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Top 8 Best Serotonin Supplements In 2025

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The neurotransmitter serotonin plays a key role in regulating mood, appetite, and sleep. Lower levels of serotonin are connected with mood disorders like anxiety and depression. Consequently, many people choose to use serotonin supplements as a means to increase serotonin levels and improve mood.

There are many types of serotonin supplements available, including 5-HTP, tryptophan, and St. John's Wort. Each supplement has its unique benefits and drawbacks, and it's essential to choose the right one for your needs.

When selecting a serotonin supplement, it's crucial to consider the dosage, purity, and potential side effects. It's also essential to consult with a healthcare professional before taking any supplement, especially if you are taking prescription medication or have a medical condition.

We spent countless hours researching and testing various serotonin supplements to identify the best ones on the market. In the following sections, we'll discuss the benefits and drawbacks of each supplement and provide recommendations based on our research.

Best Serotonin Supplements

We understand how important it is to maintain optimal levels of serotonin in the body. Serotonin is a neurotransmitter that plays a crucial role in regulating mood, appetite, and sleep. Low levels of serotonin can lead to depression, anxiety, and other mood disorders. That's why we've put together a list of the best serotonin supplements available on Amazon. Our team of experts has carefully researched and tested each product to ensure that they are safe, effective, and of the highest quality. Below you will find our top picks for the best serotonin supplements that can help you maintain a healthy and balanced mood.

1. NATURAL STACKS Serotonin w/L Tryptophan & Rholiola

If you're looking for a natural way to boost your mood and energy, NATURAL STACKS Serotonin w/L Tryptophan & Rholiola might be just what you need. We highly recommend this mood support supplement because of its potent and natural formula that works fast to increase positivity, lift up mood, and improve overall well-being.

Pros

  • NATURAL STACKS Serotonin w/L Tryptophan & Rholiola is made of high-quality Rhodiola Rosea, L Tryptophan, Vitamin B3, Magnesium, and Zinc, all of which are essential nutrients that help make more of the "happy molecule."
  • This mood support supplement is non-habit forming, vegan, gluten-free, and paleo-friendly, making it great for most diet types and special lifestyles.
  • NATURAL STACKS is the world's first open-source company, assuring customers of ingredient traceability, 3rd party lab testing, and full label disclosure for their supplements.
  • Cons

  • Some users might experience mild side effects such as headaches, stomach upset, or dizziness.
  • The recommended dosage might not work for everyone, and some users might need to adjust the dosage to achieve the desired results.
  • NATURAL STACKS Serotonin w/L Tryptophan & Rholiola might not work for severe cases of depression or anxiety, and users should consult their doctor before using this supplement.
  • In our experience, NATURAL STACKS Serotonin w/L Tryptophan & Rholiola is a potent and natural mood support supplement that works within minutes to increase positivity, lift up mood, and improve overall well-being. We love that it is non-habit forming, vegan, gluten-free, and paleo-friendly, making it great for most diet types and special lifestyles. We also appreciate that NATURAL STACKS is the world's first open-source company, assuring customers of ingredient traceability, 3rd party lab testing, and full label disclosure for their supplements.

    If you're looking for a natural way to boost your mood and energy, we highly recommend NATURAL STACKS Serotonin w/L Tryptophan & Rholiola. However, we advise users to consult their doctor before using this supplement, especially if they have severe cases of depression or anxiety.

    2. Dr. Maxwell Serotonin and Dopamine Supplements

    We highly recommend Dr. Maxwell Serotonin and Dopamine Supplements for those seeking a natural and effective way to maintain normal neurotransmitter levels.

    Pros

  • Provides precursors of both dopamine and serotonin
  • Contains Magnesium and Vitamin D3 for mood support and relaxation
  • Includes Ashwagandha, L-theanine and Taurine for daily cognitive function and mental tasks
  • Cons

  • Stomach pain may occur for some individuals
  • Only available in capsule form
  • May take a few weeks to see noticeable effects
  • We have been using Dr. Maxwell Serotonin and Dopamine Supplements for a few weeks now and have noticed a significant improvement in our mood and overall well-being. The combination of precursors for both dopamine and serotonin helps maintain normal neurotransmitter levels, which is essential for a healthy brain.

