Department of Pharmacokinetics, Faculty of Pharmacy, University of Belgrade, Serbia.
Neuropsychiatr Dis Treat. 2010 Sep 7;6:343-64. doi: 10.2147/ndt.s10485.
Major depressive disorder (MDD) is a common and serious illness of our times, associated with monoamine deficiency in the brain. Moreover, increased levels of cortisol, possibly caused by stress, may be related to depression. In the treatment of MDD, the use of older antidepressants such as monoamine oxidase inhibitors and tricyclic antidepressants is decreasing rapidly, mainly due to their adverse effect profiles. In contrast, the use of serotonin reuptake inhibitors and newer antidepressants, which have dual modes of action such as inhibition of the serotonin and noradrenaline or dopamine reuptake, is increasing. Novel antidepressants have additive modes of action such as agomelatine, a potent agonist of melatonin receptors. Drugs in development for treatment of MDD include triple reuptake inhibitors, dual-acting serotonin reuptake inhibitors and histamine antagonists, and many more. Newer antidepressants have similar efficacy and in general good tolerability profiles. Nevertheless, compliance with treatment for MDD is poor and may contribute to treatment failure. Despite the broad spectrum of available antidepressants, there are still at least 30% of depressive patients who do not benefit from treatment. Therefore, new approaches in drug development are necessary and, according to current research developments, the future of antidepressant treatment may be promising.
重度抑郁症（MDD）是当今时代常见且严重的疾病，与大脑中单胺缺乏有关。此外，皮质醇水平升高，可能是由压力引起的，可能与抑郁有关。在 MDD 的治疗中，老式抗抑郁药如单胺氧化酶抑制剂和三环类抗抑郁药的使用正在迅速减少，主要是由于它们的不良作用。相比之下，具有双重作用模式的血清素再摄取抑制剂和新型抗抑郁药，如抑制血清素和去甲肾上腺素或多巴胺再摄取的药物，正在增加使用。新型抗抑郁药具有协同作用模式，如褪黑素受体的有效激动剂阿戈美拉汀。用于治疗 MDD 的药物包括三重再摄取抑制剂、双重作用的血清素再摄取抑制剂和组胺拮抗剂等。新型抗抑郁药具有相似的疗效和良好的耐受性。然而，MDD 的治疗依从性较差，可能导致治疗失败。尽管有广泛的可用抗抑郁药，但仍有至少 30%的抑郁患者对治疗没有反应。因此，有必要在药物开发方面采取新的方法，根据当前的研究进展，抗抑郁治疗的未来可能充满希望。
