Advances in the treatment of depression

Serretti, Alessandro

doi:10.1097/yic.0000000000000424

Cited by 4 publications

(2 citation statements)

References 19 publications

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“…In the more distant future, a number of potentially interesting new antidepressant mechanisms will be available, including new drug targets, drug repurposing and genetic or epigenetic manipulations [98][99][100][101][102]. Rapid scientific advances in bioinformatics and artificial intelligence are already yielding exciting results.…”

Section: Further Perspectivesmentioning

confidence: 99%

A Critical View on New and Future Antidepressants

Serretti

2024

Clin Psychopharmacol Neurosci

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For the first time after many decades, many new antidepressants have been approved and many more are under various stages of development and will soon be available in the market. The new drugs present a range of new mechanisms of action with benefits in terms of speed of action, tolerability and range of treatable disorders. Neurosteroids have been recently approved and their rapid benefit may extend from postpartum depression to anxious depression and bipolar depression, dextromethorphan and bupropion combination may prove useful in major depression but also in treatment resistant depression, dextromethadone is a possible augmentation in partial antidepressant response, psychedelic drugs have the potential of long lasting benefits after a single administration, though are still experimental treatments. Botulinum has the same advantage of psychedelics of a single administration and its antidepressant effects may last for weeks or more. Further potentially interesting new antidepressant mechanisms include new drug targets, drug repurposing and genetic or epigenetic manipulations. It is therefore important that clinicians are kept up to date with new evidence so that new evidence can be rapidly translated into clinical practice.

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Section: Further Perspectivesmentioning

confidence: 99%

A Critical View on New and Future Antidepressants

Serretti

2024

Clin Psychopharmacol Neurosci

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“…It is important to note that the effectiveness of psychotherapy in treating anhedonia in depression may vary depending on individual factors, such as the severity of depression, the presence of other symptoms, and personal preferences. A personalized approach to treatment that takes these factors into account is therefore recommended [ 101 ].…”

Section: Treatment Of Anhedoniamentioning

confidence: 99%

Anhedonia and Depressive Disorders

Serretti

2023

Clin Psychopharmacol Neurosci

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Anhedonia is a core symptom of depression and of several psychiatric disorders. Anhedonia has however expanded from its original definition to encompass a spectrum of reward processing deficits that received much interest in the last decades. It is a relevant risk factor for possible suicidal behaviors, and that it may operate as an independent risk factor for suicidality apart from the episode severity. Anhedonia has also been linked to inflammation with a possible reciprocal deleterious effect on depression. Its neurophysiological bases mainly include alterations in striatal and prefrontal areas, with dopamine being the most involved neurotransmitter. Anhedonia is thought to have a significant genetic component and polygenic risk scores are a possible tool for predicting an individual’s risk for developing anhedonia. Traditional antidepressants, such as selective serotonin reuptake inhibitors, showed a limited benefit on anhedonia, also considering their potential pro-anhedonic effect in some subjects. Other treatments may be more effective in treating anhedonia, such as agomelatine, vortioxetine, ketamine and transcranial magnetic stimulation. Psychotherapy is also widely supported, with cognitive-behavioral therapy and behavioral activation both showing benefit. In conclusion, a large body of evidence suggests that anhedonia is, at least partially, independent from depression, therefore it needs careful assessment and targeted treatment.

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The bidirectional interaction between antidepressants and the gut microbiota: are there implications for treatment response?

Borgiani,

Possidente,

Fabbri

et al. 2024

International Clinical Psychopharmacology

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This review synthesizes the evidence on associations between antidepressant use and gut microbiota composition and function, exploring the microbiota’s possible role in modulating antidepressant treatment outcomes. Antidepressants exert an influence on measures of gut microbial diversity. The most consistently reported differences were in β-diversity between those exposed to antidepressants and those not exposed, with longitudinal studies supporting a potential causal association. Compositional alterations in antidepressant users include an increase in the Bacteroidetes phylum, Christensenellaceae family, and Bacteroides and Clostridium genera, while a decrease was found in the Firmicutes phylum, Ruminococcaceae family, and Ruminococcus genus. In addition, antidepressants attenuate gut microbial differences between depressed and healthy individuals, modulate microbial serotonin transport, and influence microbiota’s metabolic functions. These include lyxose degradation, peptidoglycan maturation, membrane transport, and methylerythritol phosphate pathways, alongside gamma-aminobutyric acid metabolism. Importantly, baseline increased α-diversity and abundance of the Roseburia and Faecalibacterium genera, in the Firmicutes phylum, are associated with antidepressant response, emerging as promising biomarkers. This review highlights the potential for gut microbiota as a predictor of treatment response and emphasizes the need for further research to elucidate the mechanisms underlying antidepressant-microbiota interactions. More homogeneous studies and standardized techniques are required to confirm these initial findings.

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Advances in the treatment of depression

Abstract: The treatment of depression is one of the most relevant challenges for healthcare systems. This is due to both the high prevalence of depression and the limitations that current antidepressant treatments have, despite the benefit of recently introduced compounds and strategies (

Cited by 4 publications

References 19 publications

A Critical View on New and Future Antidepressants

A Critical View on New and Future Antidepressants

Anhedonia and Depressive Disorders

The bidirectional interaction between antidepressants and the gut microbiota: are there implications for treatment response?

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