Neuroprotective Benefits of Antidepressants in Multiple Sclerosis: Are We Missing the Mark?

Neuroprotective Benefits of Antidepressants in Multiple Sclerosis: Are We Missing the Mark? J Neuropsychiatry Clin Neurosci. 2019 Apr 03;:appineuropsych18070164 Authors: Grech LB, Butler E, Stuckey S, Hester R Abstract The potential of antidepressant medication to have a neuroprotective effect for people with multiple sclerosis (MS) has received increased interest in recent years. The possibility of antidepressants, particularly fluoxetine, for potential repurposing to treat primary progressive and secondary progressive MS is of interest as a result of the relative lack of disease-modifying medications for these subtypes. A number of animal studies have found positive results for a neuroprotective effect of antidepressant use in MS, with human studies showing mixed results. These human studies all have a significant limitation: they exclude people with moderate to severe depressive symptoms, a core symptom of MS beyond that of reactive depression. It is likely that reregulation of the common mechanisms in depression and MS, such as inflammation, serotonin, norepinephrine, glutamate and brain-derived neurotropic factor disruption, and hypothalamic-pituitary-thalamic axis dysregulation, are important to the neuroprotective value of antidepressant medication. Given that MS is known for its heterogeneity, the question might be less about whether antidepressant medication provides neuroprotective benefits to people with multiple sclerosis...
Source: Journal of Neuropsychiatry and Clinical Neurosciences - Category: Psychiatry Tags: J Neuropsychiatry Clin Neurosci Source Type: research