Modulating the serotonin system in the treatment of major depressive disorder

CNS Spectrums ◽  
2014 ◽  
Vol 19 (S1) ◽  
pp. 54-68 ◽  
Author(s):  
Debbi Ann Morrissette ◽  
Stephen M. Stahl
Keyword(s):  
Major Depressive Disorder ◽  
Depressive Disorder ◽  
Psychiatric Illness ◽  
Atypical Antipsychotics ◽  
Treatment Resistance ◽  
Major Depressive ◽  
Serotonin System ◽  
And Behavior ◽  
5Ht Receptors

Learning Objective: Discuss the theory of modulation of receptor activity or the blockade of the reuptake of multiple neurotransmitter systems for the future treatment of MDD.Major depressive disorder (MDD) is a serious and often crippling psychiatric illness with a high risk of relapse and treatment resistance. In this article, we discuss the role of the serotonergic system in MDD including our current understanding of how various serotonin (5HT) receptors modulate monoamine neurotransmission and behavior. We also discuss how pharmacologic interventions, including novel and existing antidepressants and atypical antipsychotics, may be utilized to adjust serotonergic neurotransmission and provide more effective treatments for patients with MDD.

scholarly journals Exploring the Role of Gut Microbiota in Major Depressive Disorder and in Treatment Resistance to Antidepressants

Biomedicines ◽  
2020 ◽  
Vol 8 (9) ◽  
pp. 311
Author(s):  
Andrea Fontana ◽  
Mirko Manchia ◽  
Concetta Panebianco ◽  
Pasquale Paribello ◽  
Carlo Arzedi ◽  
...  
Keyword(s):  
Major Depressive Disorder ◽  
Gut Microbiota ◽  
Depressive Disorder ◽  
Treatment Resistance ◽  
Major Depressive ◽  
Bacterial Populations ◽  
The Family ◽  
Stool Samples ◽  
Penalized Logistic Regression

Major depressive disorder (MDD) is a common severe psychiatric illness, exhibiting sub-optimal response to existing pharmacological treatments. Although its etiopathogenesis is still not completely understood, recent findings suggest that an altered composition of the gut microbiota might play a role. Here we aimed to explore potential differences in the composition of the gut microbiota between patients with MDD and healthy controls (HC) and to identify possible signatures of treatment response by analyzing two groups of MDD patients characterized as treatment-resistant (TR) or responders (R) to antidepressants. Stool samples were collected from 34 MDD patients (8 TR, 19 R and 7 untreated) and 20 HC. Microbiota was characterized using the 16S metagenomic approach. A penalized logistic regression analysis algorithm was applied to identify bacterial populations that best discriminate the diagnostic groups. Statistically significant differences were identified for the families of Paenibacillaceae and Flavobacteriaceaea, for the genus Fenollaria, and the species Flintibacter butyricus, Christensenella timonensis, and Eisenbergiella massiliensis among others. The phyla Proteobacteria, Tenericutes and the family Peptostreptococcaceae were more abundant in TR, whereas the phylum Actinobacteria was enriched in R patients. Moreover, a number of bacteria only characterized the microbiota of TR patients, and many others were only detected in R. Our results confirm that dysbiosis is a hallmark of MDD and suggest that microbiota of TR patients significantly differs from responders to antidepressants. This finding further supports the relevance of an altered composition of the gut microbiota in the etiopathogenesis of MDD, suggesting a role in response to antidepressants.

scholarly journals The Way to a Human’s Brain Goes Through Their Stomach: Dietary Factors in Major Depressive Disorder

2020 ◽  
Vol 14 ◽  
Author(s):  
Janine Aly ◽  
Olivia Engmann
Keyword(s):  
Major Depressive Disorder ◽  
Depressive Disorder ◽  
Treatment Options ◽  
Dietary Factors ◽  
Omega 3 ◽  
Major Depressive ◽  
Number Of Patients ◽  
Omega 6 ◽  
And Behavior

Globally, more than 250 million people are affected by depression (major depressive disorder; MDD), a serious and debilitating mental disorder. Currently available treatment options can have substantial side effects and take weeks to be fully effective. Therefore, it is important to find safe alternatives, which act more rapidly and in a larger number of patients. While much research on MDD focuses on chronic stress as a main risk factor, we here make a point of exploring dietary factors as a somewhat overlooked, yet highly promising approach towards novel antidepressant pathways. Deficiencies in various groups of nutrients often occur in patients with mental disorders. These include vitamins, especially members of the B-complex (B6, B9, B12). Moreover, an imbalance of fatty acids, such as omega-3 and omega-6, or an insufficient supply with minerals, including magnesium and zinc, are related to MDD. While some of them are relevant for the synthesis of monoamines, others play a crucial role in inflammation, neuroprotection and the synthesis of growth factors. Evidence suggests that when deficiencies return to normal, changes in mood and behavior can be, at least in some cases, achieved. Furthermore, supplementation with dietary factors (so called “nutraceuticals”) may improve MDD symptoms even in the absence of a deficiency. Non-vital dietary factors may affect MDD symptoms as well. For instance, the most commonly consumed psychostimulant caffeine may improve behavioral and molecular markers of MDD. The molecular structure of most dietary factors is well known. Hence, dietary factors may provide important molecular tools to study and potentially help treat MDD symptoms. Within this review, we will discuss the role of dietary factors in MDD risk and symptomology, and critically discuss how they might serve as auxiliary treatments or preventative options for MDD.

