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[thismoment]

There is no scientific evidence that any mental disorder-- including depression-- is caused by serotonin abnormalities. Dangerously high serotonin levels resulting in serious illness and even death, however, are often caused by serotonin drugs like SSRIs and SNRIs-- especially when a patient is prescribed two or more of these drugs simultaneously.

 

Dr. Wayne Goodman, Chairman of Psychopharmacologic Committee of the FDA said, "Biological psychiatrists have looked very closely for a serotonin imbalance or dysfunction in patients with depression or OCD, and to date it has been elusive. [They found no link] Although an SSRI or antidepressant may work well in an individual, this doesn't prove there's an underlying imbalance, defect, or dysfunction in the person's serotonin system."

 

The four current guesses why antidepressants may work are the following:

1.  Changes in neurotransmitters.

2.  Placebo effect.

3.  Neurogenesis (new brain cell growth).

4.  Amphetamine-like side-effects give the patient more energy.

 

How do antidepressants work? Nobody knows.

Antidepressants physically alter the brain. Once drugs are withdrawn, does the brain fully restore? Nobody knows.

What are the long-term effects of antidepressants? Nobody knows.

[albergo11]

People are aware that ssri's create effects on the brain:

 

https://www.karger.c...FullText/370338

 

That's one article that's peer reviewed, and you can read all the references in that paper as well.

 

There used to be a website called paxilprogress.org that had posts that were basically a large collection of anecdotal information on the subject, but that website was taken down and it's more difficult to find knowledge around the net, but it exists.  For example, you will find that survivingantidepressants.org is a pretty good place to find recovery stories.

 

You're right however, that no one really understands the specific mechanism that can be responsible for all the withdrawal symptoms that people experience when they take drugs like duloxetine.  I can only guess:  it floods all synapeses with a shitload of serotonin and norepinephrine, reasulting in all sorts of gene-level alterations in protein synthesis, and downregulation of receptors, changes in neurlolgocal pathways, blood vessle density, and nerve connectivity changes.  It may also cause some sort of nerve damage similar to a nueropathy within the brain itself that takes long time to heal.  Most of this is speculation, but it's strong stuff that's potent just like street drugs.  It's likely that the effects of ssris most closlely mimic the effects of the seritonergic drug ecstacy, but I can't really say how or why - it would be good to see a study on the subject, but I'm not aware of one.