So the myth that serotonin is somehow a "happy hormone", and therefore that "more is better", has been pushed on people by Big Pharma ever since the development of selective serotonin-reuptake inhibitor (SSRI) antidepressant medications. As most people here are probably aware, SSRI medications have been MASSIVELY unsuccessful since they were introduced. It is clear that these drugs only provide temporary relief (in some cases) and actually seem to perpetuate the psychological issues they are purported to remedy. Increasing the bio-activity of serotonin makes depression worse!
But we can go even further with this and see that serotonin is not only intimately tied with depression and other psychiatric disorders, but it directly implicated in stress, metabolic dysfunction, and physiological degradation.
First, for some background information on serotonin's role in the brain and on psychological health, see this article by Dr Kelly Brogan. She highlights some very important points about serotonin in relation to depression (of which only a couple of excerpts are below):
-Social Anxiety Disorder Linked to High Serotonin Levels
-Serotonin and Depression: A Disconnect between the Advertisements and the Scientific Literature
-Is serotonin an upper or a downer? The evolution of the serotonergic system and its role in depression and the antidepressant response
-Low Serotonin Levels Don’t Cause Depression
-What has serotonin got to do with depression?
-Researchers Suggest Anxiety Is Caused By Too Much Serotonin
Anti-serotonin drugs = anti-depressant
[quote author=http://www.functionalps.com/blog/2012/10/30/serotonin-reuptake-enhancer-as-an-anti-depressant/]The predominant theory of depression suggests that a deficiency of serotonin (the “feel good neurotransmitter” or “happy chemical”) is a major player in depression. However, a more unified & integrated approach sees serotonin as prime facilitator of stress and degeneration that synergizes with other stress substances like estrogen, polyunsaturated fats, excitatory amino acids, prolactin, and glucocorticoids to create vicious, stress stimulating loops.
The proven anti-depression effects of tianapetine (Stablon, Coaxil, Tatinol), a selective serotonin reuptake enhancer (SSRE), calls into question the current model of depression since it has the opposite effect of the selective serotonin reuptake inhibitors (SSRI) drugs commonly used to treat depressives. Instead of inhibiting the uptake of serotonin like an SSRI, an SSRE increases uptake of serotonin, lowering serotonin’s activity. Tianeptine is well tolerated, decreases the excitatory effects of glutamate, prevents or reverse stress-related brain changes, doesn’t cause dependence or withdrawal symptoms, improves memory, and does not impair cognitive function.
SSRI drugs can sometimes cause very adverse side effects including increased symptoms of depression and suicide, as the Boston Globe article “Prozac Revisited” discusses. Making a Killing: The Untold Story of Psychotropic Drugging is a documentary that reveals how the current model for treating depression needs modification.
Tianeptine is referred to as an “atypical” anti-depression treatment. With a different perspective on physiology and the stress response, it’s the SSRI treatments that are atypical. Hopefully, the efficacy of tianeptine will open the mainstream’s consciousness to the stress-promoting effects of serotonin. This new consciousness can lead to a better understanding of other stress-related health problems.
Animal Hibernation - Energy redirection
Serotonin plays an important role in preparing animals for hibernation:
[quote author=http://www.open.edu/openlearn/nature-environment/natural-history/animals-the-extremes-hibernation-and-torpor/content-section-6.5]The activity of tryptophan hydroxylase (TPH), a key enzyme in the biosynthesis of another monoamine transmitter, serotonin, undergoes marked changes in the brain during entry into hibernation, and arousal in Spermophilus erythrogenys. An increase in TPH activity was found in several regions of the brain during the pre-hibernation period in euthermic ground squirrels. A further increase in TPH activity to 150% was observed during the entry into hibernation. Significant elevation was found not only in potential TPH activity measured at the incubation temperature of 37° C but also at incubation temperature of 7° C, approximating the body temperature in hibernation. Serotonin may also contribute to the chemical induction and maintenance of hibernation.
[/quote]
-Does serotonin play a role in entrance into hibernation?
-Brain serotonin metabolism in hibernation.]
