LOS ANGELES - s4story -- Described as authoritative and well-researched, a new book by Professor Joanna Moncrieff, Chemically Imbalanced: The Making and Unmaking of the Serotonin Myth,[1] has reinforced calls from the mental health industry watchdog Citizens Commission on Human Rights (CCHR) International calls for patients to be fully informed that a chemical imbalance in their brain is not the source of their emotional issues.

Moncrieff, a professor of psychiatry at University College London, earlier led a systematic review of meta-studies examining the relationship between the chemical serotonin and depression. Alongside a team of five leading UK and European specialists, she concluded from all relevant published studies that "there is no evidence of a connection between reduced serotonin levels of activity and depression." Published in Molecular Psychiatry in 2022, the study was read by over one million people, "attracted international coverage," and sent "shockwaves through academic psychiatry."[2]

The study is now one of the most widely read and influential scientific papers of modern times. Altmetric, an online influence tracker, ranks it in the top five percent of all papers.[3]

In discussing her new book, Prof. Moncrieff wrote, "The fact is the theory that depression is caused by low serotonin is not supported by reliable evidence. Put simply, the emperor has no clothes – and this matters, because our widespread use of antidepressants for mental health problems is grounded in this myth."

She further explains, "Indeed, all mental health problems – as they're now referred to – are overwhelmingly seen as medical conditions arising from a chemical imbalance, or something similar, which needs correcting with drugs just like other diseases."[4]

This misconception has contributed to the widespread use of antidepressants. IQVia, the largest vendor of U.S. physician prescribing data, reports that 45 million Americans are taking antidepressants, including 2.1 million children aged 0-17.[5]

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"My view on depression is that it's a complex emotional state usually arising from life difficulties, rather than a biologically determined condition," Prof. Moncrieff adds. She emphasizes the importance of ensuring people are "properly informed about what they take," noting that this was her aim when publishing the comprehensive 2022 overview of research into depression and serotonin.[6]

According to Psychology Today's review on Chemically Imbalanced, the serotonin hypothesis served as "the principal justification for the use of antidepressants." The review states, "Moncrieff shows how the framing of depression and its treatment evolved from a 'drug-centered' to a 'disease-centered' model, with significant implications for how we think about the condition, even before we set about treating it."[7] The book contends that "the process of medicalization only makes things worse. It gives people false hope and leads to the over-prescription of potentially harmful drugs that, at best, offer ways to stifle uncomfortable feelings. We have to find better ways to help people."

Prof. Moncrieff suggests that better approaches to treatment would be "first and foremost about helping people to address the problems in their lives."[8]

This perspective is further underscored by data showing that 8.6 million people in England—nearly 19% of adults—were taking an antidepressant in 2022-23.[9] This is despite the 2019 position statement from the Royal College of Psychiatrists in the UK, which also found no evidence linking low serotonin levels to causing depression and dismissed the notion that antidepressants "correct a chemical imbalance in the brain."[10]

Yet, "at the same time, the quest for money and professional status has lured the psychiatric profession (whether individuals are consciously aware of it or not) into promoting these barely useful and potentially harmful drugs," Prof. Moncrieff says. "People have been profoundly misled about antidepressants." She details: "Not only have they never been shown to rectify a chemical imbalance or any other abnormality, but…they actually interfere with the normal state of the brain, just like alcohol and other mind-altering drugs. This is how they can produce potentially devastating side-effects – from rare suicidal thoughts to severe sexual problems."[11]

She adds: "Prescribing drugs has also long fulfilled the ambitions of the psychiatric profession to be just like other doctors – bringing them 'out of the asylum' by administering pills to make patients better."[12]

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However, CCHR argues that these pills have failed to improve the overall mental health of U.S. or UK citizens. Instead, the number of people taking them is increasing, not decreasing.

CCHR says that the chemical imbalance information must translate into stronger informed consent procedures within the mental health system. CCHR, which was established in 1969 by the Church of Scientology and Professor of psychiatry, Thomas Szasz, has been raising awareness about the lack of scientific evidence supporting the chemical imbalance theory of mental disorders. It has provided a detailed timeline of this issue on its website and has consistently fought for greater informed consent rights for patients.

CCHR calls for doctors to ensure that mental health patients are disabused of the idea that a chemical imbalance is what ails them as the first step in this informed consent process.

Sources:

[1] "'Chemically Imbalanced': A Book Review, A new history of antidepressants challenges the evidence supporting their use," Psychology Today, 16 Jan 2025, www.psychologytoday.com/us/blog/side-effects/202501/chemically-imbalanced-a-book-review

[2] "'Chemically Imbalanced': A Book Review…" Psychology Today, 16 Jan 2025

[3] "Medicating misery by doling out antidepressants is based on a myth: NHS psychiatrist PROFESSOR JOANNA MONCRIEFF reveals the shameful truth about Big Pharma," Daily Mail, 13 Jan. 2025, www.dailymail.co.uk/health/article-14279653/Medicating-misery-antidepressants-myth-NHS-psychiatrist-PROFESSOR-JOANNA-MONCRIEFF.html

[4] "Medicating misery by doling out antidepressants is based on a myth…," Daily Mail, 13 Jan. 2025

[5] www.cchrint.org/psychiatric-drugs/people-taking-psychiatric-drugs/; www.cchrint.org/psychiatric-drugs/children-on-psychiatric-drugs/

[6] "Medicating misery by doling out antidepressants is based on a myth…," Daily Mail, 13 Jan. 2025

[7] "'Chemically Imbalanced': A Book Review…" Psychology Today, 16 Jan 2025

[8] "'Chemically Imbalanced': A Book Review…" Psychology Today, 16 Jan 2025

[9] "Medicating misery by doling out antidepressants is based on a myth…," Daily Mail, 13 Jan. 2025

[10] www.cchrint.org/2022/08/09/world-psychiatric-group-must-tell-its-members-to-expunge-chemical-imbalance-myth/ citing: Royal College of Psychiatrists, "Position statement on antidepressants and depression," May 2019

[11] "Medicating misery by doling out antidepressants is based on a myth…," Daily Mail, 13 Jan. 2025

[12] "Medicating misery by doling out antidepressants is based on a myth…," Daily Mail, 13 Jan. 2025