scholarly journals The NMDA receptor and new possibilities in antidepressant therapy

2018 ◽  
Vol 72 ◽  
pp. 788-794
Author(s):  
Weronika Stasiuk ◽  
Monika Prendecka ◽  
Krzysztof Chara ◽  
Teresa Małecka-Massalska
Keyword(s):  
Nmda Receptor ◽  
Affective Disorders ◽  
Depressive Disorders ◽  
Treatment Strategies ◽  
Antidepressant Effect ◽  
Antidepressant Medications ◽  
Treatment Of Depression ◽  
Potential Alternative ◽  
Disorder Treatment

Due to the inadequate effectiveness of pharmacological methods currently being utilized in the treatment of depression, there is an ongoing need to find newer and safer treatment strategies. Studies undertaken to date aimed at finding more effective methods for the treatment of affective disorders have been widened to incorporate other neurotransmission systems. Experiments with compounds that modify the function of the glutamatergic system highlight a new direction in the study of affective disorder treatment methods. It has been shown that one of the key mechanisms in achieving an antidepressant effect is by weakening the function of the NMDA receptor. Pre-clinical as well as clinical trials have revealed that compounds that modulate the activity of the NMDA receptor are characterized by a significant antidepressant effect which identifies them as potential antidepressant medications. In this study an attempt was made at identifying the role of the NMDA receptor in the pathogenesis and therapy of depressive disorders as well as the influence of ligands (especially antagonist) of this receptor on the function of classical antidepressant medications. Results shown in the attached studies by numerous scientists will in the future potentially add to the development of more effective and safer therapies for patients with affective disorders as well as offering a potential alternative in the treatment of drug resistant forms of depression.

scholarly journals New Treatment Strategies of Depression: Based on Mechanisms Related to Neuroplasticity

2017 ◽  
Vol 2017 ◽  
pp. 1-11 ◽  
Author(s):  
Yu-Jhen Huang ◽  
Hsien-Yuan Lane ◽  
Chieh-Hsin Lin
Keyword(s):  
Nmda Receptor ◽  
Brain Stimulation ◽  
Depressive Disorders ◽  
Treatment Strategies ◽  
Nmda Receptor Antagonist ◽  
Brain Dysfunction ◽  
Antidepressant Effect ◽  
Noninvasive Brain Stimulation ◽  
Magnetic Seizure Therapy ◽  
New Treatment

Major depressive disorder is a severe and complex mental disorder. Impaired neurotransmission and disrupted signalling pathways may influence neuroplasticity, which is involved in the brain dysfunction in depression. Traditional neurobiological theories of depression, such as monoamine hypothesis, cannot fully explain the whole picture of depressive disorders. In this review, we discussed new treatment directions of depression, including modulation of glutamatergic system and noninvasive brain stimulation. Dysfunction of glutamatergic neurotransmission plays an important role in the pathophysiology of depression. Ketamine, an N-methyl-D-aspartate (NMDA) receptor antagonist, has rapid and lasting antidepressive effects in previous studies. In addition to ketamine, other glutamatergic modulators, such as sarcosine, also show potential antidepressant effect in animal models or clinical trials. Noninvasive brain stimulation is another new treatment strategy beyond pharmacotherapy. Growing evidence has demonstrated that superficial brain stimulations, such as transcranial magnetic stimulation, transcranial direct current stimulation, cranial electrotherapy stimulation, and magnetic seizure therapy, can improve depressive symptoms. The antidepressive effect of these brain stimulations may be through modulating neuroplasticity. In conclusion, drugs that modulate neurotransmission via NMDA receptor and noninvasive brain stimulation may provide new directions of treatment for depression. Furthermore, exploring the underlying mechanisms will help in developing novel therapies for depression in the future.

scholarly journals Gut Microbiota in Depression: A Focus on Ketamine

2021 ◽  
Vol 15 ◽  
Author(s):  
Alina Wilkowska ◽  
Łukasz Piotr Szałach ◽  
Wiesław Jerzy Cubała
Keyword(s):  
Gut Microbiota ◽  
Treatment Strategies ◽  
Antidepressant Effect ◽  
Global Burden ◽  
Major Contributor ◽  
Treatment Resistant ◽  
Major Depressive ◽  
Animal Models Of Depression ◽  
Treatment Of Depression