-The influence of the neurohumor serotonin on hibernation in the golden-mantled ground squirrel, Citellus lateralis
Why would this be? It seems that serotonin can successfully redirect energy and distribute it appropriately throughout the system in response to environmental conditions.
In other words: When the body perceives there is danger/a lack of food availability/environmentally stressful conditions, it will redirect energy toward survival-only functions, and downregulate other non-essential functions such as reproduction etc.
The paper already mentioned by Andrews et al includes the following:
Possible reason for the observed benefits of taking SSRI's and 5HT supplements is that it induces an adaptive response (an increase in protective allopregnenalone production):
Another possible reason for "feeling great" is the activation of stress hormones - which temporarily induce feelings of 'bliss':
Excess serotonin is excitotoxic - via increased activity of glutamate in the brain:
Some quotes from Dr Ray Peat on the subject:
But we can go even further with this and see that serotonin is not only intimately tied with depression and other psychiatric disorders, but it directly implicated in stress, metabolic dysfunction, and physiological degradation.
First, for some background information on serotonin's role in the brain and on psychological health, see this article by Dr Kelly Brogan. She highlights some very important points about serotonin in relation to depression (of which only a couple of excerpts are below):
...In a review of serotonin theories of depression, Andrews et al. turn the paradigm on its head and conclude:
we propose that depressed states are high serotonin phenomena, which challenges the prominent role the low serotonin hypothesis continues to have in depression research (Albert et al., 2012). We also propose that the direct serotonin-enhancing effects of antidepressants disturb energy homeostasis and worsen symptoms. We argue that symptom reduction, which only occurs over chronic treatment, is attributable to the compensatory responses of the brain attempting to restore energy homeostasis.
In this paper, they work to deconstruct our indoctrination around serotonin as a “happy chemical”, and elucidate its complex role in redirecting energy production when a creature is under duress. It is only when we perturb the system with medication that the body’s response can sometimes result in a chemically adaptive state, that is temporary, at best (accounting for relapse rates, while on medication, of up to 60%). Even this analysis is a theoretical offering in the service of challenging the dominant paradigm.
A New England Journal of Medicine review on Major Depression, stated:
” … numerous studies of norepinephrine and serotonin metabolites in plasma, urine, and cerebrospinal fluid as well as postmortem studies of the brains of patients with depression, have yet to identify the purported deficiency reliably.”
[..]
The foundational “data” for the modern serotonin theory of mood utilizes tryptophan depletion methods which involve feeding volunteers amino acid mixtures without tryptophan and are rife with complicated interpretations.
Simply put, there has never been a study that demonstrates that this intervention causes mood changes in any patients who have not been treated with antidepressants.
In an important paper entitled Mechanism of acute tryptophan depletion:is it only serotonin?, van Donkelaar et al caution clinicians and researchers about the interpretation of tryptophan research. They clarify that there are many potential effects of this methodology, stating:
In general, several findings support the fact that depression may not be caused solely by an abnormality of 5-HT function, but more likely by a dysfunction of other systems or brain regions modulated by 5-HT or interacting with its dietary precursor. Similarly, the ATD method does not seem to challenge the 5-HT system per se, but rather triggers 5HT-mediated adverse events.
Andrews goes further to include this interpretation in a long list of arguments against the role of low serotonin in depression (Box 1).
So if we cannot confirm the role of serotonin in mood and we have good reason to believe that antidepressant effect is largely based on belief, then why are we trying to “boost serotonin”?
-Social Anxiety Disorder Linked to High Serotonin Levels
-Serotonin and Depression: A Disconnect between the Advertisements and the Scientific Literature
-Is serotonin an upper or a downer? The evolution of the serotonergic system and its role in depression and the antidepressant response
-Low Serotonin Levels Don’t Cause Depression
-What has serotonin got to do with depression?
-Researchers Suggest Anxiety Is Caused By Too Much Serotonin
Anti-serotonin drugs = anti-depressant
[quote author=http://www.functionalps.com/blog/2012/10/30/serotonin-reuptake-enhancer-as-an-anti-depressant/]The predominant theory of depression suggests that a deficiency of serotonin (the “feel good neurotransmitter” or “happy chemical”) is a major player in depression. However, a more unified & integrated approach sees serotonin as prime facilitator of stress and degeneration that synergizes with other stress substances like estrogen, polyunsaturated fats, excitatory amino acids, prolactin, and glucocorticoids to create vicious, stress stimulating loops.
