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Psychiatry & Psychotherapy Podcast

The Serotonin Hypothesis: Controversies and Nuance with Awais Aftab, MD

Psychiatry & Psychotherapy Podcast

David J Puder

Science, Health & Fitness, Medicine

4.81.3K Ratings

🗓️ 14 March 2025

⏱️ 77 minutes

🧾️ Download transcript

Summary

Is depression really caused by low serotonin? Dr. Awais Aftab joins Dr. David Puder to explore the serotonin hypothesis, antidepressant efficacy, and the controversies surrounding SSRIs. They dive into the history of the serotonin deficiency theory, key research on antidepressants vs. placebo, and how neuroplasticity, psychotherapy, and lifestyle changes factor into depression treatment. The episode also examines differences between major treatment guidelines, including RANZCP and NICE, and what the latest evidence suggests about the future of mental health care.

By listening to this episode, you can earn 1.25 Psychiatry CME Credits.

Link to blog.

Link to YouTube video.

Links for Dr. Awais Aftab:

Substack

World Psychiatry

Conversations in Critical Psychiatry

Transcript

Click on a timestamp to play from that location

0:00.0

All right, welcome back to the podcast. I am joined with Avess Offtop. He is a psychiatrist psychiatrist in practice and Cleveland, Ohio, he is into psychiatry and where sort of anti-scikiatry

0:30.3

meets psychiatry. He is a practicing psychiatrist who runs an IOP partial program with about 40 patients.

0:37.0

He publishes on the psychiatry and philosophy and he has a very popular sub-stack, what is it called?

0:45.9

And psychiatry had the margins, psychiatry margins,

0:48.2

I wanted to get that right.

0:49.5

And he also is very popular on X, formerly known as Twitter,

0:54.5

with about 23,000 followers.

0:57.9

He often engages topics that are

1:02.7

conflictual with nuance and articulation. And I am happy today to have them on to talk about the serotonin hypothesis and antidepressants

1:12.7

and

1:13.9

we have or he has pre-written which I have commented on a

1:19.2

article that is

1:20.9

21 pages so right now and it goes through all of the different articulations

1:27.0

on the different theory, the conflicts in the theory,

1:31.5

and the main article, Moncreef at all, 2022,

1:36.2

which we'll be talking about,

1:37.4

which was a meta-analysis and critical review,

1:41.0

and then people that counter that.

1:42.7

So I hope this is a discussion that's helpful for you.

1:46.8

And so welcome to the podcast.

1:48.7

Thank you, David.

1:49.8

Pleasure to be here.

...

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