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Mitochondria and Energetic Failures - A New Understanding of Antidepressant Withdrawal? An Interview with Chris Masterjohn

43m 54s

Mitochondria and Energetic Failures - A New Understanding of Antidepressant Withdrawal? An Interview with Chris Masterjohn

In this podcast episode, host Brooke Siem, author of a memoir on antidepressant withdrawal, interviews nutritional scientist Dr. Chris Masterjohn. The discussion centers on a critical re-evaluation of SSRIs and serotonin. Dr. Masterjohn argues that the prevailing model—which views serotonin primarily as a brain neurotransmitter regulating mood—is fundamentally flawed and incomplete. He contends that serotonin's main role is in systemic energy metabolism, helping mitochondria throughout the body adapt to fluctuating oxygen levels. This perspective explains the severe physical withdrawal symptoms both speakers have witnessed, such as extreme fatigue, muscle cramps, and tachycardia, which indicate a "catastrophic energetic deficit" rather than just psychological distress. Dr. Masterjohn's hypothesis, developed through client case studies and deep research, suggests that SSRIs disrupt this body-wide energy regulation system. Consequently, withdrawal involves a physiological crisis that current strategies like hyperbolic tapering cannot fully resolve for everyone. The conversation calls for moving beyond the narrow, drug-marketing-influenced view of serotonin to a holistic understanding that incorporates mitochondrial health and nutrition to properly address the full impact of antidepressants.

