Department of Psychiatry, University of California San Diego, La Jolla, CA, USA.
Mol Psychiatry. 2017 May;22(5):656-665. doi: 10.1038/mp.2017.36. Epub 2017 Mar 21.
Depression is a leading cause of disability worldwide and a major contributor to the burden of suicide. A major limitation of classical antidepressants is that 2-4 weeks of continuous treatment is required to elicit therapeutic effects, prolonging the period of depression, disability and suicide risk. Therefore, the development of fast-onset antidepressants is crucial. Preclinical identification of fast-onset antidepressants requires animal models that can accurately predict the delay to therapeutic onset. Although several well-validated assay models exist that predict antidepressant potential, few thoroughly tested animal models exist that can detect therapeutic onset. In this review, we discuss and assess the validity of seven rodent models currently used to assess antidepressant onset: olfactory bulbectomy, chronic mild stress, chronic forced swim test, novelty-induced hypophagia (NIH), novelty-suppressed feeding (NSF), social defeat stress, and learned helplessness. We review the effects of classical antidepressants in these models, as well as six treatments that possess fast-onset antidepressant effects in the clinic: electroconvulsive shock therapy, sleep deprivation, ketamine, scopolamine, GLYX-13 and pindolol used in conjunction with classical antidepressants. We also discuss the effects of several compounds that have yet to be tested in humans but have fast-onset antidepressant-like effects in one or more of these antidepressant onset sensitive models. These compounds include selective serotonin (5-HT) receptor antagonists, a 5-HT receptor agonist, a 5-HT receptor antagonist, NMDA receptor antagonists, a TREK-1 receptor antagonist, mGluR antagonists and (2R,6R)-HNK. Finally, we provide recommendations for identifying fast-onset antidepressants using rodent behavioral models and molecular approaches.
抑郁症是全球范围内导致残疾的主要原因之一,也是自杀负担的主要因素。经典抗抑郁药的一个主要局限性是需要连续治疗 2-4 周才能产生治疗效果,从而延长了抑郁、残疾和自杀风险的时间。因此,开发快速起效的抗抑郁药至关重要。快速起效抗抑郁药的临床前鉴定需要能够准确预测治疗起效延迟的动物模型。尽管存在几种经过充分验证的可预测抗抑郁潜力的检测模型,但很少有经过充分测试的动物模型能够检测到治疗的开始。在这篇综述中,我们讨论并评估了目前用于评估抗抑郁药起始的七种啮齿动物模型的有效性:嗅球切除术、慢性轻度应激、慢性强迫游泳试验、新奇性诱导的摄食量减少(NIH)、新奇性抑制摄食(NSF)、社会挫败应激和习得性无助。我们回顾了经典抗抑郁药在这些模型中的作用,以及在临床上具有快速起效抗抑郁作用的六种治疗方法:电休克疗法、睡眠剥夺、氯胺酮、东莨菪碱、GLYX-13 和与经典抗抑郁药联合使用的吲哚洛尔。我们还讨论了几种尚未在人类中进行测试但在这些抗抑郁药起始敏感模型中的一种或多种模型中具有快速起效抗抑郁样作用的化合物的作用。这些化合物包括选择性 5-羟色胺(5-HT)受体拮抗剂、5-HT 受体激动剂、5-HT 受体拮抗剂、NMDA 受体拮抗剂、TREK-1 受体拮抗剂、mGluR 拮抗剂和(2R,6R)-HNK。最后,我们提供了使用啮齿动物行为模型和分子方法识别快速起效抗抑郁药的建议。