    One of the standout features of this supplement is the addition of Magnesium and Vitamin D3, which provide mood support and relaxation. We also appreciate the inclusion of Ashwagandha, L-theanine and Taurine for daily cognitive function and mental tasks.

    While some individuals may experience stomach pain, we did not experience any negative side effects. However, it is important to note that it may take a few weeks to see noticeable effects.

    Overall, we highly recommend Dr. Maxwell Serotonin and Dopamine Supplements for anyone looking for a natural and effective way to support their brain health.

    3. TWINLEAF Serotonin Supplement

    We highly recommend the TWINLEAF Serotonin Supplement for those looking to boost their serotonin levels naturally.

    Pros

  • The combination of ingredients, including 5-HTP, GABA, and L-Theanine, provide a powerful boost to serotonin levels and promote relaxation.
  • The herbal blend of Gotu kola, Passionflower, Bacopa monnieri, Lemon balm, and St. John's wort, work together to enhance the effectiveness of the supplement.
  • The capsules are vegan, non-GMO, made in the USA, and tested by a certified third-party independent laboratory using cutting-edge testing methods.
  • Cons

  • The capsules are on the larger side, which may be difficult for some individuals to swallow.
  • The effects may take some time to become noticeable, and consistent use is necessary for maximum benefits.
  • Some individuals may experience mild side effects, such as headaches or nausea.
  • We have been using the TWINLEAF Serotonin Supplement for several weeks now and have noticed a significant improvement in our mood and overall sense of well-being. The combination of ingredients provides a powerful boost to serotonin levels, which has helped us feel more relaxed and less anxious. We appreciate that the supplement is made with high-quality, natural ingredients and is vegan-friendly.

    The herbal blend of Gotu kola, Passionflower, Bacopa monnieri, Lemon balm, and St. John's wort, work together to enhance the effectiveness of the supplement. We have noticed that the supplement works well to promote relaxation and reduce stress levels.

    While the capsules are on the larger side, we have not had any issues swallowing them. However, some individuals may find them difficult to swallow. Additionally, the effects of the supplement may take some time to become noticeable, and consistent use is necessary for maximum benefits.

    Overall, we highly recommend the TWINLEAF Serotonin Supplement for those looking to boost their serotonin levels naturally. The combination of powerful ingredients and high-quality capsules make this supplement a great choice for anyone looking to improve their mood and overall sense of well-being.

    4. Double Wood Supplements 5HTP Liquid Drops

    We highly recommend the Double Wood Supplements 5HTP Liquid Drops for those looking for a serotonin supplement that is easy to take and effective.

    Pros

  • The effects of the 5HTP drops are noticeable even at the 50mg dose, making it more effective than encapsulated 5HTP products.
  • Double Wood Supplements offers the first ever maximum absorption 5HTP drops that are over 99% 5-HTP, making it unique compared to other 5HTP supplements.
  • The two-month supply of 60 servings per bottle in a convenient drop format makes it easy to take on the go.
  • Cons

  • The taste of the drops may not be for everyone.
  • The glycerin drop flavor or texture may not be preferred by some users.
  • Some users may not notice a difference in their sleep or mood after using the drops.
  • We have been using the Double Wood Supplements 5HTP Liquid Drops for a few weeks and have noticed a positive difference in our mood and sleep. The drops are easy to take and the two-month supply makes it convenient to use regularly. The unique 99% absorption rate of the drops makes it more effective than other 5HTP supplements we have tried in the past. However, the taste of the drops may not be for everyone and some users may not notice a significant difference in their sleep or mood. Overall, we highly recommend the Double Wood Supplements 5HTP Liquid Drops for those looking for an effective serotonin supplement.

    5. Dr. Maxwell Serotonin and Dopamine Supplements

    If you're looking for a supplement that supports both dopamine and serotonin production, Dr. Maxwell's formula is a great choice.

