` The Chemical Imbalance Myth
The "Chemical Imbalance" Myth *
 
"While the brain chemistry of depression is not fully understood, research suggests that depression is caused by an imbalance of certain chemicals in the brain, most notably serotonin." (Press Release on Lexapro)
 
"Both depression and OCD are thought to be caused by the imbalance of a chemical in the brain called serotonin, which sends impulses from one nerve to another." (Press Release on Luvox)
 
"Scientific evidence suggests that depression and certain anxiety disorders may be caused by a chemical imbalance in the brain. Paxil CR helps balance your brain's chemistry." (How Paxil CR Works)
 
"Depression is not fully understood, but a growing amount of evidence supports the view that people with depression have an imbalance of the brain's neurotransmitters, the chemicals that allow nerve cells in the brain to communicate with each other. Many scientists believe that an imbalance in serotonin, one of these neurotransmitters, may be an important factor in the development and severity of depression.
 
"PROZAC may help to correct this imbalance by increasing the brain's own supply of serotonin." (How Prozac Works)
 
"Zoloft® (sertraline HCl) is a prescription medicine that treats depression and anxiety. It belongs to a class of drugs known as SSRIs (Selective Serotonin Reuptake Inhibitors). Zoloft works to correct a chemical imbalance in the brain which may be related to symptoms of depression or certain anxiety conditions." (What is Zoloft)
 
 
(* myth: a widely held but false belief  -  Oxford English Dictionary)
 

"If you tell a lie big enough and keep repeating it, people will eventually come to believe it." – Joseph Goebbels

