Sunday, November 24, 2013

Testing for serotonin receptor activity

"the serotonin transporter gene (SLC6A4) which has variants that have been shown to influence the clinical response of patients of European ancestry when they are treated with selective serotonin reuptake inhibitors. Genotyping of some of the serotonin receptor genes is also available to guide clinical practice [ ... ] Given the increasingly clear cost-effectiveness of genotyping, it has recently been predicted that pharmacogenomic testing will routinely be ordered to guide the selection and dosing of psychotropic medications.

 As I'm working to revise most of my web site's material on mental illness, one of my colleague's calls me up to tell me about serotonin testing. Apparently there are tests coming to test sensitivity of serotonin receptor sensitivity.

Doing some quick research, seems people want to run genetic tests to predict how well patients will response to psychiatric drugs. Well, if this helps to prevent some of the worse reactions to psych drugs it's not all bad, HOWEVER...

This has little to do with what "depression" and "mental illness" is. It is also guiding people in a direction that is leading them further away from the real problems.

Depression is not a disease. It is a feeling. Feelings are not pathologies. Feelings are not supposed to be treated. The whole train of thought makes no sense.

Feeling depressed all the time is a problem. Feeling suicidal is a problem. But the thing to treat is the patient, not the feeling itself.

What can cause depression? Well, what causes disease in general?
  • Nutritional deficiency
  • Toxicity
  • Structural issues (ie. car accident, joint sublexation, etc...)
  • Emotional trauma/stress
How should the patient who feels depressed be treated? By taking a full history and treating what is wrong! Sorry, you do not treat depression in naturopathy.  Naturopathy, like all other holistic healing disciplines is patient focused, not disease focused.

Do people have genetically faulty serotonin receptors?

Perhaps there are some people who do. There are some uncommon genetic diseases. However, most illnesses with a genetic component will only be expressed in the right environment. So the real question is not if people have faulty serotonin receptors. It's better to ask if some people are more genetically predisposed to feeling depressed, given a set of environmental stresses.

That may be so. But I wouldn't call that having a defective brain that needs to be treated with psych drugs. We all have genetic predispositions. Also, often these supposed weak genes that make us susceptible to certain disease serve important other functions as well (the most well known examples is perhaps sickle cell anemia as protection against malaria).

What should be treated is the cause of illness. Nutrition, toxicity, emotional trauma and physical structure. I doubt that many people would feel depressed if those needs could be taken care of. Personally, I wish as a ND I could do more, I can work with nutrition, detoxification and help the body deal with emotional stress, but I can not remove my clients from bad jobs, bad relationships, bad parents, etc... I wish I could, as sometimes it's clear that is most what they need, not some supplement or drug.

We are not born with defective brains, defective genes, or defective serotonin receptors. If we simply give our body's what they need, we will feel fine. Depression is the body's feedback mechanism that something is wrong. 

The above article I link to mentions "serotonin receptor genes." They can give a gene whatever arbitrary name or label they wish. However the very idea that there is a point to point relationship between genes and one specific function has been dis-proven. Since researchers know the body is far more complex, I wish they would use language that better reflected the way they body worked, instead of deceptive names.

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