The Doctor's Kitchen Podcast

#336 Whether Antidepressants Actually Work and the Myth of Serotonin Imbalance | Professor Joanna Moncrieff

12 snips
Feb 18, 2026
Professor Joanna Moncrieff, a UCL psychiatrist and author who challenges the serotonin/chemical imbalance idea. She explores how the serotonin theory arose and was marketed, the limits of measuring serotonin, and what the 2022 review found. The conversation covers antidepressant effectiveness, emotional numbing, side effects and withdrawal, and safer approaches to treating depression with informed consent.
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INSIGHT

Umbrella Review Shows Weak Evidence

  • Moncrieff performed an umbrella systematic review collecting meta-reviews across serotonin research.
  • Her synthesis found weak, contradictory evidence and concluded the serotonin-depression link is unproven.
INSIGHT

Early Small Studies Didn't Hold Up

  • Early small studies often showed positive serotonin links that faded as sample sizes and quality increased.
  • Large recent genetic studies show no effect of the serotonin transporter gene on depression risk.
ADVICE

Explain Antidepressants Honestly

  • Explain antidepressants honestly: they alter consciousness and may cause emotional blunting rather than 'fixing' a brain disease.
  • Offer patients both pharmacological and non-pharmacological options for informed consent.
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