Since SSRI raise serotonin levels almost immediately , why isnt there an immediate effect if depressed people lack serotonin ?
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It’s almost entirely a myth that depression is linked with serotonin. There’s very little evidence to support that claim and it’s typically of bad quality. SSRIs themselves are the main evidence implicating serotonin in depression; we know SSRIs increase levels of serotonin AND that SSRIs help depression sometimes, so we made the assumption that depressed people lack serotonin. But we do not fully understand depression nor do we fully understand SSRIs. They’re very new drugs and the research on them is highly obfuscated due to the large amounts of money generated by them and monetary ties between researchers and pharmaceutical companies.
One theory I’ve read is actually that SSRIs take so long to work because they’re causing the person to essentially build a tolerance to serotonin. Some victims of suicide have been found to have an unusually high density of 5-HT2C receptors, and it’s hypothesized that chronic overstimulation by the increased levels of serotonin leads to downregulation of these receptors over time. It’s similar to how most other drugs start losing effectiveness over time as you build a tolerance.
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