open access

Vol 1, No 2 (2004)
Editorial
Published online: 2004-06-16
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Novel studies on stress and depression and their influence on opinions about mechanism of action of antidepressants

Wojciech Kostowski
Psychiatria 2004;1(2):63-71.

open access

Vol 1, No 2 (2004)
Artykuły redakcyjne
Published online: 2004-06-16

Abstract

Recent laboratory and clinical studies are producing real improvements in our understanding the stress, depression as well as mechanism of action of antidepressant drugs. In particular, the broadening of our understanding of the role of HPA axis in depression is opening new strategies for pharmacotherapy of depression. It has been reported that acute depression is characterized by hypersecretion of CRH, ACTH and cortisol. On the other hand, in chronic depression cortisol remained elevated while ACTH levels are reduced. Antagonists of CRH and cortisol could therefore, represent a new gneration of antidepressants. Further, recent clinical studies have shown antidepressant efficacy of melatonin agonists, in particular agonists of MT-1 receptors, thus suggesting that these compounds hold promise for use as novel antidepressants. Finally, laboratory studies have been found that the molecular basis of antidepressant action involves postreceptor components such as second messenger systems, protein kinases and transcription factors. Antidepressant drugs have also been reported to stimulate the production of neurotropic factors and neurotrophins thus counteracting the neurodegenerative processes associated with stress and depression. Therefore, it has become apparent that antidepressants share mechanisms beyond the monoamine synapse. These mechanisms seem to be at least as important as the monoaminergic ones.

Abstract

Recent laboratory and clinical studies are producing real improvements in our understanding the stress, depression as well as mechanism of action of antidepressant drugs. In particular, the broadening of our understanding of the role of HPA axis in depression is opening new strategies for pharmacotherapy of depression. It has been reported that acute depression is characterized by hypersecretion of CRH, ACTH and cortisol. On the other hand, in chronic depression cortisol remained elevated while ACTH levels are reduced. Antagonists of CRH and cortisol could therefore, represent a new gneration of antidepressants. Further, recent clinical studies have shown antidepressant efficacy of melatonin agonists, in particular agonists of MT-1 receptors, thus suggesting that these compounds hold promise for use as novel antidepressants. Finally, laboratory studies have been found that the molecular basis of antidepressant action involves postreceptor components such as second messenger systems, protein kinases and transcription factors. Antidepressant drugs have also been reported to stimulate the production of neurotropic factors and neurotrophins thus counteracting the neurodegenerative processes associated with stress and depression. Therefore, it has become apparent that antidepressants share mechanisms beyond the monoamine synapse. These mechanisms seem to be at least as important as the monoaminergic ones.
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Keywords

depression; stress; pathogenesis of depression; cortisol

About this article
Title

Novel studies on stress and depression and their influence on opinions about mechanism of action of antidepressants

Journal

Psychiatria (Psychiatry)

Issue

Vol 1, No 2 (2004)

Article type

Editorial

Pages

63-71

Published online

2004-06-16

Bibliographic record

Psychiatria 2004;1(2):63-71.

Keywords

depression
stress
pathogenesis of depression
cortisol

Authors

Wojciech Kostowski

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