"Your Drug May Be Your Problem: How and Why to Stop Taking Psychiatric Medications"
by Peter R. Breggin, M.D. & David Cohen, Ph.D.
(Dr Breggin is an internationally known psychiatrist and author. Dr Cohen is a Professor at the School of Social Work at Florida International University, Miami, Florida; he is recognized as an expert on the adverse effects of psychotropic drugs and on psychiatric drug withdrawal.)
"Are There Biochemical Imbalances?"
"As one of our colleagues recently said, "Biochemical imbalances are the only diseases spread by word of mouth."
"Of course, our bodies can affect our emotional outlook. We all find it much easier to maintain a bright and enthusiastic attitude when physically healthy than when physically ill. And anything from lack of sleep to the common cold can affect our moods...
"It is therefore theoretically possible that some anxious or depressed people may be afflicted with an as-yet-undetected physical dysfunction. But this speculation doesn't justify the unfounded conclusion that people in emotional distress are beset by specific biochemical imbalances or that such imbalances can be corrected with drugs."
"What Do We Really Know About Psychiatric Drugs and the Brain?"
"Almost all psychiatric drug research is done on the normal brains of animals, usually rats. ... we have no techniques for measuring the actual levels of neurotransmitters in the synapses between the cells. Thus all the talk about biochemical unbalances is pure guess work. More important, what's actually being studied is the disruption of normal processes by the intrusion of foreign substances.
"This research in no way bolsters the idea that psychiatric drugs correct imbalances. Rather, it shows that psychiatric drugs create imbalances. In modern psychiatric treatment, we take the single most complicated known creation in the universe—the human brain—and pour drugs into it in the hope of "improving" its function when in reality we are disrupting its function.
"The notion that Prozac corrects biochemical imbalances is sheer speculation—propaganda from the biological psychiatric industry."
"Can We Test for Biochemical Imbalances?"
"Because of ethical and legal restraints, researchers cannot conduct studies that are certain to cause brain damage in human subjects. For example, they are not allowed to implant electrodes or to inject minute amounts of drugs into the brain tissue of living patients to test the effects of experimental drugs. Because there is no other way to do it, the basic biochemical research on drug effects is carried out on animals rather than on humans...
"In short, when explaining how a psychiatric drug like Prozac or lithium affects the biochemistry of the human brain, researchers are drawing almost entirely on animal research conducted on normal mammalian brains rather than from studies involving people with supposed biochemical imbalances in their brains!
"The concept of biochemical imbalances in people diagnosed with depression, anxiety, or other "disorders" remains highly speculative and even suspect... Although medication advocates often speak with seeming confidence about how psychiatric drugs can correct biochemical imbalances in the brain, they are merely indulging in pure speculation. There's little evidence for the existence of any such imbalances and no way to demonstrate how the drugs would affect them if they did exist."
"Causing, Not Curing, Biochemical Imbalances"
"As confirmed in animal research, all psychiatric drugs directly affect the brain's normal chemistry by disrupting it. ...
"It is important to keep this in mind: The brain is always impaired by psychiatric drugs. If a drug is strong enough to have a supposedly positive effect, then it is disrupting normal brain function. Although this conclusion may seem controversial, it is supported by common sense and an enormous amount of scientific research detailing the biochemical imbalances in the brain created by psychiatric medication. These drug-induced biochemical imbalances commonly cause psychiatric disorders in routine psychiatric practice."
"More Flaws in the Myth of Biochemical Imbalances"
"Even if some emotional problems turned out to be caused by subtle, as-yet-undetected biochemical imbalances, this finding would not be a rational justification for using any of the psychiatric drugs that are currently available. Because they impair normal brain function, such drugs only add to any existing brain malfunction."
"Conclusion"
"As earlier noted, the public has been subjected to a high-power selling campaign for psychiatric drugs. This campaign, conducted by drug companies and organized psychiatry, has convinced most people that psychiatric drugs are much safer and more valuable than they really are."
"Psychiatric drugs do not work by correcting anything wrong in the brain. We can be sure of this because such drugs affect animals and humans, as well as healthy people and diagnosed patients, in exactly the same way. There are no known biochemical imbalances and no tests for them. That's why psychiatrists do not draw blood or perform spinal taps to determine the presence of a biochemical imbalance in patients. They merely observe the patients and announce the existence of the imbalances. The purpose is to encourage patients to take drugs."
"Ironically, psychiatric drugs cause rather than cure biochemical imbalances in the brain. In fact, the only known biochemical imbalances in the brains of patients routinely seen by psychiatrists are brought about by the psychiatrists themselves through the prescription of mind-altering drugs."
"The Risk of Permanent Brain Dysfunction Caused by Psychiatric Drugs"
"Very few studies have examined the danger of potentially permanent changes in brain chemistry caused by long-term use of psychiatric medication..
"Prozac, Zoloft, Paxil, and Luvox are recent examples of drugs tailor-made in the laboratory to stimulate the activity of the serotonin system...
"All four drugs, known as selective serotonin reuptake inhibitors (SSRIs), block the normal removal of the neurotransmitter serotonin from the synaptic cleft—the space between nerve cells. The resultant overabundance of serotonin then causes the system to become hyperactive. But the brain reacts against this drug-induced overactivity by destroying its capacity to react to stimulation by serotonin. This compensatory process is know as "downregulation." Some of the receptors for serotonin actually disappear or die off.
"To further compensate for the drug effect, the brain tries to reduce its output of serotonin. This mechanism is active for approximately ten days and then begins to fail, whereas downregulation continues indefinitely and may become permanent." ...
"Psychiatric drugs do not always overstimulate neurotransmitter systems. Some drugs inhibit or block nerve transmission in the brain. When this happens, the brain again tries to compensate by reacting in the opposite direction—this time by "upregulation" of the suppressed neurotransmitter system. The "antipsychotic" drugs—such as Thorazine, Haldol, Prolixin, Risperdal, and Zyprexa—tend to suppress the dopamine system. The brain tries to overcome this effect by making the dopamine system hypersensitive. As discussed below (see book), this upregulation can lead to severe, even permanent neurological disorders.
"In its attempt to overcome the effects of psychiatric drugs, the brain becomes distorted in its functioning. And as already emphasized, the brain cannot immediately recover its original functions once the drugs are stopped. In some cases, the brain may never recover."
"Children at Grave Risk for Antidepressant-Induced Mania"
"Prozac even more commonly induces mania in children. In a study intended to tout the drug's safety and efficacy, 6 percent of the children were forced to drop out due to Prozac-induced mania. None of the controls became psychotic. A similar drug, Luvox, produced a 4 percent rate of "manic reactions" in children, according to the Physicians' Desk Reference (Luvox was being taken by Eric Harris at the time he committed the murders at Columbine High School in Littleton, Colorado, on April 20,1999).
"Without a doubt, Prozac and other antidepressants are causing tens of thousands of psychotic reactions that can ruin the lives not only of the afflicted individuals but also of their family members. With the increasing prescription of such drugs to children, we expect the devastation to increase."

