미래의 항우울제

Abstract

Recent advances in research on depression have confirmed that it is common, chronic, recurrent and disabling men-tal disorder. The treatment of depression has gained growing importance because of its major impact on the patient’s wellbeing, personal and social achievements. Recently, as an increasing number of antidepressants of various types continue to be developed for the treatment of depression, psychopharmacotherpy is the major approach to depression in clinical setting. Unfortunately, there are clear limitations to the currently approved pharmacotherapies of depression, including the fact that they are all essentially monoamine based, have modest efficacy and a relatively slow onset of efficacy, and suffer from significant tolerability issues. Recently, several promising hypotheses of depression and antidepressant action have been formulated. These hypotheses are based on dysregulation of hypothalamic-pituitary-adrenal(HPA) axis, neurotrophic mechanisms, glutamate, neurokinin, phosphodiesterase, cytokines. This article reviews these most promising novel mechanisms that are not represented in compounds currently approved for de-pression in either the United States or Europe and that may represent the future of the psychopharmacologic treatment of depression.