This past September Gary Greenburg published a blog that outlined the impending doom of the chemical imbalance theory.[i] For much of the last 30 years medical science has been enamored with the idea that all disorders of behavior and emotion could be explained by an imbalance of the chemicals inside our brains. In depression we lacked serotonin. In ADHD we need increased activity of norepinephrine and/or serotonin. In other disorders like schizophrenia, it has been thought that perhaps we had too much.

Well, it has become apparent that the theory which has ruled psychiatry and behavioral medicine is slowly being strangled at the end of an economic rope. Greenburg gives an interesting account of the history of psychiatric medicines. Like much of medicine they appeared in great measure because of chance observations that a medicine being used for other reasons also affected emotions and behavior. When medicines like Tofranil (depression), Thorazine (schizophrenia) and lithium were discovered, the doctors were actually looking for something else. At the time they had no idea why these medicines calmed the minds of those who took them.

Finding out how they worked would be kicked like a can further down the road. Eventually Joseph Schildkraut said that he believed that antidepressants worked by affecting serotonin, dopamine and norepinephrine in our brains. And, medical science was off to the race to discover similar compounds that had fewer side effects. And, Prozac was born.

The amusing secret in all of it was that actually no one really knew if these drugs raised serotonin in the brains of humans. Or, if they did, whether or not raising serotonin actually made any difference in how people acted or felt. Without any objective way to measure either serotonin or an understanding of the change in the human brain that was supposed to cause depression, they were making educated guesses. Studies were presented that showed that to some extent people said they felt better when they took the medicine. Unfortunately over time we found that people who took placebo pills (look like the real thing but do not contain medication) did just as well and often better than those who took the real medicine.

Why then at the pinnacle of success is the chemical imbalance theory dying? Well, it is not because researchers have been telling us that the theory cannot be proven. People have continued to believe it and doctors and manufacturers have continued to use the concept to prescribe medicine.

The cause of death is twofold. First, the patents on the major Psychiatric medications are running out. Cymbalta is running out this year. Soon it may be possible to buy it off the four dollar Wal-Mart drug list instead of paying 200 to 400 dollars a month.

Greenberg notes that several major drug companies have closed down their research departments that develop psychiatric drugs. In the absence of a real understanding of how the current drugs work, Greenberg says they really don’t know which direction to go for new psychiatric medicine. Forty years of research have not produced enough solid information to do any better on drug development than the chance discoveries that started psychiatric pharmacology in the first place.

With no new drugs in the pipeline and declining revenue from drugs headed off patent, there is no more money to continue “chasing down chemical imbalances that don’t exist.” “Without a new explanatory framework, drug company scientists don’t even know where to begin, so it makes no sense for the industry to stay in the psychiatric-drug business.”[ii] 

This may be a watershed time in medicine when an old theory will pass into history along with the humoral imbalances of Hippocrates. Most research today says that simply talking with depressed and anxious patients help them as much as the medicines that we have.

Maybe that is where a better answer will be found. And, that is where Biblical Counseling can offer hope from the scriptures to people who worry and are sad over loss.


[i]“The Psychiatric Drug Crisis, What Happened to Psychiatry’s Magic bullets? Gary Greenberg, 9/3/2013. Electronically retrieved at.

 http://www.newyorker.com/online/blogs/elements/2013/09/psychiatry-prozac-ssri-mental-health-theory-discredited.html

[ii] Ibid

1/14/2014 12:47:03 am

Thank you for this very informative and helpful article.

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