New Treatment Strategies of Depression: Based on Mechanisms Related to Neuroplasticity

• Published in: Journal of neural transplantation & plasticity Vol. 2017; no. 2017; pp. 1 - 11
• Main Authors: Huang, Yu-Jhen, Lin, Chieh-Hsin, Lane, Hsien-Yuan
• Format: Journal Article
• Language: English
• Published: Cairo, Egypt Hindawi Publishing Corporation 01.01.2017; Hindawi; John Wiley & Sons, Inc; Hindawi Limited; Wiley
• Subjects: Animals; Antidepressants; Antidepressive Agents - therapeutic use; Brain - metabolism; Brain - physiopathology; Brain-derived neurotrophic factor; Care and treatment; Clinical Trials as Topic; Depressive Disorder, Major - metabolism; Depressive Disorder, Major - physiopathology; Depressive Disorder, Major - therapy; Disease Models, Animal; Drug Partial Agonism; Electroconvulsive Therapy; Health aspects; Humans; Ketamine; Ketamine - administration & dosage; Kinases; Major depressive disorder; Mental depression; Neuronal Plasticity; Neuroplasticity; Pathophysiology; Phosphorylation; Proteins; Psychotropic drugs; Receptors, Metabotropic Glutamate - antagonists & inhibitors; Receptors, N-Methyl-D-Aspartate - agonists; Receptors, N-Methyl-D-Aspartate - antagonists & inhibitors; Receptors, N-Methyl-D-Aspartate - metabolism; Response rates; Review; Signal Transduction; Studies; Synaptic Transmission; Transcranial Direct Current Stimulation; Transcranial Magnetic Stimulation; Treatment Outcome
• ISSN: 2090-5904; 0792-8483; 1687-5443
• DOI: 10.1155/2017/4605971

Major depressive disorder is a severe and complex mental disorder. Impaired neurotransmission and disrupted signalling pathways may influence neuroplasticity, which is involved in the brain dysfunction in depression. Traditional neurobiological theories of depression, such as monoamine hypothesis, cannot fully explain the whole picture of depressive disorders. In this review, we discussed new treatment directions of depression, including modulation of glutamatergic system and noninvasive brain stimulation. Dysfunction of glutamatergic neurotransmission plays an important role in the pathophysiology of depression. Ketamine, an N-methyl-D-aspartate (NMDA) receptor antagonist, has rapid and lasting antidepressive effects in previous studies. In addition to ketamine, other glutamatergic modulators, such as sarcosine, also show potential antidepressant effect in animal models or clinical trials. Noninvasive brain stimulation is another new treatment strategy beyond pharmacotherapy. Growing evidence has demonstrated that superficial brain stimulations, such as transcranial magnetic stimulation, transcranial direct current stimulation, cranial electrotherapy stimulation, and magnetic seizure therapy, can improve depressive symptoms. The antidepressive effect of these brain stimulations may be through modulating neuroplasticity. In conclusion, drugs that modulate neurotransmission via NMDA receptor and noninvasive brain stimulation may provide new directions of treatment for depression. Furthermore, exploring the underlying mechanisms will help in developing novel therapies for depression in the future.