Transcription

6695 Words, 37734 Characters

English
Welcome to the Madden America Podcast, your source for science, psychiatry, and social justice. Welcome to the Madden America Podcast. My name is Brook Seen and I am the author of the award-winning memoir on antidepressant withdrawal, May Cause Side Effects. Today I am so excited because I am with Chris Masterjohn PhD. Chris is an nutritional scientist, former professor, and founder of Mytom. With a PhD in nutritional science and years of research in mitochondrial biology, Chris's work focuses on translating peer-reviewed science into practical tools for human health. At Mytom, Dr. Masterjohn pioneered the first analysis designed to measure mitochondrial respiratory chain function directly, identifying individual energy bottlenecks and guiding personalized science-back protocols to optimize the system responsible for over 90% of cellular energy production. His mission is to bring mitochondrial testing out of the rare disease space and into everyday health. And all of this is going to connect to his work around antidepressants and SSRIs, which is why I am specifically very excited to have him here today. Chris, thank you so much for being here. Thank you for having me. Great to be here. So I started researching more of you and your work back over in the summer because I had been following you for a while, and we had gone from talking a lot more about nutrition to suddenly talking about SSRIs. And in my case, I was put on a combination of effects or XR. And we'll be using XL when I was 15 as a kid. And my father had suddenly died. I was tossed on these drugs. And then I was almost drugs, one with four others for other side effects from the antidepressants for the next 15 years. And then I was suddenly pulled off of them by a psychiatrist, which sent me into horrific antidepressant withdrawal. And 10 years later, I am very lucky you'd say that I have healed, but I had spent so much of the past decade researching antidepressant withdrawal, trying to figure out what happened to me and generally just unpacking the nightmare that is the psychiatric system in this country and all over the world. And that is why I was so interested when I started reading your work because you are talking about angles of this that I have suspected for quite a while, but hadn't really seen anybody talk about. And that goes into my first question, it, which is, why do you care about antidepressants and antidepressant withdrawal? What led you to start researching this space? What I've been doing since around 2023 through earlier this year, I had been doing a biochemical optimization program for individual clients. And that often led to me having to do some research on why they were experiencing something in particular. And two of the people in that program had catastrophic post SSRI, energetic failures. The first one, he gave me an update at two weeks, six weeks, eight and a half months, and just recently had about 11 months. And he had looked for years to try to find improvement in his situation and really didn't get any until the protocol that he just got. But now this guy, he had lost 17 pounds of muscle and he gained it all back this year. He had stopped traveling because every time he was traveling somewhere, he wound up in the ER because he was having electrolyte issues and things like that. And now he's traveling all over the world and making PRs in the gym and totally excited about life now. So in both of these cases, they had effects of either going off SSRIs or switching SSRIs or both, along with some other drugs like Walbutrin, etc. And the general picture in the two of them was that there was something about going off SSRIs and switching SSRIs that produced completely new problems that weren't there before that were absolutely not psychological in nature. Now, I'm not saying there weren't psychological aspects to it. So in the second case, there were things like de-realization episodes and things like that that occurred. But even in the second case, the main problem was a massive energetic deficit. You could see this because he was in his 20s and he had spent an entire year where he couldn't get out of bed to go to the bathroom, so he had a portable bedside toilet or excuse me, no, that was one month, not one year. And that one month was inside of a larger year where he didn't even have the energy to be able to stand up in the shower. And then the other one, not so much fatigue, but things that are still energetic in nature. So for example, having to pee all the time, having a tachycardia, having cramps and muscle spasms, all of those are just very obvious signs of energetic deficits because your ability to control the distribution of water and electrolytes and your ability to control muscular contraction is all something you do with energy. I think everyone intuitively understands that in order to be strong, you need energy, they understand that in order to run fast, you need energy, but people generally don't immediately grasp until they start studying physiology that you need energy to relax your muscles and you need energy to control whether your muscles are contracted or relaxed. So the fact that they had each had a version of catastrophic energetic deficit and the fact that I was specifically working on how to optimize people's energy production not entirely, but primarily with micronutrients. Because I was doing that, I was running comprehensive biochemical data on them looking at what was happening inside their mitochondria, looking at what was happening to their metabolism of vitamins, minerals, carbohydrates, fats, and protein in their body. How are they converting food to energy? How are they using that energy, and what were the specific bottlenecks in that? I had access to all these data, but in order to really make sense of the historical picture, I needed to do that deep dive into how SSRIs were functioning. I'll say that the massive success over the first 11 months of case number one really convinced me that I was on to something. That is why it made so much sense to keep investing the research time into it. What I found convinced me that we totally don't understand what serotonin actually does in the body. Also, I don't even think