Intended for healthcare professionals

Letters Serotonin and depression

Personalised pharmacotherapy: an interim solution for antidepressant treatment?

BMJ 2015; 350 doi: https://doi.org/10.1136/bmj.h2502 (Published 14 May 2015) Cite this as: BMJ 2015;350:h2502
  1. Adam M Chekroud, candidate for doctor of philosophy degree1,
  2. John H Krystal, professor2
  1. 1Department of Psychology, Yale University, New Haven, CT 06511, USA
  2. 2Department of Psychiatry, Yale University
  1. adam.chekroud{at}yale.edu

Healy’s engaging historical perspective on the rise of selective serotonin reuptake inhibitor (SSRI) antidepressants questions the efficacy and biological plausibility of these drugs.1 However, his focus on low serotonin levels is irrelevant to whether SSRIs are effective treatments for depression. Importantly, the response to SSRIs seems to be heterogeneous rather than universally poor.

Unbiased trajectory based analysis of more than 2500 patients treated with SSRIs or placebo indicated that most patients (>75%) given an SSRI showed a superior response to those given placebo. However, nearly a quarter of …

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