How antidepressants work: new perspectives on the pathophysiology of depressive disorder

Ian C. Reid, Caroline A. Stewart

    Research output: Contribution to journalReview articlepeer-review

    85 Citations (Scopus)

    Abstract

    Background: New research in animals is beginning to change radically our
    understanding of the biology of stress and the effects of
    antidepressant agents. Aims: To relate recent findings from the basic
    neurosciences to the pathophysiology of depressive disorder. Method:
    Drawing together findings from molecular and physiological studies in
    rats, social studies in primates and neuropsychological studies in
    humans, we review the neurotrophic and neuroplastic effects of
    antidepressants and stress. Results: Stress and antidepressants have
    reciprocal actions on neuronal growth and vulnerability (mediated by the
    expression of neurotrophins) and synaptic plasticity (mediated by
    excitatory amino acid neurotransmission) in the hippocampus and other
    brain structures. Stressors have the capacity to progressively disrupt
    both the activities of individual cells and the operating
    characteristics of networks of neurons throughout the life cycle, while
    antidepressant treatments act to reverse such injurious effects.
    Conclusions: We propose a central role for the regulation of synaptic
    connectivity in the pathophysiology of depressive disorder.

    Original languageEnglish
    Pages (from-to)299-303
    Number of pages5
    JournalBritish Journal of Psychiatry
    Volume178
    Issue number4
    DOIs
    Publication statusPublished - 2001

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