the researchers who are trying to study SSRI discontinuation syndrome have the slightest clue what's causing it. I think they're all completely distracted by what is essentially an intellectually bankrupt model of how serotonin and SSRIs work, which is the idea that they're primarily acting inside the brain to pull levers on your personality. Everyone who knows, you know, in medicine and psychiatry knows that serotonin does other things besides acting on personality, and that's why we have things like serotonin syndrome. So if you overdose on serotonin syndrome, you're breathing too fast. Your body temperature goes too high and very, you know, lots of things happen that are not personality. But the main view is that the average general practitioner, the average psychiatrist, the average person who goes on SSRIs in the average researcher in the field is primarily thinking that the reason that serotonin is involved in depression or that antidepressants work in OCD or anxiety or depression and the reason that people have withdrawal when they go off them, and they think that all of that is primarily about pulling levers inside the brain that change your personality, and maybe there's side effects because you pulled too much on one of these levers. And, you know, yes, people do understand that the brainstem is also using serotonin to regulate sort of autonomic function. But even extending it to that is still really missing the major picture, which is that serotonin primarily acts outside the brain, and it's doing the same thing outside the brain that it's doing in the brain. Neurotransmitters explain some of personality. They don't explain the totality of human cognitive experience, or the totality of human perception, or the totality of human behavior, or the totality of anything. Serotonin is doing an analogous role in an energy metabolism throughout the entire body, but is in fact mostly acting outside the brain, and is in fact mostly acting outside of neurons, probably even in the brain, you know, to not be conscious of that is I think why no one can figure out what's going wrong in SSRI discontinuation and in post-essistriasexual dysfunction, and the big reason for that is that when SSRIs came out in the 80s, they plucked up one aspect of serotonin, one particular model for understanding it, and then they basically made the entire scientific research operation about serotonin, primarily act in the service of the marketing the SSRIs, and so even though if you go back in history before SSRIs came out, serotonin was discovered in the gut, then it was discovered in the, it was named after the fact that it's in the blood. But then, you know, once SSRIs came out, just the complete understanding of serotonin just moved into it's inside the brain, and it's pulling on these levers, and some of them are pulling on autonomic functions, some of them are pulling on, and you know, the big ones are pulling on personality, and until we exit that model and start to understand serotonin, SSRIs in a way more holistic way, no one's going to get anywhere on this, and that's why it was worth me spending several months publishing all that stuff, but it does fundamentally go back to the fact that I was trying to look at the power of nutrition to help people in general, including a couple of people who were suffering from those problems. You really hit on exactly what my problem is and what I've been seeing in the world of withdrawal and withdrawal researchers, and this is such a tricky conversation to have if you've spent a lot of time in this world, because there's so much progress in a lot of ways that has been made in the past, you know, Giovanni Fava first put out a paper in 2015 that started to really talk about antidepressant withdrawal, right? So that's the first time I saw it in literature, that was not that long ago. Then I think it was 2020-2021 where we started to see the word hyperbolic tapering get involved in what I'm seeing now is that the idea that hyperbolic tapering and slow tapering is the way because of, because of cert occupancy, right? Will you explain cert occupancy real quickly to the audience? So the serotonin transporter is being blocked by the SSRIs, and that type of tapering is not exclusive to SSRIs. Even the argument was based on the general principle that if you're taking a lot of a drug, the marginal increase in the dose that you're taking is having less and less of an effect because you're basically maxing out what you can get out of that. And that's just because the small doses are having a huge effect. So when you go backwards, you get these really small effects from going down a large amount early, but then as you go further down, you know, each five milligrams, you cut or each 10 milligrams, you cut or each 2 milligrams, you cut, is having way more physiological impact. And so therefore, you need to go slower and slower and slower when you go down. In the case of SSRIs, it's driven by the fact that the specific SSRI is binding to the serotonin transporter more weekly as you go up in dose, but it's just a broadly generalizable dose response effect. In a lot of ways, it makes a lot of sense, and I think it saved a lot of people a lot of suffering rather than like with me, I was pulled off cold turkey and I just have no idea what would have happened if I had been put on a more hyperbolic or slower taper. But the thing that I've started to see and the reason why I'm so interested in your work is that it's not a panacea hyperbolic tapering does not help everybody. And very often people can be going on a real great hyperbolic plan and then they run into a wall at some seemingly arbitrary dose of the SSRI. And then they run into a complete withdrawal full body problem. And when I started seeing that because people would breach out to me, they'd be sharing their stories. And then there's usually collection of symptoms that come with it, right? They very often become very hypersensitive. They can't reinstate the dose without having problems. They can't lower the dose without having problems. They are suddenly sensitive to caffeine or sugar or food or supplements. They are kind of trapped in this damned if you do, damned if you don't place. And when I started seeing that, it