According to the WHO, major depressive disorder is the leading cause of disability worldwide, and it is a major contributor to the overall global burden of disease. The pathophysiology of this common and chronic disease is still not completely understood. The gut microbiome is an increasingly recognized environmental factor that can have a role in depression, acting through the gut–microbiota–brain axis. The available treatment for depression is still insufficient since 30% of patients are treatment-resistant. There is an unquestionable need for novel strategies. Ketamine is an effective antidepressant in treatment-resistant patients. It is suggested that the antidepressant effect of ketamine may be partially mediated by the modification of gut microbiota. In this study, we presented a review of data on gut microbiota in depression with special attention to the effect of ketamine on the microbiome in animal models of depression. Earlier reports are preliminary and are still insufficient to draw firm conclusion, but further studies in this field might help to understand the role of the gut–brain axis in the treatment of depression and might be the ground for developing new effective treatment strategies.

Glucocorticoids in the Physiological and Transcriptional Regulation of 5-HT1A Receptor and the Pathogenesis of Depression

2020 ◽  
pp. 107385842097571
Author(s):  
Darakhshan Jabeen Haleem
Keyword(s):  
Transcriptional Regulation ◽  
Critical Role ◽  
Treatment Strategies ◽  
Therapeutic Agents ◽  
Stressful Events ◽  
Antagonist Activity ◽  
Treatment Of Depression ◽  
Prevalence Of Depression ◽  
Circulating Levels

There is growing increase in the global prevalence of depression, but treatment outcome of this highly disabling disease is not satisfactory. Many patients are not benefitted by the currently prescribed antidepressants—together with this partial remission is very common. Improving treatment strategies and developing better therapeutic agents for treating depression is therefore highly needed. Stress-related epigenetic changes play a critical role in the pathogenesis as well as treatment of depression. Stressful events activate hypothalamic-pituitary-adrenal axis to increase circulating levels of glucocorticoids (GCs), and a greater sensitivity to this fright and flight response increases risk of depression. A role of serotonin (5-hydroxytryptamine; 5-HT) in responses to stress and in the pathogenesis and treatment of depression is well established. Substantial evidence supports a critical role of 5-HT1A receptors in these effects of 5-HT. The present article targets stress-induced higher and sustained increases of GCs and mediated influences on the physiological as well transcriptional regulation of 5-HT1A receptors to evaluate their causal role in the pathogenesis of depression. It is suggested that synthetic compounds with antagonist activity for GC receptors and agonist activity for 5-HT1A receptors may prove better therapeutic agents for treating depression.

Self-Directed Approaches to the Treatment of Depression

2016 ◽  
pp. 468-477
Author(s):  
Pim Cuijpers ◽  
Annet Kleiboer
Keyword(s):  
Depressive Disorders ◽  
Future Research ◽  
Evidence Based ◽  
Advantages And Disadvantages ◽  
Self Help ◽  
Treatment Of Depression ◽  
High Prevalence ◽  
Evidence Based Treatments ◽  
The Common

This article examines self-directed approaches to the treatment of depression. It first considers some of the reasons why the uptake of mental health services by depressed people is low, despite the high prevalence of depressive disorders and the availability of evidence-based treatments. It then looks at the role of self-management in increasing access to evidence-based treatments for depression. It also defines what self-directed treatments are and goes on to discuss the different types of self-directed therapy, the common components of self-directed interventions for depression, Internet-based interventions for depression, and the advantages and disadvantages of self-directed interventions. Finally, it summarizes the findings from research on self-directed interventions for depression and suggests directions for future research and development in this area. Some titles of self-help books that can be used in self-directed interventions are presented.

scholarly journals Assessing the Evidence of Micronutrients on Depression among Children and Adolescents: An Evidence Gap Map

2020 ◽  
Vol 11 (4) ◽  
pp. 908-927
Author(s):  
Susan C Campisi ◽  
Clare Zasowski ◽  
Shailja Shah ◽  
Ashka Shah ◽  
Glyneva Bradley-Ridout ◽  
...  
Keyword(s):  
Children And Adolescents ◽  
Depressive Disorders ◽  
Unipolar Depression ◽  
Eligibility Criteria ◽  
Treatment Of Depression ◽  
Comprehensive Search ◽  
Major Depressive Disorders ◽  
Severity Of Depression ◽  
The Impact

