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왜 다양한 항우울제가 필요한가?Why Do We Need Diverse Antidepressants?

Other Titles
Why Do We Need Diverse Antidepressants?
Authors
윤호경김용구
Issue Date
Jan-2008
Publisher
대한신경정신의학회
Keywords
Antidepressant; Neurobiology; Monoamine; Cytokine; Depression
Citation
JOURNAL OF THE KOREAN NEUROPSYCHIATRIC ASSOCIATION, v.47, no.1, pp.11 - 21
Indexed
KCI
Journal Title
JOURNAL OF THE KOREAN NEUROPSYCHIATRIC ASSOCIATION
Volume
47
Number
1
Start Page
11
End Page
21
URI
https://scholarworks.korea.ac.kr/kumedicine/handle/2020.sw.kumedicine/17217
ISSN
1015-4817
Abstract
Depression is a chronic, recurring and potentially life-threatening illness. Depression is a syndrome notable for heterogeneity of its clinical presentation, treatment responsiveness, neurobiology, and genetics. The highly variable compilation of symptoms that is used to define depression, and the highly variable course of the illness and its response to various treatments, indicate that depression subsumes numerous disease states of distinct etiology, and perhaps distinct pathophysiology. Current understanding of the mechanisms of pharmacotherapy for depression is characterized by the emphasis on increasing synaptic availability of serotonin, noradrenaline, and possibly dopamine, while minimizing side effects. This is unfortunate, because less than half of individuals with depression show full remission in response to these mechanisms. While current pharmacotherapies target monoaminergic systems, distinct neurobiological underpinnings and other systems are likely involved in the pathogenesis of depression. Recently, several promising hypotheses of depression and antidepressant action have been formulated. These hypotheses are largely based on dsyregulation of neural plasticity, CREB, BDNF, corticotropin-releasing factor, glucocorticoid, hypothalamic-pituitary adrenal axis and cytokines. Based on these new theories and hypotheses of depression, a number of new and novel agents show a considerable promise for refining treatment options for depression. In this article, we provide an overview of the mechanisms of action of currently available antidepressant treatments. We then provide a progress report on some of the most promising current strategies.
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Kim, Yong Ku
안산병원 (Department of Psychiatry, Ansan Hospital)
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