was telling me that the hyperbolic strategy is part of the story, but it's definitely not the whole story, at least not for all people. The very concept of using an SSRI inside a food first pharmacist approach is borderline insane because there are hundreds of randomized controlled trials on psychotherapy. There are hundreds of randomized controlled trials on nutrients. There are hundreds of randomized controlled trials on exercise. And the evidence basis does not put SSRIs in any special place. And so, you know, when people wind up on SSRIs, it's almost never because there was a rational trying of the least risky, highest potential payoff things first that then led down the ladder to the SSRI is usually because they were tried first. And so, that's just so foreign. No, totally fair. The reason why I brought that up is just because I think for folks who have been throughout, we have a little bit of a different perspective. And the reason why I say that is because so much of the time when people talk about it, it's like, yeah, the psychological issues are there. The depression and anxiety, that stuff, you can deal with that. You've been there, but it's the insane intrusive thoughts and then the physical side effects that are typically what are really messing with people. And when I think about the physical side effects, that's what tells me, okay, this is more than just an emotional thing. There's a full body problem here. And that's where your work, when you started talking about mitochondria, came into play where I said, okay, I think this guy's on something. So, can you basically explain your hypothesis about what SSRIs are doing to ourselves in a way that even us English majors can understand? It would help just for context to situate that in the context of a serotonin is doing. So, serotonin, if you look at its history, it was first discovered in the gut, and it was named in teramine. And teramine means an amino acid, amino acids are the building blocks of protein. Few years later, another group finds that it's in the blood. And in fact, the word serotonin, sero means serum. That's what it means. It's found in the blood. And they said, what does it do in the blood? It constricts blood vessels. And we now know that it doesn't constrict blood vessels by acting on the neurological control of blood vessel constriction. It acts directly on serotonin receptors on the muscle cells and causes them to contract the blood vessels to make them smaller. Which are found throughout the whole body, right? Throughout the entire body. Yeah, if you didn't have blood vessels in part of your body, it would die and it would fall off. The entire vascular that is serving to go to your lungs, pick up oxygen, bring it to the heart, get pumped through the body, deliver the oxygen to tissues, carry the deoxygenated blood back, repeat the cycle, all of that serotonin has the possibility of acting to constrict those blood vessels. All right, think about the names of those two things. And it's drawing your attention to the fact that it's in the gut and it's in the blood. So if you look at the word SSRI, it's referring to reuptake, which is a brain specific or a nervous system specific term. And that's referring to the fact that when two neurons talk to each other in order to carry out brain functions and nervous system functions, you've got one that releases serotonin, you've got the next one that's going to be responsive to it. And the point between there is the synapse. And if you can block the reuptake of serotonin back into the first neuron, you can allow it to stay in the synapse longer, which means it activates the second neuron for longer. So how did we, how do we take the S in SSRI and refer to something that's in the blood? And then we take the R and we pretend that it's only in the brain. And I think if you look to history, like I said before, what essentially happened is that the explosion of interest in psychedelics in the 60s and 70s in the research community led to the growth, the dominance of the neurotransmitter model of the brain. And so the idea was the promise of molecular biology and molecular biology is real, but it was purposefully cultivated to rise above all of the other ways that you could analyze humans like the energetic model or the organismal model or the evolutionary model or the environmental model and so on. And so when psychedelics exploded, they showed that you could take microgram quantities of something and put it under your tongue, and you're transported into a completely different state of consciousness for eight hours. And so this led to the idea of wow, there are specific molecules that control specific receptors inside the brain. And we can just pull one lever and make you a completely different person. And then we can pull a different lever and make you a totally different person. And this promise to be the fulfillment of your original idea of social control by allowing us to map out how all the different levers you could pull in the brain would impact psychology. So because this was so promising that suddenly when when we had a path to mapping that out, that kind of dominated everything else. And serotonin is very specifically related to the psychedelics because all the psychedelics can act, but on serotonin receptors. The guy D. L. Woolie who is credited with discovering the role of serotonin as a neurotransmitter, his interest in serotonin was completely the idea that serotonin was an anti-metabolite of LSD. If you just look at the history of SSRIs, he's credited with being the foundation of SSRIs because he developed the understanding of serotonin as a neurotransmitter in the brain. And so yes, serotonin is in the brain. And yes, it does things. And yes, you can increase your decrease it. And you will get different results in behavior and personality is that those things are true. But essentially that was extracted. It's just the way that the molecular biology was extracted from science in general to prioritize it above everything else. My point is you can make complete sense of why serotonin was named serotonin only by looking at that research because you're now you're looking at the role of serotonin the blood and the lungs and so on. Okay, so another the