The proven anti-depression effects of tianapetine (Stablon, Coaxil, Tatinol), a selective serotonin reuptake enhancer (SSRE), calls into question the current model of depression since it has the opposite effect of the selective serotonin reuptake inhibitors (SSRI) drugs commonly used to treat depressives. Instead of inhibiting the uptake of serotonin like an SSRI, an SSRE increases uptake of serotonin, lowering serotonin’s activity. Tianeptine is well tolerated, decreases the excitatory effects of glutamate, prevents or reverse stress-related brain changes, doesn’t cause dependence or withdrawal symptoms, improves memory, and does not impair cognitive function.
SSRI drugs can sometimes cause very adverse side effects including increased symptoms of depression and suicide, as the Boston Globe article “Prozac Revisited” discusses. Making a Killing: The Untold Story of Psychotropic Drugging is a documentary that reveals how the current model for treating depression needs modification.
Tianeptine is referred to as an “atypical” anti-depression treatment. With a different perspective on physiology and the stress response, it’s the SSRI treatments that are atypical. Hopefully, the efficacy of tianeptine will open the mainstream’s consciousness to the stress-promoting effects of serotonin. This new consciousness can lead to a better understanding of other stress-related health problems.
[/quote]Tianeptine. A review of its pharmacodynamic and pharmacokinetic properties, and therapeutic efficacy in depression and coexisting anxiety and depression.
Tianeptine is a novel antidepressant agent, both structurally (modified tricyclic) and in terms of its pharmacodynamic profile. Unlike other antidepressant agents, tianeptine stimulates the uptake of serotonin (5-hydroxytryptamine; 5-HT) in rat brain synaptosomes and rat and human platelets, increases 5-hydroxyindoleacetic acid (5-HIAA) levels in cerebral tissue and plasma, and reduces serotonergic-induced behaviour. Tianeptine reduces the hypothalamic-pituitary-adrenal response to stress, antagonises stress-induced behavioural deficits and prevents changes in cerebral morphology. The antidepressant efficacy of tianeptine, as shown in 2 trials of patients with major depression or depressed bipolar disorder with or without melancholia, is greater than that of placebo. In patients with major depression without melancholia or psychotic features, depressed bipolar disorder or dysthymic disorder, the antidepressant efficacy of short term (4 weeks to 3 months) tianeptine therapy appears to be similar to that of amitriptyline, imipramine and fluoxetine and may be superior to that of maprotiline in patients with coexisting depression and anxiety.
Neurobiological and clinical effects of the antidepressant tianeptine.
Clinically, tianeptine is an antidepressant effective in reducing symptoms of depression in mild to moderate-to-severe major depression, including over the long term. Tianeptine is also effective in alleviating the symptoms of depression-associated anxiety. It is generally well tolerated, with little sedation or cognitive impairment. The efficacy profile of tianeptine could be explained by its neurobiological properties observed in animal models. Tianeptine prevents or reverses stress-associated structural and cellular changes in the brain and normalizes disrupted glutamatergic neurotransmission. In particular, in the hippocampus, it prevents stress-induced dendritic atrophy, improves neurogenesis, reduces apoptosis and normalizes metabolite levels and hippocampal volume. Tianeptine also has beneficial effects in the amygdala and cortex and can reverse the effects of stress on neuronal and synaptic functioning.
Can a serotonin uptake agonist be an authentic antidepressant? Results of a multicenter, multinational therapeutic trial.
Tianeptine is clearly active in classical animal models predictive of antidepressant activity, and is also active in behavioral screening tests: it antagonizes isolation induced aggression in mice and behavioral despair in rats. Biochemical studies have revealed that in contrast to classical tricyclic antidepressant, tianeptine stimulates 5-HT uptake in vivo in the rat brain. This somewhat surprising property was observed in the cortex and the hippocampus following both acute and chronic administrations. This increase in 5-HT uptake has also been confirmed in rat platelets after acute and chronic administrations. Moreover, in humans, a study in depressed patients demonstrated that tianeptine significantly increased platelet 5-HT uptake after a single administration as well as after 10 and 28 days of treatment.
