Receptor sensitivity and the mechanism of action of antidepressant treatment. Implications for the etiology and therapy of depression.
Receptor sensitivity and the mechanism of action of antidepressant treatment. Implications for the etiology and therapy of depression.
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DOI：
10.1001/archpsyc.1981.01780350094011
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发表时间：
1981-10
影响因子：
--
通讯作者：
D. Charney;D. Menkes;G. Heninger
中科院分区：
文献类型：
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作者：
D. Charney;D. Menkes;G. Heninger
大量证据表明，抗抑郁药治疗对脑去甲肾上腺素（NE）和血清素（5-HT）系统的急性影响不能完全解释其延迟治疗作用。本文综述了长期抗抑郁药物治疗对生物胺代谢及突触前和突触后受体功能各项指标的影响。与对NE和5-羟色胺转换以及突触前受体敏感性的可变影响相反，几乎所有长期抗抑郁药物治疗都会在突触后胺受体敏感性的许多测量中产生一致的改变。研究发现，长期治疗可降低-肾上腺素能敏感性，同时增强对血清素能和-肾上腺素能刺激的反应，这表明受体敏感性的调节可能是三环抗抑郁药、“非典型”抗抑郁药、单胺氧化酶抑制剂和电休克治疗的共同作用机制。这些发现为抑郁症中胺受体异常的假设提供了支持，并表明需要扩大对患者胺受体功能的研究。
Considerable evidence suggests that the acute effects of antidepressant treatments on brain norepinephrine (NE) and serotonin (5-HT) systems cannot account fully for their delayed therapeutic action. This review evaluates the effects of long-term antidepressant treatment on biogenic amine metabolism and on various indexes of presynaptic and postsynaptic receptor function. In contrast to variable effects on NE and 5-HT turnover and on presynaptic receptor sensitivity almost all long-term antidepressant treatments produce consistent alterations in a number of measures of postsynaptic amine receptor sensitivity. Long-term treatment has been found to reduce beta-adrenergic sensitivity while enhancing responses to serotonergic and alpha-adrenergic stimulation, suggesting that modulation of receptor sensitivity may be a mechanism of action common to tricyclic antidepressants, "atypical" antidepressants, monoamine oxidase inhibitors, and electroconvulsive therapy. These findings provide support for hypotheses of amine receptor abnormalities in depression and indicate the need for expanded studies of amine receptor function in patients.