history you get the point. So serotonin is all about making sure that under conditions of inadequate oxygen supply, your mitochondria, which are the powerhouse of the cell, they're responsible for converting the food you eat into usable energy, using oxygen in the air that you breathe to make the energy and distribute it in the way that that is consistent with health. And serotonin is playing a role throughout the entire body including in the brain by saying you will always be undergoing times where the amount of oxygen compared to what the mitochondria need in that instant is inadequate. And it's jumping into that brink in order to bridge the gap and allow the mitochondria to function in that context and to adapt to it. Now some people intuitively when they hear me say not enough oxygen, they're like, oh, when you're drowning or oh, if you're getting strangled, but that's not the right way to think about it. Every time you take a breath in parts of your lungs are getting more oxygen than other parts. And if you distribute blood to the lungs evenly, you're going to waste a lot of the energy that the heart used to pump that blood to the lungs because it's not going to get as much oxygen from some parts versus others. And this is more true for us the way we breathe in the modern era because most of us don't breathe in a very healthy way. But it would be always, it would always be true no matter what that you take a breath in parts of your lungs are really oxygenated. Other parts are not so much serotonin plays the role as a traffic cop in every single breath you take to make the blood go to where the oxygen is and not get wasted, right? So whenever you're breathing, your heart is spending energy to pump blood to the lungs. The lungs are spending energy to inhale and exhale. You need an ROI. You need a return on your investment. And in order to do that efficiently, you need a traffic cop to make the blood go to where the oxygen is so it doesn't get wasted. So that's one context. Another context is waking up in the morning. When you're sleeping, one of the main benefits of deep sleep is that your mitochondria, which are working hard to make energy all day long, take a rest. They don't go down to zero, but they get become less active, produce less ATP. But you the rest of your body become so much even less active that the demand for energy sinks below what the mitochondria are making. And you restore the energy that you made that you use the previous day. Now, if you look at depression, people with insomnia are two times more likely to experience depression. Why? Because brain energy is the primary determinant of your ability to resist depressive thoughts and thought patterns and to motivate the networks that are involved in optimism. And so if you don't sleep, you don't restore yesterday's energy, your brain lacks that energy, and it can't go on. When you wake up, your mitochondria, the demand goes way up. But you notice when you wake up, you're usually that you might have a great day, and there might be some people wake up and they're ready to go. But most of us, we wake up and there's a little bit of lag before we feel good in the morning. That lag is at the. Like as soon as you wake up, your metabolic rate goes up, then you stand up, just standing up, compared to sitting burns 30% more energy. I don't know what standing up compared to laying down is, but it's even more than that, right? And now you're going to try to do something like you're going to go into the kitchen and make coffee. Now you're walking. So your demand is very rapidly going up. The mitochondria are going to take a half hour or an hour to really adjust to that. And so the key thing that allows that adaptation to go smoothly is morning sunlight is the primary stimulus to make serotonin in your brain. That serotonin helps the oxygen get to the mitochondria and helps them adjust to the low oxygen state and they catch up. One of the more common complaints about people who are in pretty severe withdrawal is that mornings are worse and that they tend to get better as the day goes on. And this is kind of explaining that a little bit potentially. Yeah, I think that's a that represents a dysfunction in the serotonin system. And then you might also have people who can't tolerate morning sunlight. And that is a deeper mitochondrial dysfunction because the sunlight is activating the energy metabolism, but there's something missing to allow it to take place. There's not a lot of trials on morning sunlight, but the one randomized control trial that was done showed that it was twice as effective as exercise at inducing remission from depression. And that's because serotonin, the primary driver of the content of serotonin the brain is sunlight. So you wake up in the morning, sunlight makes more serotonin, serotonin helps the mitochondria. So let's tie this back to the two original discoveries of serotonin. Suddenly, after we reject the neurotransmitter, or not reject it, but after we allow ourselves to think bigger than the neurotransmitter model of the brain, and that's what serotonin is, suddenly we can make tremendous sense out of the original discoveries. Not wise, 95% of the serotonin your body and your gut because your gut is the most hypoxic part of your body. You define hypoxic for the audience. Not having oxygen. Yeah. So the lining of the gut that does all the digestion does not have access to the oxygen that you're breathing. The only way to get oxygen there is for the blood supply to come up underneath the gut lining and permeate the gut lining. So you've got the blood supply coming up at the bottom. It's got to go through a lot of cells before it gets up there. So the oxygen level in the actual layer of the gut where the food is coming in is very, very low. On top of that, when you, it requires about 10% of your total energy budget to digest your food. And then on top of that, you've got your microbiome inside your gut that are consuming oxygen for their metabolism. So the gut is very low level of oxygen. When you eat food, that food is going to take up 10% of your total of your total energy expenditure to digest. If that food sits in one segment of the gut instead of moving, all of that oxygen utilization happens in