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By Kerstin Bingefors, Lisa Ekselius, Lars von Knorring (auth.), Prof. Brian E. Leonard (eds.)

Important scientific concerns because the final result of long-term remedy with antidepressants, the time of onset of the antidepressant reaction and the constraints of the antidepressants presently to be had are coated during this monograph. best researchers within the sector of medical and experimental psychopharmacology significantly examine the development of their expert fields. The mechanisms of motion of antidepressants are thought of, by way of scientific examine into the function of the hypothalamic-pituitary-adrenal axis and the immune process within the biology of melancholy and according to therapy. the ultimate bankruptcy bargains with the $64000 chemical entities now present process improvement as antidepressants. the aim of this monograph isn't just to notify but in addition to stimulate examine into the biology of melancholy and the mechanisms at the back of the motion of powerful antidepressants. This monograph is of curiosity to psychiatrists, psychologists, pharmacologists, neuroscientists and endocrinologists.

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Firstly, current antidepressants have a slow onset of therapeutic action, taking about 2 months for a therapeutic response and up to 24 months to cause symptomatic remission. e. e. elimination of symptoms). Since a return to full function and "normality" are the real goals of antidepressant treatment, this is indeed a serious limitation for those patients who fail to remit. Thirdly, contemporary antidepressants are only partially able to reduce relapses and recurrent episodes, even if treatment is continued.

Although the reason for this was unclear it has been suggested that it may be due to the fact that antagonism of the 5-HT ID receptors results in increased extracellular 5-HT, which would stimulate the 5-HT 1A receptors, thus decreasing 5-HT cell firing and release. , 1997).

_ I' -'. J Figure I. Summary of events at the noradrenergic receptor following antidepressant treatment. 1 Post-synaptic receptor upregulated (due to decreased availability of NA). 2 Increased NA release, due to administration ofTCA. 3 Down-regulation of post-synaptic receptors However, it is likely that the use of this group of patients would reduce the chances of observing an early onset of antidepressant action (Norman and Leonard, 1994). Sachs and colleagues (1986) reported a dramatic response in three patients (meeting DSM III criteria for major depression) with the use of Electro Convulsive Therapy (ECT) in combination with yohimbine.

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