Recent developments in the psychobiology and pharmacotherapy of depression: optimising existing treatments and novel approaches for the future
by
Farvolden P, Kennedy SH, Lam RW.
Centre for Addiction and Mental Health,
250 College Street, Toronto, Ontario, M5T 1R8, Canada.
peter_farvolden@camh.net
Expert Opin Investig Drugs 2003 Jan;12(1):65-86


ABSTRACT

Effective antidepressants include monoamine oxidase inhibitors and tricyclic antidepressants, selective serotonin re-uptake inhibitors and novel agents, including serotonin and noradrenaline re-uptake inhibitors. Although effective, current treatments most often produce partial symptomatic improvement (response) rather than symptom resolution and optimal functioning (remission). While current pharmacotherapies target monoaminergic systems, different symptoms of major depressive disorder (MDD) may have distinct neurobiological underpinnings and other neurobiological systems are likely involved in the pathogenesis of MDD. In this article a review of current pharmacotherapeutic options for MDD, current understanding of the neurobiology and pathogenesis of MDD and a review of new and promising directions in pharmacological research will be provided. It is generally accepted that no single neurotransmitter or system is responsible for the dysregulation found in MDD. While agents that affect monoaminergic systems will likely continue to be first-line treatments for MDD for the foreseeable future, a number of new and novel agents, including corticotropin-releasing factor antagonists, substance P antagonists and antiglucocorticoids show considerable promise for refining treatment options. In order to better understand the neurobiology and treatment response of MDD, it is probable that more sophisticated theory-driven typologies of MDD will have to be developed.

CRH
NMDA
SSRIs
NARIs
RIMAs
1990s
Arepitant
Antisense
SNAP-7941
Siramesine
Netamiftide
Agomelatine
Comparisons
Neurotrophins
New anxiolytics
Vagus stimulation
GABA-ergic drugs
New antidepressants
Neurokinins/substance P
SNaRIs, NaSSAs, and NaRIs
Delta-opioid receptor agonists
CFR-1 antagonists: antalarmin
Beyond the monoamine hypothesis
Vasopressin V1b receptor antagonists
Mood enhancement via stem cell therapy


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