title: Recent pharmacologic advances in antidepressant therapy.
abstract: The serotonergic properties of newer generation antidepressants underscore the role of 5-hydroxytryptamine (5-HT, serotonin) in both the pathophysiology and the pharmacotherapy of major depression. Clinical differences between selective serotonin reuptake inhibitors (SSRIs) and tricyclic antidepressants (TCAs) are attributed to the greater potency and selectivity for 5-HT transporter inhibition by the SSRIs and the comparatively weak interaction of the SSRIs with nonserotonin neurotransmitter receptors. The SSRIs, monoamine oxidase inhibitors (MAOIs), and TCAs share a common adaptive regulation of noradrenergic, 5-HT, and glutamate neurotransmission, suggesting possible unifying mechanisms of action underlying their antidepressant effects. In vivo neuroimaging techniques, such as positron emission tomography (PET) and single photon emission computed tomography (SPECT) have yielded a functional neuroanatomy of compromised neurocircuitry in major depression and promise to be invaluable in mapping the in vivo effects of future novel antidepressant drugs.
authors.affiliation: Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, Georgia 30322.
authors.forename: C D
authors.initials: CD
authors.lastname: Kilts
mesh_terms: D000928:Antidepressive Agents / Q000494:pharmacology* / Q000627:therapeutic use; D003866:Depressive Disorder / Q000188:drug therapy / Q000503:physiopathology; D006801:Humans
chemical_list: D000928:Antidepressive Agents