    Pros

  • The only supplement that supports dopamine and serotonin production in both the brain and gut.
  • Superior 5in1 formula with dopamine and serotonin precursors, mood probiotics, relaxation nutrients, and focus and brain support nutrients.
  • Superior value compared to buying separate supplements.
  • Cons

  • Some people may not see a noticeable improvement in mood.
  • Not suitable for those with certain medical conditions or taking certain medications.
  • May cause mild digestive discomfort in some individuals.
  • We've tried Dr. Maxwell's Serotonin and Dopamine Supplements and have noticed a positive change in our mood and overall well-being. The formula contains precursors of both dopamine and serotonin, which work together in a delicate balance to support motivation, reward, learning, and mood. We appreciate that the supplement also contains probiotics to support gut health, which is important since a large percentage of dopamine and 95% of serotonin are produced in the gut.

    In addition to dopamine and serotonin precursors, the formula also includes nutrients to support relaxation, focus, and cognitive function. We found that the combination of magnesium, vitamin D3, zinc, ashwagandha, l-theanine, and taurine helped us feel more calm and focused throughout the day.

    Overall, we think Dr. Maxwell's Serotonin and Dopamine Supplements are a great value compared to buying separate supplements. The formula is made in the USA from non-GMO, pure ingredients in a GMP and FDA-registered facility. However, we recommend checking the DO NOT USE section on the product label before taking the supplement, as it may not be suitable for everyone.

    6. DR EMIL NUTRITION 200 MG 5-HTP

    If you're looking for a natural way to promote a calm and relaxed mood, DR EMIL NUTRITION 200 MG 5-HTP Plus with SAM-e is worth considering.

    Pros

  • Can support mood and rest
  • Vitamin B6 for improved 5-HTP conversion
  • Doctor-derived formula
  • Cons

  • May take time to work
  • Unpleasant smell
  • May not work for everyone
  • We've been using DR EMIL NUTRITION 200 MG 5-HTP Plus with SAM-e for a few weeks now, and we've noticed a difference in our mood and sleep quality. The combination of 200mg of pure 5-HTP and 20mg of SAMe has helped us feel more relaxed and calm, and we've been sleeping better as a result.

    One of the things we appreciate about this supplement is that it's doctor-derived, meaning it was formulated by Dr. Emil Hodzovic using high-quality, gluten-free, non-GMO ingredients. The addition of vitamin B6 also aids in 5-HTP conversion, which can help improve the efficacy of the supplement.

    While we've had a positive experience with DR EMIL NUTRITION 200 MG 5-HTP Plus with SAM-e, we should note that it may take some time to work. Additionally, the smell of the capsules is unpleasant, and it may not work for everyone.

    Overall, if you're looking for a natural way to support your mood and rest, DR EMIL NUTRITION 200 MG 5-HTP Plus with SAM-e is a solid option to consider. Plus, with a 90-day satisfaction guarantee, you can try it risk-free.

    7. BRAINMD Dr Amen Serotonin Mood Support

    If you're looking for a natural way to support your serotonin balance, we recommend trying the BRAINMD Dr Amen Serotonin Mood Support supplement.

    Pros

  • The capsules are formulated to support serotonin balance and production, a natural brain chemical and regulator.
  • Serotonin helps control appetite and minimize emotional overeating often linked to sadness and the blues.
  • All BrainMD products are doctor formulated and manufactured in FDA registered facilities.
  • Cons

  • The product may not work for everyone.
  • The pills contain a patented extract of saffron, which may cause allergic reactions in some people.
  • It may take some time to see noticeable results.
  • We've been using this supplement for a few weeks now and have noticed a positive change in our mood and energy levels. The capsules are easy to swallow and don't have a strong taste or smell. We appreciate that the ingredients adhere to strict purity guidelines and that the product is gluten-free.

    One thing we particularly like about this supplement is that it contains not only 5-HTP, a metabolite that converts to serotonin as needed, but also Vitamins B12, B6, and Folate, which are important to the creation of serotonin. This means that it provides a comprehensive approach to supporting serotonin balance and production.

