Why do antidepressants take so long to work? A cognitive neuropsychological model of antidepressant drug action

Harmer, Catherine J.; Goodwin, Guy M.; Cowen, Philip J.

doi:10.1192/bjp.bp.108.051193

Cited by 470 publications

(470 citation statements)

References 46 publications

Supporting

Mentioning

436

Contrasting

Unclassified

Order By: Relevance

“…insomnia) are prone to improve or worsen early in treatment as a consequence of side effects of the antidepressant, and hence will confound the assessment of early improvement. There is also some evidence that certain depressive symptoms may improve earlier and to a greater extent than other core symptoms [11,15,29]. Further research into new clinical metrics, possessing greater item sensitivity and specificity for detection of these early effects of antidepressant therapy, is required.…”

Section: Future Research Directionsmentioning

confidence: 99%

Early Switching Strategies in Antidepressant Non-Responders: Current Evidence and Future Research Directions

2014

View full text Add to dashboard Cite

Studies have found that up to two-thirds of patients with major depressive disorder (MDD) do not fully respond to the first antidepressant. While switching antidepressants is a common strategy for antidepressant nonresponders, there is still a lack of consensus about the optimal timing of a switch. Many clinicians wait for 6-12 weeks before considering a switch. The objectives of this paper are to (1) review the evidence for positive and negative predictive value (NPV) of early improvement at 2-4 weeks to predict final antidepressant response; (2) review randomized controlled trials (RCTs) that examine early switching strategies; and (3) provide future research directions and clinical recommendations for timing of antidepressant switching. We conducted a literature search for English

show abstract

Section: Future Research Directionsmentioning

confidence: 99%

Early Switching Strategies in Antidepressant Non-Responders: Current Evidence and Future Research Directions

2014

View full text Add to dashboard Cite

show abstract

“…8 In this model of depression, adult Wistar rats were socially deprived for a period of 15 days. Rats were housed singly in cages (38cm×26cm×20cm) without any visual or auditory contact with their normally housed counter parts for 15 days.…”

Section: Design Of Experimentsmentioning

confidence: 99%

Effect of nicotine on serotonin (5-HT) levels in brain of depressed rats

Bhalsinge

Barde

Worlikar

et al. 2017

Int J Basic Clin Pharmacol

View full text Add to dashboard Cite

Background: Reduction in brain serotonin (5-HT) levels contributes to depression. Nicotine may have antidepressant properties and smokers self-medicate underlying depression. Epidemiological findings suggest that smokers more often demonstrate depressive symptoms than non-smokers and depressed patients are less likely to cease smoking. Therefore, the study was planned to evaluate the effect of nicotine on serotonin levels in brain of depressed rats.Methods: Antidepressant action of study drugs was evaluated using isolation induced hyperactivity model in rats. Rats were divided into five groups with six rats in each group. Study groups: Vehicle in normal rats 1 ml/kg (subcutaneous); vehicle after isolation 1ml/kg (subcutaneous); imipramine 10 mg/kg (intraperitoneal) for 7 consecutive days; single dose of nicotine 0.4 mg/kg (subcutaneous); single dose of nicotine 0.2 mg/kg (inhalational). Brain serotonin assay was carried out. The statistical significance was determined by ANOVA followed by Tukey test (p<0.05).Results: Serotonin levels (55.93ng/g of brain tissue) in rats after isolation were significantly less than in normal rats (335.87ng/g) (p<0.001). In imipramine treated group, serotonin levels (301.4ng/g) after isolation were highly significant as compared to serotonin levels in vehicle treated group after isolation (p<0.001). Nicotine administered by subcutaneous and inhalational route showed significantly higher brain serotonin levels, i.e. 175ng/g and 254.62ng/g respectively as compared to vehicle treated rats after isolation (p<0.001).Conclusions: Single dose nicotine (inhalational) produced significant antidepressant action comparable to that of seven days’ treatment of standard antidepressant drug imipramine in rats. In rats, nicotine by both routes i.e. subcutaneous and inhalational increased serotonergic activity.

show abstract

“…140,141 Moreover, a number of studies have shown that changes in cognitive factors are not specific to CBT interventions [e.g. also being seen in patients receiving pharmacotherapy, 141,142 with some attributing such non-specific effects as being a consequence (rather than cause) of treatment 143 ].…”

Section: Introductionmentioning

confidence: 99%

Clinical effectiveness and cost-effectiveness of cognitive behavioural therapy as an adjunct to pharmacotherapy for treatment-resistant depression in primary care: the CoBalT randomised controlled trial

Wiles

Thomas

Abel

et al. 2014

Health Technology Assessment

View full text Add to dashboard Cite

Why do antidepressants take so long to work? A cognitive neuropsychological model of antidepressant drug action

Cited by 470 publications

References 46 publications

Early Switching Strategies in Antidepressant Non-Responders: Current Evidence and Future Research Directions

Early Switching Strategies in Antidepressant Non-Responders: Current Evidence and Future Research Directions

Effect of nicotine on serotonin (5-HT) levels in brain of depressed rats

Clinical effectiveness and cost-effectiveness of cognitive behavioural therapy as an adjunct to pharmacotherapy for treatment-resistant depression in primary care: the CoBalT randomised controlled trial

Contact Info

Product

Resources

About