Animal Hibernation - Energy redirection
Serotonin plays an important role in preparing animals for hibernation:
[quote author=http://www.open.edu/openlearn/nature-environment/natural-history/animals-the-extremes-hibernation-and-torpor/content-section-6.5]The activity of tryptophan hydroxylase (TPH), a key enzyme in the biosynthesis of another monoamine transmitter, serotonin, undergoes marked changes in the brain during entry into hibernation, and arousal in Spermophilus erythrogenys. An increase in TPH activity was found in several regions of the brain during the pre-hibernation period in euthermic ground squirrels. A further increase in TPH activity to 150% was observed during the entry into hibernation. Significant elevation was found not only in potential TPH activity measured at the incubation temperature of 37° C but also at incubation temperature of 7° C, approximating the body temperature in hibernation. Serotonin may also contribute to the chemical induction and maintenance of hibernation.
[/quote]
-Does serotonin play a role in entrance into hibernation?
-Brain serotonin metabolism in hibernation.]
-The influence of the neurohumor serotonin on hibernation in the golden-mantled ground squirrel, Citellus lateralis
Why would this be? It seems that serotonin can successfully redirect energy and distribute it appropriately throughout the system in response to environmental conditions.
In other words: When the body perceives there is danger/a lack of food availability/environmentally stressful conditions, it will redirect energy toward survival-only functions, and downregulate other non-essential functions such as reproduction etc.
The paper already mentioned by Andrews et al includes the following:
Table 4 lists the symptoms of three reliably diagnosed depressive states: sickness behavior, starvation depression, and
melancholia. Each involves an altered balance between metabolically expensive processes (Fig. 1). In sickness behavior, limited energetic resources are devoted to immune function at the expense of growth and reproduction. In starvation depression, energy is
devoted to maintenance functions at the expense of growth, reproduction, and immune function. In melancholia, there is an upregulation in sustained cognition at the expense of growth and reproduction. The energy regulation hypothesis suggests serotonin transmission is elevated in these states to coordinate tradeoffs in energy allocation. In melancholia, this tradeoff is coordinated by serotonin transmission to various regions, including the hypothalamus, amygdala, hippocampus and lateral prefrontal cortex (PFC) (Fig. 2). In the hippocampus and lateral PFC, the processes involved in sustained cognition are energetically expensive and can only be sustained with aerobic glycolysis (the generation of lactate from the metabolism of glucose stored in astrocytes).
Possible reason for the observed benefits of taking SSRI's and 5HT supplements is that it induces an adaptive response (an increase in protective allopregnenalone production):
Elevation of brain allopregnanolone rather than 5-HT release by short term, low dose fluoxetine treatment prevents the estrous cycle-linked increase in stress sensitivity in female rats.
All these effects were blocked by short-term administration of fluoxetine (2 × 1.75 mg kg(-1) i.p.) during LD. This dosage increased the whole brain concentration of ALLO, as determined using gas chromatography-mass spectrometry, but was without effect on the extracellular concentration of 5-HT in the dorsal PAG, as measured by microdialysis. We suggest that fluoxetine-induced rise in brain ALLO concentration during LD offsets the sharp physiological decline, thus removing the trigger for the development of anxiogenic withdrawal effects.
Allopregnanolone regulates neurogenesis and depressive/anxiety-like behaviour in a social isolation rodent model of chronic stress.
The neurosteroid allopregnanolone (3α,5α-THP; ALLO) has been shown to be reduced in depressed patients. ALLO is "stress responsive" and plays a major role in regulating hypothalamic-pituitary-adrenal (HPA) axis function. We propose that reduced ALLO levels following chronic stress leads to HPA hyperactivity due to diminished ALLO regulation. This will result in increased glucocorticoid levels and reduced BDNF expression, leading to impaired hippocampal neurogenesis and the precipitation of depression/anxiety.
Another possible reason for "feeling great" is the activation of stress hormones - which temporarily induce feelings of 'bliss':
Serotonergic stimulation of corticotropin-releasing hormone and pro-opiomelanocortin gene expression.