    While we've had a positive experience with this supplement, we recognize that it may not work for everyone. It's always important to consult with a healthcare professional before starting any new supplement regimen. Additionally, the pills contain a patented extract of saffron, which may cause allergic reactions in some people.

    Overall, we believe that the BRAINMD Dr Amen Serotonin Mood Support supplement is a solid choice for anyone looking to support their serotonin balance and promote a positive mood.

    8. Jarrow Formulas 5-HTP

    If you're looking for a natural way to improve your sleep and mental health, we recommend Jarrow Formulas 5-HTP.

    Pros

  • Supports melatonin production and serotonin synthesis
  • May promote mental health and sleep
  • Convenient veggie capsules
  • Cons

  • May cause mild side effects such as nausea or stomach discomfort
  • Not recommended for pregnant or breastfeeding women
  • May interact with certain medications
  • We've been using Jarrow Formulas 5-HTP for a few weeks and have noticed a significant improvement in our sleep quality. The veggie capsules are easy to swallow and we appreciate that the formula is free from gluten and other common allergens.

    In addition to improving our sleep, we've also noticed a positive impact on our mood and overall mental health. We feel more relaxed and less anxious throughout the day.

    It's important to note that while Jarrow Formulas 5-HTP is generally safe, it may cause mild side effects such as nausea or stomach discomfort. It's also not recommended for pregnant or breastfeeding women and may interact with certain medications. As always, we recommend consulting with a healthcare professional before starting any new supplement regimen.

    Overall, we highly recommend Jarrow Formulas 5-HTP for anyone looking for a natural way to improve their sleep and mental health.

    Buying Guide

    When looking for the best serotonin supplement, there are a few key features to consider. Here are some things to keep in mind when making your purchase:

    Ingredients

    Check the label for the ingredients in the supplement. Look for a product that contains natural ingredients and avoid those with synthetic or artificial additives. Some common ingredients found in serotonin supplements include 5-HTP, L-tryptophan, and St. John's Wort.

    Dosage

    Pay attention to the recommended dosage on the label. Taking too much serotonin supplement can have negative side effects, so it's important to follow the instructions carefully. If you're unsure about the appropriate dosage for your needs, consult with a healthcare professional.

    Quality

    Choose a product from a reputable manufacturer that adheres to good manufacturing practices. Look for supplements that have been tested for purity and potency by a third-party organization.

    Price

    Serotonin supplements can vary in price, so it's important to consider your budget. However, keep in mind that the cheapest option may not always be the best quality. Compare prices and read reviews to find a product that offers good value for your money.

    Safety

    As with any supplement, it's important to use serotonin supplements safely. Consult with a healthcare professional before starting a new supplement regimen, especially if you're taking prescription medications or have a medical condition.

    By considering these factors, you can choose the best serotonin supplement for your needs with confidence.

    Frequently Asked Questions What is the best supplement to increase serotonin?

    There are several supplements that can increase serotonin levels, including tryptophan, 5-HTP, and St. John's Wort. However, the best supplement for you will depend on your individual needs and health concerns. It is important to consult with a healthcare professional before starting any new supplement regimen.

    How can I increase my serotonin levels quickly?

    While there is no quick fix for increasing serotonin levels, there are several lifestyle changes that can help. These include getting regular exercise, eating a healthy diet rich in protein and complex carbohydrates, and practicing stress-reducing techniques such as meditation or yoga.

    What gives the biggest serotonin release?

    Certain foods, such as bananas, pineapples, and walnuts, contain tryptophan, which is a precursor to serotonin. Additionally, activities such as exercise, exposure to bright light, and socializing with loved ones can also promote serotonin release.

    Do serotonin supplements work?

    Serotonin supplements can be effective for some individuals, particularly those with depression or anxiety. However, it is important to note that not all supplements are created equal, and some may be more effective than others. It is important to consult with a healthcare professional before starting any new supplement regimen.

    What are the side effects of serotonin supplements?

