Journal
NEUROSCIENTIST
Volume 17, Issue 1, Pages 124-144Publisher
SAGE PUBLICATIONS INC
DOI: 10.1177/1073858410361780
Keywords
gamma-aminobutyric acid; glutamate; corticotrophin-releasing hormone; depression; cerebrospinal fluid; plasma
Categories
Funding
- Innovative Postgraduate Research Projects Program of Zhejiang Province, P.R. China [YK2008007]
- Nature Science Foundation of China [30970928]
- Science Foundation of Chinese University
- Royal Netherlands Academy of Arts and Sciences (KNAW) [09CDP011]
- Hersenstichting Nederland [14F06(2).07]
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Stress response and depression have a significant impact on modern society. Although the symptoms are well characterized, the molecular mechanisms underlying depression are largely unknown. The monoamine hypothesis, which postulates dysfunctional noradrenergic and serotonergic systems as the underlying primary cause of depression, has been valuable for the development of conventional antidepressants, which can reverse these dysfunctional states to some degree. However, recent data from various neuroscience disciplines have questioned the major role of amines in the pathogenesis of depression. A considerable amount of evidence has accumulated that suggests that normalization of the hypothalamo-pituitary-adrenal (HPA) system might be the final step necessary for a remission of depression. In addition, an increasing body of clinical and postmortem evidence is pointing to a role played by gamma-aminobutyric acid (GABA) and glutamate in the etiology of depression. This review examines the evidence, mainly obtained from clinical studies or from postmortem brain material, for a major role of the HPA axis, glutamatergic, and GABAergic systems in the pathogenesis of major and bipolar depression. The authors hope that these insights will stimulate further studies with the final aim of developing new types of antidepressants that combine increased efficacy with a shorter delay of the onset of action and reduced side-effect profiles.
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