The therapeutic role of 5-HT1A and 5-HT2A receptors in depression.
The selective serotonin reuptake inhibitors (SSRIs) are the most frequently prescribed antidepressant drugs, because they are well tolerated and have no severe side effects. They rapidly block serotonin (5-HT) reuptake, yet the onset of their therapeutic action requires weeks of treatment. This delay is the result of presynaptic and postsynaptic adaptive mechanisms secondary to reuptake inhibition. The prevention of a negative feedback mechanism operating at the 5-HT autoreceptor level enhances the neurochemical and clinical effects of SSRIs. The blockade of 5-HT2A receptors also seems to improve the clinical effects of SSRIs. These receptors are located postsynaptically to 5-HT axons, mainly in the neocortex. Pyramidal neurons in the prefrontal cortex are particularly enriched in 5-HT2A receptors. Their blockade may affect the function of prefrontal-subcortical circuits, an effect that probably underlies the beneficial effects of the addition of atypical antipsychotic drugs, which are 5-HT2A receptor antagonists, to SSRIs in treatment-resistant patients.
Department of Neurochemistry, Institut d'Investigacions Biomèdiques de Barcelona, Consejo Superior de Investigaciones Cientificas (Institut d'Investigacions Biomèdiques August Pi i Sunyer), Barcelona, Spain.
Pau
P
Celada
M
M
Puig
Mercè
M
Amargós-Bosch
Albert
A
Adell
Francesc
F
Artigas
D017660:Autoreceptors / Q000037:antagonists & inhibitors; D003865:Major Depressive Disorder / Q000188:drug therapy / Q000378:metabolism*; D006801:Humans; D010869:Pindolol / Q000494:pharmacology / Q000627:therapeutic use; D044282:Receptor, Serotonin, 5-HT1A / Q000187:drug effects / Q000378:metabolism / Q000502:physiology*; D044348:Receptors, Serotonin, 5-HT2 / Q000187:drug effects / Q000378:metabolism / Q000502:physiology*; D012702:Serotonin Antagonists / Q000494:pharmacology / Q000627:therapeutic use; D017367:Selective Serotonin Reuptake Inhibitors / Q000494:pharmacology / Q000627:therapeutic use
D017660:Autoreceptors; D010869:Pindolol; D044282:Receptor, Serotonin, 5-HT1A; D044348:Receptors, Serotonin, 5-HT2; D012702:Serotonin Antagonists; D017367:Selective Serotonin Reuptake Inhibitors