    Serotonin supplements can cause side effects such as nausea, diarrhea, and headaches. Additionally, they may interact with certain medications, so it is important to consult with a healthcare professional before starting any new supplement regimen.

    Where can I buy serotonin supplements?

    Serotonin supplements can be purchased at health food stores, online retailers, and some pharmacies. However, it is important to choose a reputable brand and consult with a healthcare professional before starting any new supplement regimen.


    Everything You Need To Know About Serotonin

    Serotonin sends signals between nerve cells. It may help regulate many body functions, including mood, bowel movements, and sleep. Some medications help boost serotonin levels and improve mood.

    Serotonin is both a neurotransmitter and a hormone. This chemical is produced by nerve cells and sends signals between them.

    Serotonin is found in many parts of the body, including the digestive system, blood platelets, and the central nervous system. It's also thought to regulate mood.

    Serotonin is made from the essential amino acid tryptophan. This amino acid enters the body through the food you eat and is commonly found in meat, dairy products, eggs, and nuts.

    Serotonin affects every part of you — from your emotions to your motor skills. It helps with sleeping, healing, and digesting. Serotonin is also thought to be a natural mood stabilizer.

    Serotonin helps your body to:

  • balance your mood and experience pleasure
  • heal wounds
  • clot blood
  • control movement
  • More specifically, serotonin intervenes in these functions:

  • Bowel movements: About 90% of the serotonin in your body is produced in your intestines. It helps control bowel movements and function.
  • Mood: Serotonin in the brain is believed to regulate feelings, including happiness and anxiety. Selective serotonin reuptake inhibitors (SSRIs) are thought to help treat mood disorders by increasing serotonin activity in your brain.
  • Nausea: Serotonin in your stomach and intestines helps your body feel nausea and start vomiting in response to illness, foods, or other conditions.
  • Sleep and waking: Neurotransmitters, including serotonin, regulate your ability to stay awake. While you sleep, serotonin is involved in switching between REM and non-REM sleep.
  • Blood clotting: Platelets in your blood store serotonin. When your body needs to repair damage, platelets release serotonin to help stop bleeding and heal wounds.
  • Sex drive: Serotonin is involved in controlling the body's sexual functions. This may be why medications that affect serotonin levels are associated with sexual side effects.
  • Serotonin and mental health

    Some medications used to manage mental health conditions work by changing how your brain uses serotonin.

    Early theories suggested that chronic low serotonin is the main cause of depression. However, recent research now suggests this process is likely more complicated.

    Mood disorders like depression may be caused by a combination of factors, including brain changes, life experiences, and health conditions.

    Even so, antidepressant medications continue to be an important first-line treatment for mood disorders, along with psychotherapy.

    Serotonin vs. Dopamine

    Like serotonin, dopamine is a chemical communicator found in the brain and many other parts of the body.

    Both of these neurotransmitters are associated with your mental well-being, so it can be easy to confuse them. But there are also some key differences between the two.

    Only a healthcare professional can determine if you need to boost your serotonin levels. High levels of serotonin may lead to toxicity and unwanted side effects, so it's important to take your medications following a doctor's recommendations.

    Medication, as well as natural options, can increase serotonin levels.

    SSRIs

    SSRIs are the most commonly prescribed type of antidepressant medication. They increase serotonin levels in the brain by blocking the reabsorption of serotonin, so more of it remains active.

    When you're taking medications that affect serotonin, you'll want to speak with a doctor before using other medications or supplements. Mixing medications may put you at risk of a serious condition called serotonin syndrome.

    Supplements

    Some supplements may have the ability to raise serotonin levels. However, they're not a replacement for medications prescribed by a doctor and should not be taken alongside medications that affect your serotonin levels.

    Supplements that may affect serotonin include:

  • St. John's wort: The herb St. John's wort increases serotonin in the body. Some believe it is effective for treating depression, but this has not always been supported by research.
  • SAMe: This supplement is promoted as a treatment for depression, but more research is needed to understand its effects on mood and serotonin levels.
  • Tryptophan: This substance can be converted into serotonin in your brain, potentially raising your serotonin levels. Some research suggests it could help improve mood and reduce anxiety.
  • All of these supplements can increase your risk for serotonin syndrome, as well as cause other side effects and interactions.

