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Current Drug Targets
ISSN (Print): 1389-4501
ISSN (Online): 1873-5592
VOLUME: 7
ISSUE: 2
DOI: 10.2174/138945006775515464      Price:  $58









Catecholaminergic Strategies for the Treatment of Major Depression

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Author(s): Philippe Tremblay and Pierre Blier
Pages 149-158 (10)
Abstract:
Although the selective serotonin reuptake inhibitors have become the first line medications for the treatment of depression, drugs primarily targeting the norepinephrine (NE) and/or the dopamine catecholaminergic systems are also effective. These include selective NE reuptake inhibitors, such as desipramine and reboxetine, the NE releaser bupropion and the α2-adrenergic antagonists mianserin and mirtazapine. Dopamine type 2 agonists are also effective in treating depression, although they are rarely used. Since the NE, dopamine and serotonin systems have reciprocal interactions, it is virtually impossible to act on a specific neuronal element without affecting in a cascade effect the two other systems. In this review, the primary actions of the catecholaminergic strategies upon their acute and long-term administration are described, as well as their impact on other systems. Their use in treatment-resistant depressed patients is also addressed.
Keywords:
Dopamine, norepinephrine, serotonin, locus coeruleus, raphe nuclei, ventral tegmental area
Affiliation:
Institute of Mental HealthResearch, Lady Grey Building, suite 2043, Royal Ottawa Hospital, Universityof Ottawa, Ottawa, Canada.