Antidepressant and Antipsychotic Drugs

Neuroimmunomodulation in unipolar depression: a focus on chronobiology and chronotherapeutics

“…ADs have variable effects on chronobiology, and a variety of immunomodulatory effects (Janssen et al 2010;Krystal 2010;Thase et al 2010). Immunomodulatory effects on inflammatory and cellular immune processes, as well as neuroplastic processes, are outside the scope of this review and are summarised in Table 2.…”

“…Individual classes of ADs need to be considered for their differing effects on chronobiology and neuroimmunomodulatory processes, including SSRIs, serotonin noradrenaline reuptake inhibitors (SNRIs), NRIs, tricyclic antidepressants (TCAs) and other stand-alone or augmentation therapeutics such as mirtazapine, olanzapine and quetiapine (Mayers and Baldwin 2005;Baune et al 2007; Table 2 continued Inflammatory processes Krystal 2010; Thase et al 2010). In general, serotonin reuptake inhibition suppresses REM sleep and has a tendency towards wake promotion (Krystal 2010), as well as noradrenaline re-uptake inhibition appears to promote wakefulness (Krystal 2010). The negative effects of serotonin and noradrenaline attenuate over time (Thase et al 2010).…”

“…It is believed the effects of these agents depend on pharmacokinetic and dosing factors, side-effects, and individual changes to baseline sleep parameters and neuropsychiatric symptoms (Mayers and Baldwin 2005;Krystal 2010). Furthermore, these ADs appear to have melatonin modulating effects by stimulating melatonin synthesis (reviewed recently in Antonioli et al 2012).…”

“…Additionally, ADs and CTs can influence chronobiological processes via the monoamine system and the HPA axis. SSRI selective serotonin reuptake inhibitor, SNRI serotonin noradrenaline reuptake inhibitor, NRI noradrenaline reuptake inhibitor, TCA tricyclic antidepressant, CBT cognitive behavioural therapy, X-3 omega-3 polyunsaturated fatty acid, CAM cellular adhesion molecule, IGF-1 insulin-like growth factor-1, NSC neural stem cell, HPA hypothalamo-pituitary-adrenal, CCG clock-controlled gene Chronotherapeutics Whilst there are a number of chronotherapeutics available to treat circadian disruptions associated with depression, such as bright light therapy and wake promoters (modafinil), this section will focus on agomelatine and melatonin given the combined efficacy and potential neuroimmunomodulatory effects (Krystal 2010;Thase et al 2010;Wulff et al 2010).…”

“…CTs that re-synchronise circadian phase, hence ameliorating depression-related circadian dysfunction, appear to be effective in depressive symptom relief (Baune et al 2007;Coogan and Thome 2011). However, some classical ADs, including selective serotonin reuptake inhibitors (SSRIs) and noradrenaline reuptake inhibitors (NRIs), may disrupt circadian processes, hence having a detrimental effect on sleep-wake cycles (Krystal 2010;Antonioli et al 2012). A newer CT, agomelatine, effective in the treatment of depression Hickie and Rogers 2011), may also exert beneficial neuroimmunomodulatory and pro-neuroplastic effects (Bondy et al 2010;Garcia-Macia et al 2011;Min et al 2011;Racagni et al 2011;RamirezRodriguez et al 2011).…”