Depression – Let’s Talk - Role of Aashwasan Chikitsa

2017 ◽  
Vol 2 (3) ◽  
Author(s):  
Priya Vishal Naik ◽  
Prachi Datta Dalvi U.
Keyword(s):  
Major Depressive Disorder ◽  
Depressive Disorder ◽  
Positive Attitude ◽  
Medical Intervention ◽  
Medical Illness ◽  
Suicidal Tendency ◽  
Major Depressive ◽  
Curative Therapy ◽  
Personal Interaction

The WHO theme for the year 2017 is Depression. Depression (major depressive disorder) is a common and serious medical illness that negatively affects how a person feels, thinks and behaves. Psychotherapy if incorporated along with medications can be of substantial help in depression. It is also called ‘talking therapy’ and is based on personal interaction with the patient. Patients suffering from this disorder do not easily accept it and hence do not feel the need to seek medical intervention or counselling. In this process the symptoms might get aggravated and suicidal tendency (which is the worst effect of this disease) may develop. So it is extremely essential for the patient, family and society to accept, talk, discuss and seek treatment for this disease. This ‘talking therapy’ is of utmost importance in today’s life where concept of privacy is taking its toll. This therapy is mentioned in Ayurveda as Aashwasan Chikitsa. Aashwasan Chikitsa consists of good, pleasing and benevolent thoughts, spiritual ideas, positive attitude, ethics and communication with near ones. So in the treatment of psychological disorders, along with medications counselling therapy plays a very important role. Finally counselling can act as a part of preventive, curative therapy and also aids to avoid recurrence in the patients of depression.

scholarly journals The Role of Dynorphin and the Kappa Opioid Receptor in Schizophrenia and Major Depressive Disorder: A Translational Approach

2020 ◽  
Author(s):  
Samuel David Clark
Keyword(s):  
Major Depressive Disorder ◽  
Depressive Disorder ◽  
Healthy Volunteers ◽  
Opioid Receptor ◽  
Clinical Data ◽  
Potential Role ◽  
Kappa Opioid Receptor ◽  
Kappa Opioid ◽  
Major Depressive

AbstractThe kappa opioid receptor (KOR) and its endogenous ligands dynorphins (DYN) have been implicated in the development or symptomatology of a variety of neuropsychiatric disorders. This review covers a brief history of the development of KOR agonists and antagonists, their effects in healthy volunteers, and the potential role of DYN/KOR dysfunction in schizophrenia and major depressive disorder from a translational perspective. The potential role of DYN/KOR dysfunction in schizophrenia is based on several lines of evidence. Selective KOR agonists induce affective states in healthy volunteers with similarities to the symptoms of schizophrenia. Studies have shown increased DYN in patients with schizophrenia, although the data have been mixed. Finally, meta-analytic data have shown that opioid antagonists are associated with reductions in the symptoms of schizophrenia. The potential role of DYN/KOR dysfunction in major depressive disorder is also based on a combination of preclinical and clinical data. Selective KOR agonists have shown pro-depressive effects in human volunteers, while selective KOR antagonists have shown robust efficacy in several preclinical models of antidepressant activity. Small studies have shown that nonselective KOR antagonists may have efficacy in treatment-resistant depression. Additionally, recent clinical data have shown that the KOR may be an effective target for treating anhedonia, a finding relevant to both schizophrenia and depression. Finally, recommendations are provided for translating preclinical models for schizophrenia and major depressive disorder into the clinic.

scholarly journals The shared role of oxidative stress and inflammation in major depressive disorder and nicotine dependence

2013 ◽  
Vol 37 (8) ◽  
pp. 1336-1345 ◽  
Author(s):  
Sandra Odebrecht Vargas Nunes ◽  
Heber Odebrecht Vargas ◽  
Eduardo Prado ◽  
Decio Sabbatini Barbosa ◽  
Luiz Picoli de Melo ◽  
...  
Keyword(s):  
Oxidative Stress ◽  
Major Depressive Disorder ◽  
Depressive Disorder ◽  
Nicotine Dependence ◽  
Major Depressive
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