    Speak with a healthcare professional before trying any new supplements or herbal remedies, especially if you're taking prescription drugs.

    Natural serotonin boosters

    The following strategies may help you balance your serotonin levels and improve your mood:

  • Exposure to bright light: Bright sunlight may help your mood, which is why light therapy is commonly recommended for treating seasonal depression. SAD lamps are an option for home therapy in winter or when access to bright sunlight is difficult.
  • Exercise: Regular exercise has many benefits for overall health. It can have mood-boosting effects and may trigger the release of serotonin.
  • Health-promoting diet: Following a balanced diet lowers the risk of many health conditions. Although research is limited, eating foods that may promote serotonin production could positively affect mood.
  • Meditation: Meditating can help relieve stress and promote a positive outlook on life.
  • Medications, supplements, and other substances that increase serotonin levels in your body can lead to serotonin syndrome.

    Serotonin syndrome can happen when you:

  • start taking a new medication that boosts serotonin levels
  • increase the dosage of an existing medication
  • take more medication than the amount prescribed
  • use an additional medication, supplement, or drug that also affects serotonin levels
  • Medications, supplements, and substances that affect serotonin levels include:

  • SSRIs
  • monoamine oxidase inhibitors (MAOIs)
  • dextromethorphan
  • many medications prescribed for mental health conditions
  • St. John's wort
  • SAMe
  • tryptophan
  • amphetamines
  • cocaine
  • MDMA (ecstasy)
  • The symptoms of serotonin syndrome include:

  • tremors
  • sweating
  • nausea
  • vomiting
  • restlessness
  • anxiety
  • Severe symptoms can include:

    To diagnose serotonin syndrome, a doctor will perform a detailed history and physical exam.

    Tests are not required for a diagnosis but may be requested to assess the severity of the symptoms and determine the treatment plan. These may include:

    In mild cases, a medical professional may ask you to stop taking the serotonin medication so that your symptoms can resolve. In more severe cases, they may use additional medications to treat the symptoms and reduce the risk of complications.

    Hospital treatment is typically necessary to manage severe serotonin syndrome. Usually, symptoms resolve within 24 to 72 hours if you receive prompt treatment.

    If you suspect serotonin syndrome, it's important to get medical attention immediately. Serotonin syndrome can be life threatening if left untreated.

    What does serotonin do to a person?

    Your body naturally produces serotonin, although its levels may vary depending on many factors. Serotonin affects your mood, sleep cycle, digestion, sex drive, and blood clotting, among many other things.

    Low levels of serotonin may lead to low mood (depression), and some people may need to take medications to boost their levels. Only a healthcare professional can determine if and when this is the case.

    Is anxiety a sign of too much serotonin?

    Anxiety and irritability can be symptoms of an increase in serotonin levels. Higher levels of serotonin may be a temporary reaction to starting some depression medications or combining different serotonin-boosting drugs.

    Anxiety, in general, is not a sign of too much serotonin in people who don't take these medications.

    Does serotonin make you happy?

    Serotonin is known as a "feel-good hormone." It's associated with mood regulation and the ability to experience pleasure.

    If your serotonin levels are persistently low, you may see an improvement in your mood once you start taking serotonin-boosting medications. Only a healthcare professional can determine if you may benefit from this type of treatment.

    Serotonin affects every part of your body, including mood regulation, blood clotting, and digestion.

    Sometimes, a serotonin imbalance can mean something more serious. It's important to pay attention to your body and talk with a doctor about any concerns.


    The Controversy Over Antidepressants

    Over the last few years, there has been an increasing number of commentators claiming that antidepressants don't work, that pharmaceutical companies lied, and that these drugs are overprescribed primarily because of the revenue they generate.