ABSTRACT There is some evidence indicating that nutrition may have the ability to prevent, treat, and/or influence the severity of depression. The aims of this evidence gap map (EGM) are to provide an overview and to determine evidence gaps in the existing research on micronutrients and their impact on depression among children and adolescents. We conducted a comprehensive search in multiple databases of primary and secondary literature assessing the impact of micronutrients on depression-related outcomes such as unipolar depression, major depressive disorders, dysthymia, acute depression, and mood disorders. Abstracts and full-text articles were dual-screened based on predefined eligibility criteria. A total of 30 primary research publications were included in the EGM. About 47% of included studies focused on late adolescents (15–19 y), ∼40% on early adolescents (10–14 y), and ∼13% on children aged 6–9 y. Among the included studies, 8 studies examined a single micronutrient intervention and 22 studies examined micronutrient concentrations (either intake or serum), and their impact on depression. The most frequently studied micronutrients were vitamin D (n = 8), zinc (n = 8), iron (n = 6), folate (n = 7), and vitamin B-12 (n = 5). More longitudinal studies and trials are needed to determine the role of micronutrients in the etiology and treatment of depression among children and adolescents.

scholarly journals The Role of Brain-Derived Neurotrophic Factor in Mediating the Action of Antidepressants in the Treatment of Depression

2019 ◽  
Vol 74 (1) ◽  
pp. 20-28 ◽  
Author(s):  
Tamara I. Vazagaeva ◽  
Roman V. Akhapkin ◽  
Yuri A. Alexandrovsky
Keyword(s):  
Neurotrophic Factor ◽  
Depressive Disorders ◽  
Therapeutic Response ◽  
Molecular Genetic ◽  
Genetic Studies ◽  
Trkb Receptor ◽  
Treatment Of Depression ◽  
Antidepressant Efficacy ◽  
Chronic Course

According to the neurotrophic hypothesis of depression proposed two decades ago, the most important role in the pathogenesis of depressive disorders is played by abnormalities in the maintenance of neuronal plasticity regulated by brain neurotrophic factor (BDNF). Although the decline in BDNF activity in depression is now widely documented, it remains unclear whether it is a factor contributing to the onset of depression, or a consequence of the chronic course of the disease. In preclinical studies, it was found that exogenous BDNF infusions causes antidepressant-like effects, prevents the depressogenic effects of chronic stress and increases cell survival in the hippocampus and the prefrontal cortex, but the mechanisms mediating these effects have not been fully studied. The results of molecular genetic studies confirmed that BDNF is essential in mediating the therapeutic effect of antidepressants, while the role of genetic polymorphisms in predicting antidepressant efficacy in depression remains uncertain. The mechanisms of action of monoaminergic antidepressants are related to their effect on the expression of BDNF and its TrkB receptor, however, apparently, the effect size varies for different drugs. Peripheral BDNF levels increase during treatment with antidepressants, and this increase is clearly observed only during the acute phase treatment of depression, but not during the period of maintenance therapy. The serum level of BDNF is a potentially useful marker for diagnosing depression and prediction of a therapeutic response.

Mood disorders

2012 ◽  
pp. 205-253 ◽  
Author(s):  
Philip Cowen ◽  
Paul Harrison ◽  
Tom Burns
Keyword(s):  
Differential Diagnosis ◽  
Mood Disorders ◽  
Clinical Features ◽  
Acute Treatment ◽  
Depressive Disorders ◽  
Treatment Strategies ◽  
Term Treatment ◽  
Treatment Of Depression ◽  
Manic Patients

Chapter 10 discusses mood disorders, including clinical features, transcultural features, classification and differential diagnosis, epidemiology and aetiology, course and prognosis, acute treatment of depression and mania, longer-term treatment strategies, assessment and management of depressive disorders, assessment of mania, and management of manic patients.