that segment. That segment is going to essentially going to die or it's going to get very sick. It's going to get very sick. If that doesn't fix itself, it's going to wind up dying because all of the oxygen is being spent and it doesn't have any access to any more. So what does serotonin do? It stimulates gut motility to move the food along. And that helps each segment deal with the relative lack of oxygen. Why does seroton constrict blood vessels? Because when it's acting as a traffic cop in the lungs, it needs to constrict the blood vessels that would go to the parts of the lung that don't have oxygen. And it allows the blood vessels to be open when it goes to the other parts. So every breath we take, serotonin is helping negotiate where, act as the traffic cop, to make sure the blood goes to the well-oxygened parts of our lungs. If we still don't have enough oxygen relative to our demands, serotonin is going to act in the brainstem to speed up the breathing rate. It's going to act in the lungs to speed up the breathing rate and help us adapt to that. It's going to then go into tissues and help their mitochondria deal with the lack of oxygen by improving mitochondrial function and improving mitochondrial resilience. And it's doing this throughout the entire brain and throughout the body. So if you look, for example, at where serotonin serotonin receptors are and the serotonin transmitter are, they're important in every tissue, but the brain, the gut, and the reproductive tissues really stand out as being very high. Sorry, which makes sense because when we talk about people who are in withdrawal or people who have pretty major side effects, honestly, the three that I hear the most are some sort of emotional blunting, which would be brain and emotions theoretically, right? Gut issues and then we have reproductive health issues like the SSD. Yeah, you look everywhere from the lungs through the blood in the gut to the brain. Everything about serotonin says that it's about helping mitochondria deal with relative deficits of oxygen. Okay. Now SSRIs come into the picture and the only real thing that's acknowledged in psychiatry and medicine is that there's two weeks of nausea that occur at the beginning of SSRI treatment. And it's because it's acting on serotonin receptors and the gut overstimulating them and it's saying like how can, and you know, by the way, if gut motility doesn't work to support preventing parts of the gut from not having enough oxygen, what do you get? You either get diarrhea or you get vomiting. Those are the those are the those are the emergency valves for getting rid of gut food in the gut that the gut can't handle digesting. So anyway, medicine acknowledges that there's a couple of weeks of nausea and potentially vomiting with early SSRI treatment. Then it goes away. Why does it go away? My theory is because you're urinating out all the serotonin. So there's there's this idea out there that SSRIs boost your serotonin. And there's another idea out there that they, you know, some people that are most sophisticated think that they, you know, they reset the serotonergic system or, you know, some kind of high-level fancy language like that. But SSRIs cause massive whole body depletion of serotonin and it's completed by at least as early as the second week. And it's mediated by causing you to pee out all the serotonin and it lasts long term. There's no adaptation to it because if you look at people who've been on SSRIs for close to a year, they're they all have an average of 14 fold less serotonin in their blood. Outside the brain, usually what's happening is the general direction is the gut makes the serotonin. Serotonin goes into the blood. The platelets take it up and store it. And the platelets release it under hypoxic stress. And some of that winds up making its way to the lungs or the liver to get degraded. And then the degradation products leave in the urine. That's what normally happens, right? So you take the SSRI. I think what's happening, I think the reason the nausea is is usually self-limiting is that you don't change the amount of serotonin in the gut at first, but you make it all extracellular so it's actin other receptors that cause nausea and vomiting. Now that more of it is extracellular, more of it goes into the blood where it has access to the urine. Almost everything in the kidneys is just is just getting pushed into the urine no matter what it is. Then the kidney uses its active metabolism to take that what it wants back in, right? So something leaving into the urine is usually passive. Something being conserved in the body is active. So more serotonin winds up in the blood. More is exposed to the kidney, but the kidney now cannot use the serotonin transporter to suck it back up. So all of that gets left in the urine. That will be blocked by the SSRI. Yeah. Now in the brain, the brain most of the serotones being made in the brain stem. And so it is the case that you are encouraging the serotonin to be more extracellular and that might make it more likely that it enters a general circulation and can leave the body. But it's way less impacted because it's being produced in the brain. And because the brain blood brain barrier is not allowing constant back and forth of serotonin. And so it's relatively compacted. But it's still the case that you would be shocked at how little there is in the research basis on what happens to brain serotonin. When you're on SSRIs, there's like four or five animal studies. It's just bizarre that that like whatever anyone says about what happens to brain serotonin on SSRIs is invent is not based on the evidence. It's based on their theory. It's based on assumptions. And what I can say the evidence says is that there's a handful of animal experiments that show totally conflicting results. I believe I found the reason that they're totally conflicting. And it's because SSRIs after they block the serotonin from entering the cell, they go into the cell. The SSRI goes into the cell with 100% efficacy such that the free amount of SSRI inside the cell is always going to be equal to the free amount of SSRI outside the cell. And they're named by their actions on the outside of the cell, specifically in the brain, specifically