Document Detail


History and evolution of the monoamine hypothesis of depression.
MedLine Citation:
PMID:  10775017     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
The symptoms of depression can be improved by agents that act by various mechanisms to increase synaptic concentrations of monoamines. This finding led to the adoption of the monoamine hypothesis of depression, first put forward over 30 years ago, which proposes that the underlying biological or neuroanatomical basis for depression is a deficiency of central noradrenergic and/or serotonergic systems and that targeting this neuronal lesion with an antidepressant would tend to restore normal function in depressed patients. The hypothesis has enjoyed considerable support, since it attempts to provide a pathophysiologic explanation of the actions of antidepressants. However, in its original form it is clearly inadequate, as it does not provide a complete explanation for the actions of antidepressants, and the pathophysiology of depression itself remains unknown. The hypothesis has evolved over the years to include, for example, adaptive changes in receptors to explain why there should be only a gradual clinical response to antidepressant treatment when the increase in availability of monoamines is rapid. Still, the monoamine hypothesis does not address key issues such as why antidepressants are also effective in other disorders such as panic disorder, obsessive-compulsive disorder, and bulimia, or why all drugs that enhance serotonergic or noradrenergic transmission are not necessarily effective in depression. Despite these limitations, however, it is clear that the development of the monoamine hypothesis has been of great importance in understanding depression and in the development of safe and effective pharmacologic agents for its treatment.
Authors:
R M Hirschfeld
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Publication Detail:
Type:  Historical Article; Journal Article; Review    
Journal Detail:
Title:  The Journal of clinical psychiatry     Volume:  61 Suppl 6     ISSN:  0160-6689     ISO Abbreviation:  J Clin Psychiatry     Publication Date:  2000  
Date Detail:
Created Date:  2000-04-26     Completed Date:  2000-04-26     Revised Date:  2005-11-16    
Medline Journal Info:
Nlm Unique ID:  7801243     Medline TA:  J Clin Psychiatry     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  4-6     Citation Subset:  IM; Q    
Affiliation:
Department of Psychiatry and Behavioral Sciences, University of Texas Medical Branch, Galveston 77555-0188, USA. rohirsch@utmb.edu
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MeSH Terms
Descriptor/Qualifier:
Adrenergic Uptake Inhibitors / history,  pharmacology,  therapeutic use
Antidepressive Agents / history,  therapeutic use
Depressive Disorder / drug therapy*,  physiopathology*
Drug Industry
History, 20th Century
Humans
Imipramine / history,  pharmacology,  therapeutic use
Morpholines / history,  pharmacology,  therapeutic use
Norepinephrine / antagonists & inhibitors,  deficiency,  physiology*
Receptors, Biogenic Amine / antagonists & inhibitors,  drug effects
Serotonin / deficiency,  physiology*
Chemical
Reg. No./Substance:
0/Adrenergic Uptake Inhibitors; 0/Antidepressive Agents; 0/Morpholines; 0/Receptors, Biogenic Amine; 50-49-7/Imipramine; 50-67-9/Serotonin; 51-41-2/Norepinephrine; 98769-81-4/reboxetine

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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