing that pushed it into American living rooms rested on a hedge: “Scientists believe that it could be linked with an imbalance of a chemical in the brain called serotonin.” The hedge proved highly effective, even though, as David Healy explained in 2015 in “Serotonin and Depression,” in the BMJ, in practice, it entailed embracing or tacitly accepting “the marketing of a myth.” Through further oversimplification, a revised metaphor of a “chemical imbalance” took root as folk wisdom for multiple, dissimilar conditions listed in the DSM.

Returning to the controversy in “Antidepressants and the Chemical Imbalance Theory of Depression” (2015), Lacasse and Leo found that while the marketing had shifted emphasis from “correcting imbalances” to “‘adjusting’ or ‘affecting’ neurotransmitter levels,” leading psychiatrists were if anything, more wedded to the “chemical imbalance” metaphor than before.

Some had taken to the airwaves to say that it simplified communication with their patients. Daniel Carlat, the editor of The Carlat Psychiatry Report, explained on National Public Radio when asked what we know about psychiatric medication:


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