2007]. This postulate is based on the acute pharmacology of MDMA and is consistent with the hallmark theory of depression, the monoamine hypothesis [Krishnan and Nestler, 2008]. MDMA rapidly increases availability of extracellular 5-hydroxytryptamine (5-HT) at the synapse, mirroring the action of commonly prescribed antidepressants. However, current first-line treatments for depression, such as selective serotonin reuptake inhibitors (SSRIs), typically take about 6 weeks to produce optimum therapeutic change [Frazer and Benmansour, 2002]; MDMA could offer instantaneous relief. This rapid onset is an attractive prospect for treatment-resistant depression (TRD), where currently the only therapeutic option is electroconvulsive therapy (ECT). Although there is a theoretical basis, at present experimental evidence of antidepressant action of MDMA is low, with just one rodent [Majumder et al. 2011] and one volunteer study [Majumder et al. 2012] suggesting direct rapid-onset antidepressant action. MDMA is a controlled substance in most countries, typically in the most restrictive category (Class A in the UK). Despite this, MDMA is already in clinical trials for anxiety disorders such as post-traumatic stress disorder (PTSD), as an adjunct to psychotherapy where it is thought to assist therapy sessions by strengthening the
Neuroimmunology is a rapidly developing field, challenging the age-old notion of the central nervous system (CNS) as an immune-privileged site with limited immune function. In the last two decades, new technologies have demonstrated that immune processes play a critical role in normal CNS development, are integral to fundamental neurological processes, such as long-term potentiation and synaptic plasticity, and are implicated in pathologies ranging from narcolepsy to depression, schizophrenia, and Alzheimer’s disease. They indicate that immunology and mental illness are fundamentally intertwined, opening exciting new avenues for future immunotherapies tackling psychiatric disease. Here the chapter reviews basic immune mechanisms, specifically highlighting processes that are of particular relevance to neuropsychiatry. It is hoped that this chapter will serve as an accessible primer to the related fields of psychoneuroimmunology and immunopsychiatry and stimulate readers’ interest in this increasingly important and fast-evolving field.
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