The above are but a few extracts from the book by Dr Peter Breggin, M.D. and David Cohen, Ph.D. which contains further information on the "chemical imbalance" myth (correcting this phantom "chemical imbalance in the brain" seems to be the sole justification for taking SSRIs) with extensive information on common adverse reactions to psychiatric medications (such as impaired concentration, poor memory, confusion, disorientation, exaggerated response to stress, increased irritability, anger or agressivity, sleep difficulties, emotional blunting, insensitivity, fatigue, flu-like symptoms, anxiety, drug-induced euphoria or mania and depression) and several chapters devoted to how to stop taking them.
Here are the chapters in the book:
"Your Drug May Be Your Problem: How and Why to Stop Taking Psychiatric Medications" may be available at your library or local bookstore, or you can purchase a copy of the first edition containing the above extracts from Amazon through this link:
Or you may purchase a copy of the 2007 updated edition using the following link (according to Dr Cohen, changes to the sections on actual drugs and withdrawal effects were the important updates; the substance of the above excerpts from the original 1999 edition were not changed):


"Selective Serotonin Reuptake Inhibitors do exactly that: Inhibit the reuptake of serotonin, thus leaving excess serotonin which allows this stimulation to continue. It has long been known that inhibiting the reuptake of serotonin will produce depression, suicide, violence, psychosis, mania, cravings for alcohol and other drugs, reckless driving, etc." (SSRI Medications)

"Blaming the Brain: The Truth About Drugs and Mental Illness"
by Elliot Valenstein, Ph.D.
(Professor Emeritus of Psychology and Neuroscience at the University of Michigan)
"Chapter 1: Introduction"
"It may surprise you to learn that there is no convincing evidence that most mental patients have any chemical imbalance. Yet many physicians tell their patients that they are suffering from a chemical imbalance, despite the reality that there are no tests available for assessing the chemical status of a living person's brain. While there are some reports of finding evidence of an excess or deficiency in the activity of a particular neurotransmitter system in the brains of deceased mental patients, these claims are controversial, as other investigators cannot find any such relationship. At best, such claims are trends that result from averaging the data from many patients. As the brain chemistry of many patients in these studies was found to be perfectly normal, it is hard to argue that their mental problems were caused by a chemical imbalance.
"Moreover, the brains of some "normals"—people with no history of any mental disorder—may show signs of some excessive or deficient neurotransmitter activity. It needs to be recognized that even if a chemical abnormality were eventually found to be highly correlated with the incidence of a particular mental illness, it would not be clear how such a finding should be interpreted. It might well be that the chemical "abnormality" was caused by the stress or some behavioral peculiarity commonly associate with a particular mental illness, rather than having been the cause of that illness. It is also well known that psychotherapeutic drugs can be the cause of chemical abnormalities. The "cause" and the "effect" of a mental illness are routinely confused."
"When the first psychotherapeutic drugs were accidentally discovered we knew so little about brain chemistry that it was not possible to even propose a biochemical theory of mental illness or to offer any explanation of how drugs were acting on the brain. Our initial chemical theories of mental disorders emerged after it was realized that the first drugs introduced seemed to be acting on the few neurotramsmitters then know to exist in the brain. It is now estimated, however, that the number of substances that act as brain neurotransmitters may be over one hundred, and we have learned that most paychotherapeutic drugs affect many more neurotransmitters that initially suspected. Yet the theories have changed very little over the years despite much evidence that they cannot possibly be correct. The theories are held on to not only because there is nothing else to take their place, but also because they are useful in promoting drug treatment."
Here are the chapters in the book:
Blaming the Brain: The Truth About Drugs and Mental Illness by Dr Valenstein may be available at your library or local bookstore, or you can purchase it from Amazon through this link:


