Caldarone Barbara J, Zachariou Venetia, King Sarah L
Department of Neurology, Brigham and Women's Hospital and NeuroBehavior Laboratory, Harvard NeuroDiscovery Center, 77 Avenue Louis Pasteur, Boston, MA 02115, USA.
Fishberg Department of Neuroscience and Friedman Brain Institute, Icahn School of Medicine at Mount Sinai, 1425 Madison Ave, New York, NY 10029, USA.
Eur J Pharmacol. 2015 Apr 15;753:51-65. doi: 10.1016/j.ejphar.2014.10.063. Epub 2014 Nov 21.
Major depression is a prevalent and debilitating disorder and a substantial proportion of patients fail to reach remission following standard antidepressant pharmacological treatment. Limited efficacy with currently available antidepressant drugs highlights the need to develop more effective medications for treatment- resistant patients and emphasizes the importance of developing better preclinical models that focus on treatment- resistant populations. This review discusses methods to adapt and refine rodent behavioral models that are predictive of antidepressant efficacy to identify populations that show reduced responsiveness or are resistant to traditional antidepressants. Methods include separating antidepressant responders from non-responders, administering treatments that render animals resistant to traditional pharmacological treatments, and identifying genetic models that show antidepressant resistance. This review also examines pharmacological and non-pharmacological treatments regimes that have been effective in refractory patients and how some of these approaches have been used to validate animal models of treatment-resistant depression. The goals in developing rodent models of treatment-resistant depression are to understand the neurobiological mechanisms involved in antidepressant resistance and to develop valid models to test novel therapies that would be effective in patients that do not respond to traditional monoaminergic antidepressants.
重度抑郁症是一种常见且使人衰弱的疾病,相当一部分患者在接受标准抗抑郁药物治疗后未能达到缓解状态。现有抗抑郁药物疗效有限,这凸显了为治疗抵抗性患者开发更有效药物的必要性,并强调了开发更好的临床前模型的重要性,这些模型应专注于治疗抵抗人群。本综述讨论了调整和完善可预测抗抑郁疗效的啮齿动物行为模型的方法,以识别对传统抗抑郁药反应降低或具有抗性的人群。方法包括将抗抑郁反应者与无反应者分开、给予使动物对传统药物治疗产生抗性的处理,以及识别显示抗抑郁抗性的遗传模型。本综述还研究了在难治性患者中有效的药物和非药物治疗方案,以及其中一些方法如何用于验证治疗抵抗性抑郁症的动物模型。开发治疗抵抗性抑郁症啮齿动物模型的目标是了解抗抑郁抗性所涉及的神经生物学机制,并开发有效的模型来测试对传统单胺能抗抑郁药无反应的患者有效的新疗法。