New Developments in the Mechanisms of Action of Drugs Used in Depressıon Treatment

Yıl 2024, Cilt: 33 Sayı: 4, 227 - 233, 31.12.2024

Gülcan Tanrıkulu Kayan , Salim Yalçın İnan , Yusuf Karataş

https://doi.org/10.17827/aktd.1536755

Öz

Depression is a long-term emotional condition marked by symptoms such as sadness, hopelessness, loss of interest, and decreased energy. Major depressive disorder is a neuropsychiatric condition that harms millions of people. The causes and risk factors of this mental condition, which is distinguished by its high prevalence, treatment resistance, and risk of relapse, have been widely investigated in both pre- and clinical investigations. Monoamine synthesis, release, transformation and reuptake are the subject of extensive research, as they are hypothesized to play a role in the etiopathogenesis of depression. These researches are mostly concerned with explaining monoamines like norepinephrine, serotonin and dopamine. According to the national and international guidelines, selective serotonin reuptake inhibitors are typically advised as the first-line treatment for major depression. Other selective monoamine reuptake inhibitors, such as serotonin-norepinephrine reuptake inhibitors are also available. Similarly, drugs including bupropion may contribute to the treatment of depression by offering a different effect profile. However, there are some concerns about the efficacy of these drugs. Although the acute pharmacological effects of current antidepressant drugs are linked to modulation of serotonin and/or norepinephrine transmission in the brain, the cellular and biochemical mechanisms underlying the long-term adaptations required for antidepressant effects have yet to be fully understood. The purpose of this study is to provide information about the pharmacological mechanisms of antidepressants based on current evidence.

Anahtar Kelimeler

Antidepressant drugs, depression, pharmacological mechanisms

Depresyon Tedavisinde Kullanılan İlaçların Etki Mekanizmalarındaki Yeni Gelişmeler

Öz

Depresyon; kişinin duygusal durumunda uzun süreli bir bozukluğa işaret eden, üzüntü, umutsuzluk, ilgi kaybı ve enerji düşüklüğü gibi belirtilerle karakterize olan mental bir sağlık sorunudur. Majör depresif bozukluk, milyonlarca insanı olumsuz olarak etkileyen nöropsikiyatrik bir hastalıktır. Yüksek yaygınlık, tedavi direnci ve tekrarlama riski ile karakterize edilen bu ruhsal bozukluğun nedenleri ve risk faktörleri, hem öncesi hem de klinik çalışmalarda kapsamlı bir şekilde incelenmiştir. Depresyon etiyopatogenezinde rol oynadığı düşünülen monoaminlerin sentezi, salgılanması, dönüşümü ve geri alımıyla ilgili yoğun araştırmalar yapılmaktadır. Bu araştırmalar genellikle norepinefrin, serotonin ve dopamin gibi monoaminlerle ilgili açıklamalara odaklanmaktadır. Ulusal ve uluslararası kılavuzlar, major depresyonlu çoğu hastada birinci basamak tedavi olarak genellikle seçici serotonin geri alım inhibitörlerini önermektedir. Serotonin-norepinefrin geri alım inhibitörleri gibi diğer seçici monoamin geri alım inhibitörleri de bulunmaktadır. Bupropion gibi diğer ilaçlar, farklı bir etki profili sunarak depresyon tedavisine katkıda bulunabilir. Ancak bu ilaçların etkinlikleri konusunda bazı belirsizliklerin bulunduğu ifade edilmektedir. Mevcut antidepresan ilaçların akut farmakolojik etkileri, beyindeki serotonin ve/veya norepinefrin iletiminin modülasyonuyla ilişkilendirilse de, antidepresan ilaç tedavilerinin terapötik etkileri için gerekli olan uzun dönem adaptasyonların altında yatan hücresel ve biyokimyasal mekanizmalar henüz tam olarak aydınlatılamamıştır. Bu çalışmada antidepresan ilaçların farmakolojik mekanizmaları hakkında, güncel çalışmalarla bilgi verilmesi amaçlanmıştır.

Anahtar Kelimeler

Antidepresan ilaçlar, Depresyon, Farmakolojik mekanizmalar

Kaynakça

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