between two neurons is if they don't do anything else, but everywhere in the entire body that going into the cells and they're doing other things, they're activating other receptors that have nothing to do with the serotonin transport system that activate mitochondrial stress pathways. And part of those pathways is to increase serotonin production. The sigma one receptor is the main receptor that is responsible for that effect. I had to piece together, you know, parse experiments to make this fit together into a coherent story, but we know for example that the sigma one receptor, or at least we know from like one study that the sigma one receptor increases the amount of serotonin that's in the cell. We know from another experiment that it increases the amount of serotonin transport in the membrane. We, you know, we piece together what the things that it's doing. And we know that the different SSRI's mind of the sigma one receptor with a 52 fold difference in their activity. Now, the whole point of that discussion was it looks like the, it looks like some SSRI's that activate the sigma one receptor increase brain serotonin and the ones that don't decrease it. That's what it looks like from the animal experiments. In our last couple minutes here, since we are going to do a part two, let me just break down what I'm hearing and, and then you can again, tell me if it's correct or not. But what I, what I've really learned from your work is that our cells have our powerhouse called the mitochondria, which is where we produce energy to do everything from going to run up a mountain to going to work to sleeping, to thinking, to just breathing. So we need our mitochondria working well to create energy for us to exist. Serotonin is vitally important to keeping that mitochondria healthy. When we take an SSRI, we drastically interfere with how the serotonin is naturally working in the cell and with the mitochondria all over the entire body. And then my extrapolation of that because I'm so interested in withdrawal, specifically, is that when we remove the SSRI, we have created so many issues within the way our cells are working that that is likely why there are so many different types of withdrawal and so many different bodily functions that go haywire. And it's not the same for person A as it is for person B. Yeah, I think that what's happening is there are various effects on the mitochondria that differ between the different SSRIs and then will interact with genetic and nutritional very and other lifestyle, et cetera, variations in the human response to those things. And so, you know, you mentioned at the top of the hour that I that I have a mitochondrial testing company, I ran that test on the two people in my program who had post SSRI catastrophes and they were on different SSRIs, they had different switching going leading to their problems, but they had opposite effects on the abundance of mitochondria, right? So, you can wind up with too many mitochondria, or you can make wind up with not enough and some might say, well, well, why is too many harmful? It's not so much because you have a lot of them. It's because when you don't have the normal break them down, build them up process, you can't do quality control. So, if you wind up not able to break down your mitochondria, you wind up with too many dysfunctional mitochondria. And then there are, you know, various specific things going on where it's just they look like they have opposite those two people and opposite responses to the whole oxygen regulation system that serotonin is involved with. And so, I think that I and I currently am trying to organize research to look systematically at what happens when someone does a six-week randomized people to a standard six-week taper or to a horrible style lengthened, you know, correctly structured taper. What's happening to biochemistry and mitochondrial function during that? But I think, yes, I think my hypothesis is that SSRI discontinuation is mitochondrial dysfunction, SSRIs have positive effects and negative effects in the mitochondria, but they also have effects that would be positive if they were stimulated naturally. So, the single one receptor, for example, it's supposed to be cyclically and rhythmically activated through our stress response and our recovery. We're supposed to go in and out of it like exercise. And if you take that and you pervert it into a pedal to the metal like, you know, I tied a brick to the gas pedal and it's on all the time, you know, is that good or bad? Well, it's I think it's a good thing gone bad because it's not supposed to be activated that way. And then I think, you know, the different people with their genetics, their nutrition, their lifestyle, and everything, their experience, everything that's, you know, the last half a century or whatever went into who you are right now creates individual variations in what part of that system has gone wrong. And that's a big part of, I think, on the other end of doing the research, we're not going to find that there's a one-size-fits-all solution for people. I think we're going to find that there's, you know, a variety of maybe, you know, maybe there's a few things that everyone should be doing, but there's a lot of things that we need to actually like elucidate that person's biochemistry to understand what they should be doing. Amazing. Thank you so much for your time here, Chris. Is there anything you would like to leave the audience with as we finish up part one going into part two? Well, you can find me at chrismasterjohnphd.substac.com for my newsletter. You can find mydo.me for the mitochondrial testing, and my message is always think about your mitochondria first, and always use a food first, pharma-last approach. You know, it's wonderful that we have the technology to be able to have pharmaceuticals, but we really need to resist the profit motive that is just massively overusing them and trying to use them first to solve problems that. Have much better, safer solutions when approached naturally. Amazing. Thank you so much, and I can't wait for part two. We'll talk soon. Awesome. Talk to you soon. Thank you for listening to the Madden America podcast. For more news, views, and updates, visit maddenamerica.com.