"Prozac Backlash"
by Joseph Glenmullen, M.D.
(Clinical Instructor in psychiatry at Harvard Medical School, is on the staff of Harvard University Health Services
and is in private practice in Harvard Square.)
"Chapter Two: Held Hostage"
"... the Prozac group [SSRIs] boost serotonin by inhibiting — or blocking — reuptake of the neurotransmitter back into the cells that release it. This exposes cells to artificially elevated serotonin levels.
"We now appreciate that the effects of these drugs are much more profound than this simple model. In reaction to being hyperstimulated by higher levels of the neurotransmitter, brain cells attempt to compensate by reducing their sensitivity to serotonin and by other long-term adaptations. This backlash involves complex changes in the cells' internal workings. Indeed, recent research on serotonin antidepressants has shown the adaptation of brain cells involve changes in the instructions given by the DNA of the cells — the master code regulating cellular function... Changes involving DNA expression are complicated, which is part of the reason why the adaptations may take months to fully occur. In some instance, as with patients where the drugs wear off indefinitely, the changes are apparently permanent. This again raises concern about the long-term effects of these drugs on the brain.
"Until recently, the changes wrought in brain cells by central nervous system drugs have been presumed to leave the cells intact and functioning, albeit in an altered way. However, in recent years, a much more ominous possibility has emerged: neruotoxicity, that is, the possibility that some central nervous system drugs are toxic to the brain, damaging or destroying critical parts of brain cells. ...
"I think most patients would be shocked by the idea that a prescription medication could be effecting a chemical lobotomy that might lead to permanent brain damage. At least they would want to be informed if this was a possibility, rather than leaving it up to laboratory scientists to decide whether or not this is a reasonable way to be 'therapeutic.' Indeed, reading the current literature on neurotoxicity, one finds an unsettling bias. When discussing brain cell damage caused by street drugs such as amphetamines, cocaine, or Ecstasy, researches speak in the gravest terms, warning of dread effects. Only when referring to prescription drugs do they suggest that pruning nerve cells might be 'therapeutic.'"
"Epilogue"
"We need new curbs on excesses in the way the drugs are promoted. There is no established biochemical imbalance for depression. There is no established gene for depression. Prescription antidepressants should not be promoted as though these hypothetical models were established. Psychiatric diagnoses should not be expanded and marketed as part of the efforts to market the drugs. Medical ethics, not business standards, need to prevail in health care."

Prozac Backlash: Overcoming the dangers of Prozac, Zoloft, Paxil, and other antidepressants with safe, effective alternatives is available from Amazon through this link:

Also see Dr Glenmullen's ABC Primetime Live Report Q&A; from December of 2004 here wherein he states "There are no medical tests to diagnose bipolar disorder, depression, or any other psychiatric condition: no blood tests, X-rays, brain scans, or any other objective tests. Medical tests should be used to rule out other conditions that can look like depression such as thyroid conditions. But all psychiatric diagnoses are subjective and based on the patient's personal history rather than on objective medical tests. This is what makes psychiatric diagnoses susceptible to being abused at times. In recent years, many patients who have toxic reactions to antidepressants are misdiagnosed as bipolar and put on powerful anti-manic drugs because the pharmaceutical industry has not adequately educated doctors on how to recognize antidepressant toxicity."


