A psychiatrist, Giovanni Fava, performed a meta-analysis of clinical literature and neurobiological findings over several decades, concluding that the long-term outlook for depression treated with antidepressants is less than favorable. Medication effects seem to decrease over time; his finding suggests that depression may be a more progressive disease than previously thought, and also that patients develop tolerance to drugs, so that their effects fade. He also explores the impact of changing one part of the chemical interaction in the brain, and how it can effect architectural and chemical changes in other parts. For example, if a drug prevents the reception of serotonin, the brain may compensate by creating more receptors, which continues the imbalance. There is also the suggestion that impaired neurogenesis — the production of brain cells — is a factor in the cause of depression. Medications that reduce serotonin may be inhibiting neurogenesis, since serotonin affects the process.

Journal of Clinical Psychiatry (v. 64, no. 123: 123–33). Mindfulness: Journal of Personality and Social Psychology (v. 84, no. 4: 822–48).

(Article summarized from an item featured in Psychotherapy Networker)