Neurobiology of Depression and Mechanism of Action of Depression Treatments

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Antidepressants, such as selective serotonin reuptake inhibitors (SSRIs), may alleviate depressive symptoms but also leave residual symptoms. The mechanism of action of SSRIs increases serotonin (5-HT) activity but decreases norepinephrine (NE) and dopamine (DA) activity. By engaging additional targets (eg, NE, DA) along with 5-HT, clinicians may help patients with residual symptoms and treatment-resistant depression. Dual-acting agents and combination strategies can be used to target specific symptoms or block/activate specific receptors for broader therapeutic benefits. Clinicians who understand the mechanism of action of antidepressants can switch or combine agents as needed to help patients achieve complete remission.

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J Clin Psychiatry 2016;77(3):e319

https://doi.org/10.4088/JCP.13097tx3c