'Blaming The Brain' By Elliot Valenstein
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The book is available for $17.50 at www.barnesandnoble.com. Based on your review, I ordered a copy. Given that it takes several days at least for any antidepressant drug known to start working,indepedent of serum levels, the effect is not direct. This doesn't mean that it isn't an effect on neurotransmitters. The effect might be holistic rather than on single loci, in which case contrary evidence from individual loci would not be relevant. They would refute only a single locus of action theory. You may well be right that nobody could read everything available on the topic of the invovlement of neurotransmitters in depression, but certain principles are general, applying to all science. The failure to find a mechanism does not refute an empirically obeserved correlation, nor does the failure of one proposed methiod of action refute a general proposal. This continues down to finer and finer grained analysis, e.g., if the hypothesised correlations are controlled for various other variables. Also, it may be that depression is not a single condition, but many, like cancer, and there is no appropriate treatment across the board. I'm not exactly sure what you mean by neurotransmitter theories. It has been well established and accepted in the research field that depression is not caused solely by levels of serotonin, noradrenaline or dopamine or their receptors. Other theories being actively pursued involve the second messenger systems (activated by neurotransmitter receptors) such as cAMP as well as the role played by stress hormones such as corticotropin releasing factor and neuropeptides such as neuropeptide Y. You may also have read recently about a new antidepressant currently undergoing trials that is a substance P receptor antagonist, developed by Merck, that does not affect serotonin or noradrenaline levels. Because of the potential billions to be made from developing better antidepressants drug companies are pursuing all possible areas of research - we don't always hear about it however until they think they've got something that really seems good. It's usually family doctors who tell their patients about simple neurotransmitter theories of depression so that the patient will understand and have more hope that their new medication will work - the placebo effect after all is quite powerful and well worth encouraging.
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