OT: Chemical Imbalance-- Debunked but Profitable

[Guest guest]

I saw the young and handsome researchers, Lacasse and Leo, doing

their study presentation in D.C. in October. They went over how

they'd combed through high profile and influential researchers and

journalists to find even one who could substantiate the brain

chemical imbalance theory which these journalists and researchers

had purported in countless papers and articles. Lacasse and Leo

couldn't find one who could back up the claim from any source. The

presentation was hilarious and scary at the same time.

Subject: " Chemical Imbalance " --Scientifically Debunked but

Commercially

Profitable

ALLIANCE FOR HUMAN RESEARCH PROTECTION

Promoting Openness, Full Disclosure, and Accountability

http://www.ahrp.org and http://ahrp.blogspot.com

FYI

" The Media and the Chemical Imbalance Theory of Depression " by

Leo

& R. Lacasse is a follow up to their seminal article in PLoS

Medicine (2005), in which they debunked the " chemical imbalance "

theory of

depression.

The " chemical imbalance " theory in psychiatry rests on the

observation that

mood could be artificially manipulated with drugs-those which raised

monoamine levels improved mood, while those which lowered amine

levels led

to depression, but it remained to be seen if naturally occurring

fluctuations in neurotransmitter levels were responsible for, or

caused, the

ebb and flow of mood levels. As the authors point out, in spite of

the

enormous amount of money and time that has been spent in the quest to

confirm the chemical imbalance theory, direct proof has never

materialized.

Moreover, during the past several decades, a significant amount of

evidence

has accumulated which calls the theory's validity into question.

Of particular note, in the two years since publication of their PLoS

article, not a single scientific article challenged their conclusion.

Indeed, the chairman of FDA Psychopharmacology Advisory Committee

acknowledged that the " chemical imbalance " theory was but a " useful

metaphor " --as opposed to a valid hypothesis.

Another credible, evidence-based assessment of the " chemical

imbalance "

theory is to be found on the website of The Mental Health Service at

McGill

University:

" The term 'chemical imbalance' is thrown around a lot these days.

True

conditions caused by chemical imbalances are relatively rare. All

thoughts,

feelings

and motions in the brain are mediated by the release of chemicals in

brain

pathways. Every person's brain is unique, leading each of us to have

different traits and abilities. Just because your brain works in a

particular way does not mean that you have a chemical imbalance. A

certain

amount of sadness, anxiety or other emotional upset is normal, and

though we

may be able to block these feelings by chemicals, this would tend to

dehumanize us. Even when we use medication to help an individual with

overwhelming emotions, most of the time this is not to repair

a 'chemical

imbalance' but simply to help contain symptoms. "

http://www.mcgill.ca/mentalhealth/medication/

However, invalid thought it may be, as Drs. Leo and Lacasse point

out the

" chemical imbalance " theory has had extraordinary commercial value

for both

the pharmaceutical industry and psychiatry:

" With the advent of the chemical imbalance theory, the companies

were no

longer just providing soothing tonics, they were now providing

medications

to treat diseases, as exemplified by an early SSRI advertisement

stating:

" When serotonin is in short supply, you may suffer from depression. "

The

wording here is all-important. The advertisement takes a correlation

between

serotonin shortage and psychological stress-and even this is highly

questionable and unverifiable in any individual case-and makes a

leap of

faith to the conclusion that depression is caused by a serotonin

imbalance,

not that psychological stress impacts the serotonin system.

And the marketing did not stop with depression; eventually we were

told that

whatever our problems might be, whether anxiety, excessive shyness,

depression, or the inability to pay attention, the underlying cause

was a

faulty transmitter level which could be rectified with a pill. A

2005 survey

from the Harvard School of Public Health reported that nearly half

of all

Americans will at some point develop a mental illness, presumably

from a

chemical imbalance, with 29% developing an anxiety disorder and 20%

a mood

disorder. "

The " chemical imbalance " theory has provided promoters of

psychoactive " feel

good " prescription drugs with the means for distancing their

products from

illicit street drugs whose chemical action is almost

indistinguishable.

