title: The keys to improving depression outcomes.
abstract: The heterogeneity of symptoms within major depressive disorder poses significant challenges for treatment and it is likely that current pharmacotherapies do not target all symptoms equally, although they have similar efficacy rates. While there is still continuing interest in understanding monoamine interactions and consequent downstream effects, the limited efficacy and tolerability achieved with classical antidepressants provides a compelling argument to move beyond the monoamines. Several lines of biological research in depression exploring immune function, neurotrophins, amino acid and neuropeptide neurotransmitters, neuroanatomical function and circadian rhythms, may lead to novel therapeutic targets and enhance depression outcomes. This review will evaluate the evidence for emerging treatments as well as recommendations from current international guidelines regarding antidepressant management.
authors.affiliation: Department of Pharmaceutical Sciences and Neuroscience, University of Toronto, Toronto, Ontario Canada.
authors.forename: Sakina J
authors.initials: SJ
authors.lastname: Rizvi
authors.forename: Sidney H
authors.initials: SH
authors.lastname: Kennedy
mesh_terms: D000928:Antidepressive Agents / Q000494:pharmacology / Q000627:therapeutic use*; D002940:Circadian Rhythm / Q000187:drug effects / Q000502:physiology*; D003863:Depression / Q000175:diagnosis / Q000188:drug therapy* / Q000503:physiopathology*; D003866:Depressive Disorder / Q000175:diagnosis / Q000188:drug therapy* / Q000503:physiopathology; D006801:Humans; D055118:Medication Adherence / Q000523:psychology; D058990:Molecular Targeted Therapy; D016896:Treatment Outcome
chemical_list: D000928:Antidepressive Agents