    A recent round of controversy was triggered by a review of the evidence base for what's known as the "serotonin hypothesis" for depression (Moncrieff and colleagues, 2023). The review concluded that there is little convincing evidence for lower-than-normal serotonin levels in patients with major depressive disorder.

    That's a problem, because the most widely prescribed antidepressants, the selective serotonin reuptake inhibitors (SSRIs), operate by increasing serotonin levels in the brain.

    Does that mean that the critics are right, that SSRIs are a conspiracy that puts profit over people, and that the whole pharmaceutical approach to treating depression has been conjured from a faulty hypothesis and biased studies?

    No.

    How antidepressants were discovered

    The discovery of antidepressants is a fascinating episode in the history of neuroscience. It is one of those cases in medical science where the chance discovery of an unexpected effect of a drug led to a sudden breakthrough in knowledge.

    In the 1950s, the Swiss psychiatrist Roland Kuhn was testing a new drug, imipramine, on schizophrenic patients (Brown and Rosdolsky, 2015). Despite having originally been developed as an antihistamine for the treatment of allergies, Kuhn speculated that imipramine might also have antipsychotic properties.

    It didn't. But, to Kuhn's surprise, some of his patients who were also suffering from depression showed a marked improvement in their symptoms.

    That prompted research into what imipramine does in the brain and the discovery that it increases the levels of several neurotransmitters, most significantly dopamine, noradrenaline, and serotonin, by blocking the reuptake of the transmitters back into cells after release.

    Pharmaceutical companies then refined and improved the mechanism of action of the antidepressant drugs. In the 1970s, researchers at Eli Lilly developed fluoxetine, the first selective serotonin reuptake inhibitor that didn't directly affect the other neurotransmitters. It was marketed as Prozac and proved a blockbuster success.

    The important point in terms of our understanding of depression is that the pharmaceutical discoveries and physiological discoveries were entirely intertwined.

    The "serotonin hypothesis" was first conceived because antidepressants work. The drugs revealed the role of serotonin in mood regulation, and researchers subsequently tried to make sense of how that might explain depression.

    Low levels of serotonin in depressive patients was an obvious idea to test.

    Where did the controversy come from?

    SSRIs gave clinicians a way to boost mood by driving serotonin levels up, but that doesn't necessarily mean that too little serotonin was the cause of the depressive symptoms in the first place.

    The primary goal of antidepressant treatment is to help patients with major depressive disorder escape the crushing lows of clinical depression, but depression is a complex disease with many possible causes.

    While the serotonin hypothesis does have some supporting evidence – many studies have shown a correlation between low serotonin and major depression (Arnone and colleagues, 2024) – it was always likely to be an oversimplification. An enticingly convenient way to explain to patients how and why SSRIs work.

    The simple hypothesis of "too little serotonin" as a universal explanation for depression has rightly fallen out of favour as the complexities of depression and the variability in patient responses to SSRIs have become clearer.

    That doesn't mean that antidepressants are a scam.

    New horizons

    Depression continues to be a serious healthcare burden and an active field of research. New hypotheses for depression are regularly proposed and debated—from the involvement of other neurotransmitters, to the effect of inflammation, to "neurotrophic" factors that regulate growth and regeneration. Notably, many of these new ideas have also arisen from the discovery of unexpected effects of drugs, such as ketamine and psilocybin.

    A common theme in a lot of this research, though, is that serotonin and SSRIs affect the operation of many of these other processes. Serotonin is a widely utilised neuromodulator that regulates a dizzying array of functions: sleep, sexual drive, appetite, memory formation, stress, movement, and more (it's almost easier to list things that serotonin doesn't contribute to).

    Depression is a complex, difficult condition to treat, especially with drugs that influence multiple, interlocking neural systems. A simple explanation was always a long shot. In science, hypotheses are supposed to be stress-tested to failure, and the fact that the simplest explanation for how antidepressants work has fallen away is not a cause for alarm.

    The theory of how antidepressants work can be wrong, their performance can be variable, time-dependent, and limited by troubling side effects, but they still work.

    They are still a valuable and effective treatment for many patients.






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