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Titolo:
Limitations to enhancing the speed of onset of antidepressants - Are rapidaction antidepressants possible?
Autore:
Artigas, F;
Indirizzi:
IDIBAPS, CSIC, Inst Invest Biomed Barcelona, Dept Neurochem, Barcelona 08036, Spain IDIBAPS Barcelona Spain 08036 na, Dept Neurochem, Barcelona 08036, Spain
Titolo Testata:
HUMAN PSYCHOPHARMACOLOGY-CLINICAL AND EXPERIMENTAL
fascicolo: 1, volume: 16, anno: 2001,
pagine: 29 - 36
SICI:
0885-6222(200101)16:1<29:LTETSO>2.0.ZU;2-M
Fonte:
ISI
Lingua:
ENG
Soggetto:
SEROTONIN REUPTAKE INHIBITORS; 5-HT1A RECEPTOR ANTAGONISTS; PLACEBO-CONTROLLED TRIAL; MONOAMINE-OXIDASE INHIBITORS; IN-VIVO MICRODIALYSIS; SPONTANEOUS FIRING RATE; CENTRAL NERVOUS-SYSTEM; MIDBRAIN RAPHE NUCLEI; MAJOR DEPRESSION; FRONTAL-CORTEX;
Keywords:
5-HT1A receptors; antidepressants; clinical trials; pindolol; selective serotonin reuptake inhibitors; serotonin;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Life Sciences
Citazioni:
90
Recensione:
Indirizzi per estratti:
Indirizzo: Artigas, F IDIBAPS, CSIC, Inst Invest Biomed Barcelona, Dept Neurochem, Rossello 161,Barcelona 08036, Spain IDIBAPS Rossello 161 Barcelona Spain 08036 celona 08036, Spain
Citazione:
F. Artigas, "Limitations to enhancing the speed of onset of antidepressants - Are rapidaction antidepressants possible?", HUM PSYCHOP, 16(1), 2001, pp. 29-36

Abstract

Existing antidepressant treatments suffer from a limited efficacy and a slow onset of action. Some first-generation antidepressant drugs are still among the most effective treatments. Several neurobiological adaptive mechanisms are involved in the delayed action of antidepressants. Among these, a negative feed-back involving somatodendritic autoreceptors plays an important role in such delay. In the case of the SSRIs, the prevention of this effect with 5-HT1A autoreceptor antagonists enhances their effects at experimental level. Open-label and placebo-controlled trials with the mixed beta -adrenoceptor/5-HT1A antagonist pindolol support that this agent reduces the latency to achieve a clinical improvement when used in combination with SSRIs. Displacement studies support that this action is mediated by its interaction with 5-HT1A receptors. The design of clinical trials for the evaluation of fast-acting antidepressants is critical. The use of loose criteria of response may result in a poor discriminating power. Conversely, stringent clinical criteria may be more helpful in revealing the differences between treatments. The data of a double-blind, placebo-controlled trial comparing fluoxetine plus placebo and fluoxetine plus pindolol suggests that the use of sustained response (i.e., one maintained until the end of the trial) is critical for the establishment of differences between treatments. Other factors, such as a placebo lead-in phase or the frequency of visits, appear to play a minor role. Overall, these data indicate that faster antidepressant drugs can be obtained through a better knowledge of their actions in CNS. Copyright (C) 2001 John Wiley & Sons, Ltd.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 21/01/20 alle ore 07:35:21