Combined treatment with atypical antipsychotics and antidepressants in treatment-resistant depression: preclinical and clinical efficacy.
Journal Title: Pharmacological Reports - Year 2013, Vol 65, Issue 6
Abstract
Several clinical reports have documented a beneficial effect of adding atypical antipsychotic drugs to ongoing treatments with antidepressants, particularly selective serotonin reuptake inhibitors, in ameliorating drug-resistant depression. The aim of this paper was to summarize some preclinical evidence describing the mechanism responsible for the therapeutic action of combined treatment with antidepressants and atypical antipsychotics and also some clinical data supporting the efficacy and safety of the augmentation strategy for improving antidepressant-resistant depression using atypical antipsychotics. This analysis is based on five microdialysis studies and nine behavioral studies assessing the impact of combined atypical antipsychotic and antidepressant treatments on extracellular levels of dopamine, serotonin and noradrenaline in the prefrontal cortex of freely moving rats and on antidepressant-induced effects, respectively. In addition, clinical data demonstrating the efficacy and safety of augmentation strategies for treatment-resistant depression using atypical antipsychotics were included. Combined treatment of rats with all studied atypical antipsychotics (olanzapine, risperidone, clozapine and quetiapine) and antidepressants (citalopram, fluoxetine and fluvoxamine) increased the extracellular level of dopamine in the prefrontal cortex compared to a respective drug given alone; in addition, a combination of olanzapine or quetiapine plus fluoxetine or fluvoxamine increased the levels of dopamine and noradrenaline. Moreover, atypical antipsychotics administered in a low dose enhanced the antidepressant-like activity of antidepressants, with (among other mechanisms) the serotonin 5-HT1A, 5-HT2A and adrenergic α2 receptors likely playing an important role in their action. The results support the conclusion that atypical antipsychotics may be effective as adjunctive therapy in treatment-resistant depression; however, their adverse effect profile may be unfavorable in some patients.
Authors and Affiliations
Zofia Rogóż
Keywords
Related Articles
- EP ID EP157492
- DOI -
- Views 91
- Downloads 0
Effect of kaempferol on the production and gene expression of monocyte chemoattractant protein-1 in J774.2 macrophages.
Monocyte chemoattractant protein-1 (MCP-1) is produced by activated macrophages, and is involved in pathogenesis of cardiovascular and neurodegenerative disorders. There is a need to develop drugs that inhibit excessive...
Anti-apoptotic effect of phloretin on cisplatin-induced apoptosis in HEI-OC1 auditory cells.
Cisplatin is a highly effective chemotherapeutic agent, but it has significant ototoxic side effects. Apoptosis is an important mechanism of cochlear hair cell loss following exposure to cisplatin. The present study exam...
Effects of escin on acute inflammation and the immune system in mice.
Escin has been used extensively to treat chronic venous insufficiency, hemorrhoids, and edema resulting from cerebral ischemic damage, trauma or operation. However, no studies have looked at the anti-inflammatory propert...
Stress-opioid interactions: a comparison of morphine and methadone.
The utility of methadone and morphine for analgesia and of methadone for substitution therapy for heroin addiction is a consequence of these drugs acting as opioid receptor agonists.We compared the cataleptogenic and ant...
Cigarette smoke-induced biochemical perturbations in human erythrocytes and attenuation by epigallocatechin-3-gallate--tea catechin.
The protective effect of epigallocatechin-3-gallate (EGCG) against cigarette smoke (CS) induced alterations in human erythrocyte was studied using an in vitro model. Hemolysis, carboxyhemoglobin, osmotic fragility, hemin...