Novel Antidepressant Approaches for Refractory Depression

AbstractPurpose of ReviewAlthough monoaminergic antidepressants are effective for some depressed patients, at least a third remain treatment refractory even after multiple treatment trials. Investigation into novel antidepressant approaches targeted to specific mechanisms implicated in the pathophysiology of treatment-resistant depression (TRD) has significant potential to improve treatment response rates. This review highlights emerging novel antidepressant approaches for TRD, bridging neuromodulation and novel pharmacotherapeutics. We discuss how these new approaches target depression neurobiology via modulation of neurotrophic factors, cellular metabolic machinery, neurotransmitter systems, and inflammatory activity.Recent FindingsSince a significant number of depressed patients do not respond to classic monoaminergic-based antidepressants, research focus has shifted to novel approaches that have been providing promising results in TRD. Recent studies detail plenty of new technologies in the field of electrical stimulation, antidepressant medications, and novel mechanisms that are hypothesized to provide antidepressant effects through modulating neurobiological pathways implicated in the neurocircuitry of depression. Some factors known to impair therapeutic efficacy of current front-line treatments include circadian disruption, inflammation, and metabolic disturbances. Dysregulation of these systems can be readily identified using peripheral markers, implying that biologic...
Source: Current Treatment Options in Psychiatry - Category: Psychiatry Source Type: research