Dinan T G
Department of Psychological Medicine, St. Bartholomew's Hospital, London, U.K.
J Clin Psychiatry. 1996;57 Suppl 4:14-8.
Noradrenergic and serotonergic abnormalities have long been suspected in patients with major depression. Traditional tricyclic antidepressants block the reuptake of these neurotransmitters. In recent years, understanding of the complex receptor systems mediating serotonin (5-HT) and norepinephrine (NE) effects has increased substantially, and drugs selectively targeting these receptors are being developed. Presented here is a theory which suggests that stress mediated through the hypothalamic-pituitary-adrenal axis produces the disturbances seen in monoamine functioning. Hypersecretion of cortisol as well as the presence of cortisol receptors in the brain is suggested as the pathway for monoamine change.
长期以来，人们一直怀疑重度抑郁症患者存在去甲肾上腺素能和血清素能异常。传统的三环类抗抑郁药会阻断这些神经递质的再摄取。近年来，人们对介导血清素（5-HT）和去甲肾上腺素（NE）作用的复杂受体系统的了解大幅增加，并且正在开发选择性针对这些受体的药物。这里提出一种理论，该理论认为通过下丘脑 - 垂体 - 肾上腺轴介导的应激会导致单胺功能出现紊乱。皮质醇分泌过多以及大脑中存在皮质醇受体被认为是单胺变化的途径。
