___1067–1090

Psychiatr. Pol. 2020; 54(6): 1067–1090

 

Paul W. Andrews, Jay D. Amsterdam
 

FREE POLISH FULLTEXT:
 

FREE ENGLISH FULLTEXT:
 

Summary
Antidepressants such as the selective serotonin reuptake inhibitors (SSRIs) have complex temporal effects. They may worsen symptoms during early treatment, they may reduce depressive symptoms over several weeks of treatment, and they may lose effectiveness over more prolonged treatment or after repeated treatment trials. Conceptually, these effects fall within the domain of hormesis, which refers to a biphasic or multiphasic response to a drug or toxin. Hormetic effects are commonly triggered when a drug interacts with homeostatic mechanisms. We develop and evaluate a theoretical framework for understanding how adaptations to SSRIs that restore synaptic homeostasis may partially contribute to their hormetic effects. Specifically, the serotonin system adapts to SSRIs by suppressing the firing of serotonergic neurons, inhibiting the synthesis of serotonin, and reducing the overall content of serotonin in the brain. Moreover, rodent models such as inescapable shock show that serotonin neurotransmission to specific forebrain regions is a necessary, but insufficient cause of depressive symptoms. Our review suggests: (1) early worsening of symptoms may be related to the direct effects of SSRIs on synaptic serotonin; (2) the symptom-reducing effects could be related to the loss of serotonin content in the brain during SSRI exposure; (3) the loss of efficacy over prolonged exposure could be related to the central nervous system equilibrating to the SSRIs. The serotonin system’s adaptations to SSRIs may play a clinically meaningful role in their hormetic effects on depressive symptoms. A complete understanding of SSRIs’ hormetic effects will require exploring temporal dynamics in other neurotransmitter systems.


ISSN 0033-2674 (PRINT)

ISSN 2391-5854 (ONLINE)


Psychiatria Polska
is an Open Access journal:
Creative Commons: CC-BY
SHERPA RoMEO:
Blue


Zadanie finansowane
w ramach umowy
nr 739/P-DUN/2018
ze środków MNiSW
przeznaczonych
na działalność
upowszechniającą naukę


KRW PTP dziękuje 
firmie PPL – Koral – J.Koral sp.j.
za wsparcie finansowe 
udzielone w 2020 roku




Inne strony PTP:
Other PTP websites:

www.psychiatria.org.pl
www.psychiatriapsychoterapia.pl

www.archivespp.pl
www.psychoterapiaptp.pl

Psychiatria Polska
INDEXED IN:
Thomson Reuters Master List
Science Citation Index Expanded
Journal Citation Reports
(Impact Factor 1,190)

Medline/Index Medicus
PubMed/LinkOut
MNiSW (40 pkt)
Scopus/SCImago
(SJR 0,381; SNIP 0,587)
EMBASE/Excerpta Medica
PsycINFO, EBSCO,
Index Copernicus
Erih Plus, Cochrane Library
CrossRef/DOI

We recommend:

Pharmacological Reports

 


KONTAKT Z REDAKCJĄ - wyłącznie e-mail: redakcja@psychiatriapolska.pl 

Biuro KRW PTP - prenumeraty, faktury:  518-330-994 lub biuro@krwptp.pl 
krwptp.pl