The Power of Client Engagement: “Contextual Healing” Research and Implications for Treatment of Depression

2013 ◽  
Vol 15 (2) ◽  
pp. 109-119
Author(s):  
Pamela E. Guess
Keyword(s):  
Health Care Providers ◽  
External Control ◽  
Care Providers ◽  
Client Participation ◽  
Holistic Model ◽  
Antidepressant Medications ◽  
Treatment Of Depression ◽  
Common Causes ◽  
The Individual

The pervasive incidence of depression is predicted to increase even more exponentially over the next 2 decades; by 2030, depression will likely be among the most common causes of disability (Mathers & Loncar, 2006). Although efficacious interventions for depression have been established, these treatments are, paradoxically, accessed by and/or available to only a small percentage of affected individuals. Furthermore, the most frequently used interventions—traditional psychotherapy and antidepressant medications—are conceptually based within an external control model as opposed to a holistic model of care. Interventions are reactive as opposed to proactive, and they highlight the role of agents external to the individual. This conceptualization opposes a more expansive approach that incorporates medical, psychological, and social factors as equivalent contributors to health. An alternative lens through which prevention and management of depression can be viewed emphasizing the influence of client participation is described. Citing results from research in which outcomes from use of antidepressant medications only slightly exceeded the influence of placebos (Kirsch, 2010), an often overlooked intervention resource, the influence of the patient himself/herself and the “contextual healing” suggested through placebo research is highlighted. Presenting literature on hope models (Jacoby, 2003) and positive psychology (Seligman & Csikszentmihalyi, 2000), the role of the individual as a powerful resource for depression intervention, is emphasized. Examples of therapeutic strategies that capitalize on this resource are described along with a discussion regarding the ethical responsibility of health care providers to include such strategies in practice.

scholarly journals Neurobiological mechanisms of depressive disorders and their pharmacotherapy

2013 ◽  
Vol 11 (3) ◽  
pp. 20-25 ◽  
Author(s):  
Yekaterina Yevgenyevna Yakovleva ◽  
Lyudmila Konstantinovna Khnychenko ◽  
Nikolay Andreyevich Losev
Keyword(s):  
Depressive Disorders ◽  
Biochemical Changes ◽  
Cholinergic Drugs ◽  
Treatment Of Depression

The neurobiological mechanisms of depressive disorders, concerning the role of biochemical changes in cholinergic, serotonergic, dopaminergic, and other neurohumoral systems in the development of depression are reviewed. The modern approaches to pharmacotherapy of depressive disorders, with special accent on cholinergic drugs usage for treatment of depression are discussed in details.

scholarly journals Survival in hemodialysis patients: the role of depression.

1993 ◽  
Vol 4 (1) ◽  
pp. 12-27 ◽  
Author(s):  
P L Kimmel ◽  
K Weihs ◽  
R A Peterson
Keyword(s):  
Depressive Disorders ◽  
Somatic Symptoms ◽  
Hemodialysis Patients ◽  
Independent Factor ◽  
Immunologic Function ◽  
Treatment Of Depression ◽  
Predicting Outcome ◽  
Effect Of Treatment ◽  
Esrd Patients

Depression has been identified at the most prevalent psychologic problem in patients with ESRD treated with hemodialysis (HD). Depression has been associated with mortality in HD patients; however, the similarity of the symptoms of depressive disorders to those of uremia and the difficulties in measuring depression and dissociating psychologic from physical aspects of depression in such patients render these studies difficult to evaluate. Conflicting data regarding the effects of depression on survival in HD patients may be the result of using somatic symptoms in quantifying the extent of depression. In this review, studies regarding the diagnosis of depression in HD patients, the association of depression and survival in HD patients in light of recent work on factors related to the morbidity and mortality in the ESRD population, and aspects of therapy for depression in HD patients are considered. Specifically, depression may affect immunologic function, nutrition, and compliance factors that may affect the prescription and delivery of dialysis, which may, in turn, influence outcome. Alternatively, depression may be an independent factor in influencing survival. Cognitive depression measures may be more useful in predicting outcome in HD patients than standard measures used in nonmedically ill populations. Although there are few studies of the effect of treatment of depression on outcome in HD patients, it is reasonable to hypothesize that treatment of depressive disorders in HD patients might effect outcome. Further studies on the association of depression and its treatment and mortality in ESRD patients are warranted.

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