eli5: How do antidepressant actually work?

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I always hear people say the monoamine hypothesis of depression is outdated, so what’s actually happening and why is their a delay in symptom reduction when starting? Brain changes are seen a few hours after first dose

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Nobody is 100% sure. Thats where we are – there are lots of hypotheses but when ketamine comes along and seems to work instantly whereas prozac takes weeks then all bets are off,

A very basic explanation is that they connect with seratonin (a hormone which helps regulate mood and mental function) receptors to encourage your body to produce more seratonin and level out your hormones. However, there are dozens of different kinds of anti-depressents. Patients may trial any number of medications till they find one that works, i went through 3 personally. Each person reacts very differently.

The current theory appears to be that there is some intrinsic factor of the serotonin receptor that is responsible for the symptoms of depression. Therefore, by blocking the reuptake of serotonin (pretty much every antidepressant does this to some extent), there is more of it in the brain. This leads to a reduction in the number of receptors, which reduces the symptoms.