Why don't we know how antidepressants work yet?

> Moncrieff argues that drug companies, doctors and psychiatrists benefit from this situation because it’s profitable.

I recently discovered low dose lithium for myself. (self-medicated OTC lithium orotate, 5mg 2x daily)

This has greatly improved my mood and attitude to life.

Lithium has removed most of my procrastination by eliminating negative thoughts (i.e. "that is a difficult task, so I better defer this to tomorrow"). Starting and finishing something has become so easy now.

All work and household related tasks are now lightweight (chores, washing dishes, making beds). All things I found annoying to do before.

I am generally happy, positive-minded and open-minded toward other people.

Lithium is not a sedative or a pain killer -- I am still normally tired after a day, but now I am prioritizing my time rationally, and not based on negative emotions.

Somebody said that Lithium is too cheap, no profit to make, so pharma companies will not spend much on further R&D.

P.S. Of course lithium is a psycho-active substance, and surely has some side-effects. All above is only my personal experience. Please consult your doctor and be extremely careful with self-medication.

It's not just anti-depressants, no?

If I am mistaken, we do not know why plenty of medications work -- especially those within in the domain of mental disorders.

For example, why does lithium work, amphetamines, etc.? Obviously, we know such medications work, but not the "how"/"why."

Without antidepressants I'd be fully housebound from agoraphobia.

They work. Not perfect. And tolerance at different dosages build over time. But it's not a placebo effect.

Even more evidence we have no idea what is going on: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10509198/#:~:te.... My silly anecdotal theory is that the vagal nerve and the gut are very involved in these various disfunctions for some populations....also see use of SSRIs as off-label solutions for GERD, IBS etc.

There's a strong bias toward assuming that an effective treatment must necessarily address the disease etiologically.

Here is a wiki page on drugs whose mechanism of action is unknown: https://en.m.wikipedia.org/wiki/Category:Drugs_with_unknown_...

This tells us why many species have found herbal stuff to alleviate pain, cure ailments, etc.

Antidepressants are interesting but only part of the story.

People with depression don't fully understand how "broken" they actually are and normalise depressive behaviours further drilling in the issue.

I've dealt with bad depression before to the point of suicidal ideation and weird conspiratorial paranoia... on the other side of it you get a very realised perspective of what these words mean to sufferers instead of a surface level description.

Antidepressants seem to be a way to disrupt the usual flow of information and allow a rewrite to occur; LSD seems to be a theme these days for the same effect but I get the feeling something that's instantly hallucinogenic isn't the best way to rewire a mind... Research continues though.

Another example could be (for those who have been) addiction to nicotine or any other substance: You don't understand why someone just doesn't stop until you've experienced it firsthand. There are drugs that disrupt the addiction pathways and allow an addict to recover.

Because we don’t know how the brain works yet. Modern psychology and psychiatry is a joke.

If you can’t quantify “level of depression,” then you can’t measure improvement from any intervention, pharmaceutical or otherwise.

We can’t know how antidepressants work until we better understand how depression works.

brain complicated. many chemicals, many structures, many unknowns.

They don't.

Because they don't, just make people addicted, soooo many.