"Psyched Out: How Psychiatry Sells Mental Illness and Pushes Pills That Kill"
by Kelly Patricia O'Meara
(Award-winning Investigative Reporter)
"Chapter Three: Chemical Imbalance: A Measure of Madness?"
"There always are people who want to believe in the "chemical imbalance" theory, regardless of the evidence or, in this case, the lack of evidence. In fact, the APA, governmental bodies, pharmaceutical companies and private mental health organizations have spent billions on advertising campaigns to educate and reassure those afflicted with the reported psychiatric mental illnesses that it isn’t their fault and that they shouldn’t be stigmatized.
"So for those skeptics that still believe that the "chemical imbalance" is more than a theory—indeed a hypothesis—there is one sure-fire way to know the truth on a very personal level: Ask your treating physician or psychiatrist for a paper copy of the results of the test that was conducted to measure your brain chemical levels. Something along the lines of: grossly, minimally, or just a smidge out of balance, providing the physician a template to determine the necessary dosage and, more importantly, the duration of treatment. And, one might assume, this test presumably would also be used at the completion of treatment to determine if the chemical "imbalance" had been sufficiently corrected or balanced.
"Researchers would be unable to locate a single psychiatric drug user capable of providing such results. It is fair to say that if objective, confirmable proof of a neurological "chemical imbalance" were required prior to filling a prescription for any of the psychiatric mind-altering antidepressants that reportedly "correct" the "chemical imbalance" in the brain, not a single prescription would be written because to date the only known method of determining chemical levels in the brain is during autopsy.
"Jonathan Leo, associate professor of anatomy at Western University of Health Sciences and author of Broken Brains or Flawed Studies? A Critical Review of ADHD Neuroimaging Research, hit the nail on the head about the legitimacy of "chemical imbalance" when he explained in his 2004 paper "The Biology of Mental Illness": "If a psychiatrist says you have a shortage of a chemical, ask for a blood test and watch the psychiatrist’s reaction. The number of people who believe that scientists have proven that depressed people have low serotonin is a glorious testament to the power of marketing."

Psyched Out: How Psychiatry Sells Mental Illness and Pushes Pills That Kill is available for purchase from the author's website or you can purchase it from Amazon through this link:


"Serotonin and Depression: A Disconnect between the Advertisements and the Scientific Literature"
(from this PLoS Medicine article)