The neurotransmitter serotonin (5-HT) stimulates adrenocorticotropic hormone (ACTH) secretion from the anterior pituitary gland via activation of central 5-HT1 and 5-HT2 receptors. The effect of 5-HT is predominantly indirect and may be mediated via release of hypothalamic corticotropin-releasing hormone (CRH). We therefore investigated the possible involvement of CRH in the serotonergic stimulation of ACTH secretion in male rats. Increased neuronal 5-HT content induced by systemic administration of the precursor 5-hydroxytryptophan (5-HTP) in combination with the 5-HT reuptake inhibitor fluoxetine raised CRH mRNA expression in the paraventricular nucleus (PVN) by 64%, increased pro-opiomelanocortin (POMC) mRNA in the anterior pituitary lobe by 17% and stimulated ACTH secretion five-fold.
Excess serotonin is excitotoxic - via increased activity of glutamate in the brain:
One effect of sustained serotonin transmission is to activate cortical networks, which are primarily glutamatergic (Puig and Gulledge, 2011). Current research suggests depression is associated with elevated glutamatergic activity in many regions (Alcaro et al., 2010; Sanacora et al., 2012). (C) During acute SSRI treatment, blockade of the serotonin transporter (SERT) shifts the balance of serotonin into the extracellular compartment. Extracellular serotonin is therefore perturbed above the depressed equilibrium. Since SERT blockade mimics the effects of a sustained increase in serotonin transmission, glutamatergic activity rises above the depressed equilibrium (Fu et al.,
2012) and symptoms often worsen (Cusin et al., 2007; Oswald et al., 1972). (
Some quotes from Dr Ray Peat on the subject:
– In hibernating animals, the stress of a declining food supply causes increased serotonin production. In humans and animals that don’t hibernate, the stress of winter causes very similar changes. Serotonin lowers temperature by decreasing the metabolic rate. Tryptophan and melatonin are also hypothermic. In the winter, more thyroid is needed to maintain a normal rate of metabolism.
-The protective, defensive reactions involving serotonin's blocking of certain types of reaction to ordinary stresses, are similar to the effects of serotonin in hibernation and in Alzheimer's disease (Mamelak, 1997; Heininger, 2000; Perry, et al., 2002). In those extreme conditions, serotonin reduces energy expenditure, eliminating all brain functions except those needed for simple survival. These parallels suggest that improving energy production, for example by providing ketones as an alternative energy source, while reducing the stress hormones, might be able to replace the defensive reactions with restorative adaptive nerve processes, preventing or reversing Alzheimer's disease.
One of the factors promoting excess cortisol production is intestinal irritation, causing absorption of endotoxin and serotonin. Fermentable fibers (including pectins and fructooligosaccharides) support the formation of bacterial toxins, and can cause animals to become anxious and aggressive. Fed to horses, some types of fiber increase the amount of serotonin circulating in the blood. Grains, beans, and other seeds contain fermentable fibers that can promote intestinal irritation.
– Overdose with the serotonin reuptake inhibitors, or with 5-hydroxytryptophan [or 5-HTP], which has effects similar to serotonin, can cause the sometimes fatal “serotonin syndrome.” Symptoms can include tremors, altered consciousness, poor coordination, cardiovascular disturbances, and seizures. Treatment with anti-serotonin drugs can alleviate the symptoms and usually can prevent death.
– The high serotonin syndrome has been reported in users of St. John’s wort as an antidepressant.
– Although several amino acids can be acutely or chronically toxic, even lethal, when too much is eaten, tryptophan is the only amino acid that is also carcinogenic. (It can also produce a variety of toxic metabolites, and it is very susceptible to damage by radiation.) Since tryptophan is the precursor of serotonin, the amount of tryptophan in the diet can have important effects on the way the organism responds to stress, and the way it develops, adapts, and ages.
– Decreasing tryptophan or decreasing serotonin improves learning and alertness, while increased serotonin impairs learning.
– Serotonin’s contribution to high blood pressure is well established. It activates the adrenal cortex both directly and through activation of the pituitary. It stimulates the production of both cortisol and aldosterone.