Open AccessStrategies for Treatment-Resistant Depression: Lessons Learned from Animal Models
Author(s) -
Gislaine Z. Réus,
Airam B. de Moura,
Laura A. Borba,
Helena M. Abelaira,
João Quevedo
Publication year - 2019
Publication title -
complex psychiatry
Language(s) - English
Resource type - Journals
eISSN - 2673-3005
pISSN - 2673-298X
DOI - 10.1159/000500324
Subject(s) - antidepressant , treatment resistant depression , major depressive disorder , electroconvulsive therapy , animal models of depression , depression (economics) , memantine , neuroscience , deep brain stimulation , neuroplasticity , psychology , medicine , nmda receptor , animal studies , glutamate receptor , psychiatry , hippocampus , schizophrenia (object oriented programming) , receptor , cognition , disease , parkinson's disease , macroeconomics , economics
Around 300 million individuals are affected by major depressive disorder (MDD) in the world. Despite this high number of affected individuals, more than 50% of patients do not respond to antidepressants approved to treat MDD. Patients with MDD that do not respond to 2 or more first-line antidepressant treatments are considered to have treatment-resistant depression (TRD). Animal models of depression are important tools to better understand the pathophysiology of MDD as well as to help in the development of novel and fast antidepressants for TRD patients. This review will emphasize some discovery strategies for TRD from studies on animal models, including, antagonists of N-methyl-D-aspartate (NMDA) receptor (ketamine and memantine), electroconvulsive therapy (ECT), lithium, minocycline, quetiapine, and deep brain stimulation. Animal models of depression are not sufficient to represent all the traits of TRD, but they greatly aid in understanding the mechanism by which therapies that work for TRD exert antidepressant effects. Interestingly, these innovative therapies have mechanisms of action different from those of classic antidepressants. These effects are mainly related to the regulation of neurotransmitter activity, including general glutamate and increased connectivity, synaptic capacity, and neuroplasticity.