Podcast Summary

Key Points:

  1. The podcast discusses the limitations of current understanding regarding SSRIs and serotonin, arguing that the dominant neurotransmitter model is incomplete and overlooks serotonin's primary role in systemic energy metabolism and mitochondrial function.
  2. Personal experiences with severe antidepressant withdrawal are shared, highlighting physical symptoms like catastrophic energetic deficits, which challenge the purely psychological model of withdrawal and suggest a full-body physiological disruption.
  3. A hypothesis is presented that serotonin fundamentally helps mitochondria adapt to low oxygen conditions throughout the body, and that SSRIs disrupt this system-wide energy regulation, leading to withdrawal symptoms that are not addressed by current tapering strategies alone.
  4. The conversation critiques the historical and marketing-driven focus on serotonin in the brain, advocating for a more holistic, nutrition and mitochondria-focused approach to understanding and treating the physical consequences of SSRI use and discontinuation.

Summary:

In this podcast episode, host Brooke Siem, author of a memoir on antidepressant withdrawal, interviews nutritional scientist Dr. Chris Masterjohn. The discussion centers on a critical re-evaluation of SSRIs and serotonin. Dr. Masterjohn argues that the prevailing model—which views serotonin primarily as a brain neurotransmitter regulating mood—is fundamentally flawed and incomplete. He contends that serotonin's main role is in systemic energy metabolism, helping mitochondria throughout the body adapt to fluctuating oxygen levels.

This perspective explains the severe physical withdrawal symptoms both speakers have witnessed, such as extreme fatigue, muscle cramps, and tachycardia, which indicate a "catastrophic energetic deficit" rather than just psychological distress. Dr. Masterjohn's hypothesis, developed through client case studies and deep research, suggests that SSRIs disrupt this body-wide energy regulation system. Consequently, withdrawal involves a physiological crisis that current strategies like hyperbolic tapering cannot fully resolve for everyone. The conversation calls for moving beyond the narrow, drug-marketing-influenced view of serotonin to a holistic understanding that incorporates mitochondrial health and nutrition to properly address the full impact of antidepressants.

FAQs

His work focuses on translating peer-reviewed nutritional science into practical tools for human health, particularly through mitochondrial testing to identify energy bottlenecks and guide personalized protocols.

He began researching after two clients in his biochemical optimization program experienced severe energetic deficits following SSRI discontinuation, which he linked to mitochondrial dysfunction.

A common misconception is that SSRIs primarily act in the brain to influence personality, whereas serotonin actually plays a broader role in energy metabolism throughout the entire body.

Hyperbolic tapering involves gradually reducing SSRI doses to minimize withdrawal, but it may not prevent all withdrawal symptoms because it doesn't address underlying energetic deficits or mitochondrial issues.

Serotonin acts throughout the body, such as constricting blood vessels and regulating mitochondrial energy production, not just as a neurotransmitter in the brain.

Symptoms include severe fatigue, muscle cramps, tachycardia, frequent urination, and hypersensitivity to substances like caffeine or sugar, indicating energetic deficits.

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