In response to the speaker’s wondering "why the pt is low in serotonin if she’s on an SSRI." SSRI’s actually deplete serotonin so the patient needs to take it concomitantly, just at least 6 hrs apart from meds. That’s one reason why the SSRIs stop working, and that is also why the patient's have discontinuation syndrome. Of course our approach is to start them off with the precursors only, no meds, to replenish the serotonin from the get-go, and they most likely will not need meds with their attendant often serious side effects. In fact, we also know that the SSRI's are largely placebo in mild- moderate depression.
In response to the speaker’s wondering "why the pt is low in serotonin if she’s on an SSRI." SSRI’s actually deplete serotonin so the patient needs to take it concomitantly, just at least 6 hrs apart from meds. That’s one reason why the SSRIs stop working, and that is also why the patient's have discontinuation syndrome. Of course our approach is to start them off with the precursors only, no meds, to replenish the serotonin from the get-go, and they most likely will not need meds with their attendant often serious side effects. In fact, we also know that the SSRI's are largely placebo in mild- moderate depression.