"In the United States, selective serotonin reuptake inhibitor (SSRI) antidepressants are advertised directly to consumers. These highly successful direct-to-consumer advertising (DTCA) campaigns have largely revolved around the claim that SSRIs correct a chemical imbalance caused by a lack of serotonin ...
"The pertinent question is: are the claims made in SSRI advertising consistent with the scientific evidence?
The Serotonin Hypothesis
"In 1965, Joseph Schildkraut put forth the hypothesis that depression was associated with low levels of norepinephrine, and later researchers theorized that serotonin was the neurotransmitter of interest. In subsequent years, there were numerous attempts to identify reproducible neurochemical alterations in the nervous systems of patients diagnosed with depression... Attempts were also made to induce depression by depleting serotonin levels, but these experiments reaped no consistent results. Likewise, researchers found that huge increases in brain serotonin, arrived at by administering high-dose L-tryptophan, were ineffective at relieving depression.
"... While neuroscience is a rapidly advancing field, to propose that researchers can objectively identify a "chemical imbalance" at the molecular level is not compatible with the extant science. In fact, there is no scientifically established ideal "chemical balance" of serotonin, let alone an identifiable pathological imbalance. To equate the impressive recent achievements of neuroscience with support for the serotonin hypothesis is a mistake.
"With direct proof of serotonin deficiency in any mental disorder lacking, the claimed efficacy of SSRIs is often cited as indirect support for the serotonin hypothesis. Yet, this ex juvantibus line of reasoning (i.e., reasoning “backwards” to make assumptions about disease causation based on the response of the disease to a treatment) is logically problematic – the fact that aspirin cures headaches does not prove that headaches are due to low levels of aspirin in the brain. Serotonin researchers from the US National Institute of Mental Health Laboratory of Clinical Science clearly state, “The demonstrated efficacy of selective serotonin reuptake inhibitors…cannot be used as primary evidence for serotonergic dysfunction in the pathophysiology of these disorders.”
"... in addition to what these authors say about serotonin, it is also important to look at what is not said in the scientific literature. To our knowledge, there is not a single peer-reviewed article that can be accurately cited to directly support claims of serotonin deficiency in any mental disorder, while there are many articles that present counterevidence. Furthermore, the Diagnostic and Statistical Manual of Mental Disorders (DSM), which is published by the American Psychiatric Association and contains the definitions of all psychiatric diagnoses, does not list serotonin as a cause of any mental disorder. ...
Consumer Advertisements of Antidepressants
"Contrary to what many people believe, the FDA does not require preapproval of advertisements. Instead, the FDA monitors the advertisements once they are in print or on the air. Misleading content is frequently found in various DTCA (Direct-To-Consumer Advertising) campaigns; hence, it is valuable to compare SSRI advertisements to the scientific evidence reviewed above...
The Role of the FDA
"In the US, the FDA monitors and regulates DTCA. The FDA requires that advertisements "cannot be false or misleading" and "must present information that is not inconsistent with the product label". Pharmaceutical companies that disseminate advertising incompatible with these requirements can receive warning letters and can be sanctioned. The Irish equivalent of the FDA, the Irish Medical Board, recently banned GlaxoSmithKline from claiming that paroxetine corrects a chemical imbalance even in their patient information leaflets. Should the FDA take similar action against consumer advertisements of SSRIs?...
"In order to determine whether these advertisements actually comply with FDA regulations, it is useful to consult the Code of Federal Regulations under which DTCA is regulated. The regulations state that an advertisement may be cited as false or misleading if it "[c]ontains claims concerning the mechanism or site of drug action that are not generally regarded as established by scientific evidence by experts qualified by scientific training and experience without disclosing that the claims are not established and the limitations of the supporting evidence…" (text is bolded in PLoS article).
Stating that depression may be due to a serotonin deficiency is seemingly allowed, but, as stated in the regulations, only if the limitations of the supporting evidence are provided. In our examination of SSRI advertisements, we did not locate a single advertisement that presented any such information. Instead, the serotonin hypothesis is typically presented as a collective scientific belief, as in the Zoloft advertisement, which states that regarding depression, "Scientists believe that it could be linked with an imbalance of a chemical in the brain called serotonin". Consumers viewing such advertisements remain uninformed regarding the limitations of the serotonin hypothesis (reviewed above).
According to federal regulations, advertisements are also proscribed (forbidden) from including content that "contains favorable information or opinions about a drug previously regarded as valid but which have been rendered invalid by contrary and more credible recent information".
This means that a disconnect between the evolving peer-reviewed literature and advertisements is not permitted. Regarding SSRIs, there is a growing body of medical literature casting doubt on the serotonin hypothesis, and this body is not reflected in the consumer advertisements. In particular, many SSRI advertisements continue to claim that the mechanism of action of SSRIs is that of correcting a chemical imbalance, such as a paroxetine advertisement, which states, "With continued treatment, Paxil can help restore the balance of serotonin...". Yet, as previously mentioned, there is no such thing as a scientifically established correct "balance" of serotonin. The take-home message for consumers viewing SSRI advertisements is probably that SSRIs work by normalizing neurotransmitters that have gone awry. This was a hopeful notion 30 years ago, but is not an accurate reflection of present-day scientific evidence."
See the full article for additional information from this peer-reviewed open-access journal published by the Public Library of Science.


"You can fool some of the people all of the time, and all of the people some of the time, but you can not fool all of the people all of the time." – Abraham Lincoln