Why do antidepressants take so long to work? A cognitive neuropsychological model of antidepressant drug action
Why do antidepressants take so long to work? A cognitive neuropsychological model of antidepressant drug action
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DOI：
10.1192/bjp.bp.108.051193
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发表时间：
2009-08-01
影响因子：
10.5
通讯作者：
Cowen, Philip J.
中科院分区：
文献类型：
--
作者：
Harmer, Catherine J.;Goodwin, Guy M.;Cowen, Philip J.
背景抗抑郁药物的神经药理作用有很好的特点，但我们对这些变化如何转化为改善情绪的理解仍在不断涌现。目的调查抗抑郁药物对情绪处理的作用是否是这些药物对抑郁影响的中介因素。方法我们审查了关键发表的研究结果，这些发现探索了抗抑郁药物对情绪处理的行为和功能磁共振成像(FMRI)测量的影响。结果负性情绪偏差与抑郁确实相关。一致的结果表明，抗抑郁药调节情绪处理和增加积极情绪处理的时间比对情绪的影响要早得多。情绪处理的这些变化与边缘和前额叶神经回路的神经调节有关。结论抗抑郁药物的作用方式可能与抑郁症的认知理论一致。抗抑郁药并不直接起到情绪增强剂的作用，而是改变了积极和消极情绪处理的相对平衡，为随后的认知和心理再巩固提供了一个平台。
BackgroundThe neuropharmacological actions of antidepressants are well characterised but our understanding of how these changes translate into improved mood are still emerging.AimsTo investigate whether actions of antidepressant drugs on emotional processing are a mediating factor in the effects of these drugs in depression.MethodWe examined key published findings that explored the effects of antidepressants on behavioural and functional magnetic resonance imaging (fMRI) measures of emotional processing.ResultsNegative emotional bias has been reliably associated with depression. Converging results suggest that antidepressants modulate emotional processing and increase positive emotional processing much earlier than effects on mood. These changes in emotional processing are associated with neural modulation in limbic and prefrontal circuitry.ConclusionsAntidepressants may work in a manner consistent with cognitive theories of depression. Antidepressants do not act as direct mood enhancers but rather change the relative balance of positive to negative emotional processing, providing a platform for subsequent cognitive and psychological reconsolidation.