Whereas drugs used to " take the edge off " stress are typically

considered

street drugs and are consumed by " users " or " addicts, " substances

used to

rectify a " chemical imbalance " can be called medications--and these

are

legitimately consumed by patients.

A fly in the ointment occurred when Ricky , the star running

back

for the Miami Dolphins who had been " diagnosed " with Social Anxiety

Disorder, and for several years was paid by GlaxoKline to

promote Paxil

for anxiety disorder, was described in 2002, by People magazine, as

suffering from a " depression-like chemical imbalance that affects

roughly

three million Americans. " tested positive for marijuana on

several

occasions. But while his marijuana use was frowned upon, his use of

Paxil

was considered acceptable. One was a medication supposed to treat a

chemical

imbalance, while the other was a drug signaling a lack of willpower.

However, ' contract with Glaxo came to a sudden halt in

2004, when

he stated that marijuana was ten times better than Paxil.

What got him into hot water, Drs. Leo and Lacasse, note, was not so

much

praising the competition, but rather putting his

sponsor's " medication " in

the same category as an illicit drug. threatened the

assumption

underlying the conventional unsupportable divide between legal and

illegal

drug use. His juxtaposition threatened the most powerful

industries--including professional sports, the pharmaceutical

industry,

psychiatry, and the mass media.

Another fly in the ointment raising questions about the validity of

the

dividing line between prescribed and illicit psychoactive

substances, is a

recent controlled clinical trial conducted by researchers at s

Hopkins.

The researchers ostensibly tested the " Mystical " effects of

psilocybin, the

active ingredient in mushrooms which is an illegal drug that causes

hallucinations. However, two months after the trial they found

that " 79% of

those prescribed psilocybin reported moderately or greatly increased

levels

of life satisfaction compared with those given a placebo. A majority

said

their mood, attitudes and behaviors had changed for the better. "

http://www.hopkinsmedicine.org/Press_releases/2006/07_11_06.html

No SSRI clinical trial had that high a rate of long-lasting

improvements in

mood, attitude and behavior.

The authors sent inquiries to reporters who mentioned the " chemical

imbalance " theory as if it had been proven, asking for citations of

such

proof. The responses--or lack of responses--and the biased, pro-

industry

reporting about mental health treatments, are no less troubling than

the

biased reporting in the New York Times about the events leading up

to the

Iraq War.

" In hindsight, as the Times editors now acknowledge (5/326/04),

Judith

's war coverage was overly one-sided. Her fundamental flaw

could be

described as a lack of professional skepticism toward the Bush

administration, as she willingly parroted what those pushing for war

were

saying, while giving little credence to the stance of the other side.

Writing in the New York Review of Books, Massing commented

that the

Times and 's reporting were examples of media " submissiveness. "

This depiction could just as well apply to the media's reporting of

mental

health issues. As just one example, in some cases, the media still

go to the

people responsible for the original problems. For instance, several

of the

researchers involved with the studies of SSRIs in children are still

cited

in the press even though the following information has come out

about their

published studies: they downplayed the suicide risk; they

exaggerated the

benefits; and the papers published under their names were actually

written

by ghostwriters paid by the pharmaceutical industry.

The Times editors have acknowledged both the problems with 's

reporting and their own lack of editorial oversight of her. It

remains to be

seen if members of the

media will ever look inward and reflect on their role in the

promotion of

the chemical imbalance theory. (For those familiar with the New York

Times'

coverage of mental

health issues over the past 10 years, it is refreshing that after a

series

of health reporters who essentially abdicated their role as

investigative

journalists, there is a newer group of Times reporters with more

skeptical

inclination... "

Both articles by Leo and Lacasse are freely

accessible.

http://www.springerlink.com/content/u37j12152n826q60/fulltext.pdf

and

http://medicine.plosjournals.org/perlserv/?request=get-

document & doi=10.1371/

journal.pmed.0020392