[New developments in pharmacotherapy of depression].
In spite of recent progress in the pharmacotherapy of depression, major issues are still unresolved. These include the nonresponse rate of approximately 30% to conventional antidepressant pharmacotherapy, side effects of available antidepressants, and the latency period of several weeks until clinical improvement. Current treatment strategies aim to enhance serotonergic and/or noradrenergic neurotransmission. However, in the meantime, several new pharmacological principles are under investigation with regard to their antidepressant potency. Placebo-controlled, double-blind studies have been performed with 5-HT(1A) receptor agonists and tachykinin receptor antagonists which point towards antidepressant efficacy. While there is some evidence for putative antidepressant properties of various interventions within the hypothalamic-pituitary-adrenal system such as CRH(1) receptor antagonists, steroid synthesis inhibitors, and glucocorticoid receptor antagonists in animal studies, case series, open studies, and small placebo-controlled studies, no definite proof for their antidepressant efficacy has been furnished. Nevertheless, follow-up of new pharmacological strategies is of major importance to provide even better strategies for the clinical management of depression, which also has great socioeconomic impact.
Rupprecht
R
R
Klinik für Psychiatrie und Psychotherapie, Ludwig-Maximilians-Universität München. Rainer.Rupprecht@psy.med.uni-muenchen.de
Baghai
Th C
TC
Möller
H-J
HJ
D000818:Animals; D000928:Antidepressive Agents / Q000627:therapeutic use*; D002986:Clinical Trials as Topic; D003866:Depressive Disorder / Q000188:drug therapy* / Q000503:physiopathology; D006801:Humans; D006854:Hydrocortisone / Q000097:blood; D007030:Hypothalamo-Hypophyseal System / Q000187:drug effects / Q000503:physiopathology; D009638:Norepinephrine / Q000819:agonists; D010913:Pituitary-Adrenal System / Q000187:drug effects / Q000503:physiopathology; D018019:Receptors, Corticotropin-Releasing Hormone / Q000037:antagonists & inhibitors / Q000502:physiology; D011985:Receptors, Serotonin / Q000187:drug effects / Q000502:physiology; D018039:Receptors, Tachykinin / Q000037:antagonists & inhibitors / Q000502:physiology; D016896:Treatment Outcome; D000099052:CRF Receptor, Type 1
D000928:Antidepressive Agents; D018019:Receptors, Corticotropin-Releasing Hormone; D011985:Receptors, Serotonin; D018039:Receptors, Tachykinin; D000099052:CRF Receptor, Type 1; D006854:Hydrocortisone; D009638:Norepinephrine