Depression: From Psychopathology to Pharmacotherapy

Depression: From Psychopathology to Pharmacotherapy

Modern Trends in Pharmacopsychiatry Vol. 27 Series Editor B.E. Leonard Galway

Depression: From Psychopathology to Pharmacotherapy Volume Editors J.F. Cryan Cork B.E. Leonard Galway 11 figures and 13 tables, 2010 Basel Freiburg Paris London New York Bangalore Bangkok Shanghai Singapore Tokyo Sydney

Modern Trends in Pharmacopsychiatry (Formerly published as Modern Problems in Pharmacopsychiatry ) John F. Cryan, PhD Senior Lecturer in Pharmacology School of Pharmacy Department of Pharmacology & Therapeutics Cavanagh Pharmacy Building University College Cork Cork (Ireland) Prof. Brian E. Leonard Department of Pharmacology National University of Ireland Galway (Ireland) Library of Congress Cataloging-in-Publication Data Depression : from psychopathology to pharmacotherapy / volume editors, J.F. Cryan, B.E. Leonard. p. ; cm. -- (Modern trends in pharmacopsychiatry, ISSN 1662-2685 ; 27) Includes bibliographical references and indexes. ISBN 978-3-8055-9605-3 (hard cover : alk. paper) -- ISBN 978-3-8055-9606-0 (e-isbn) 1. Antidepressants. 2. Depression, Mental--Chemotherapy. 3. Depression, Mental--Pathophysiology. I. Cryan, J. F. (John F.) II. Leonard, B. E. III. Series: Modern trends in pharmacopsychiatry, 27. 1662-2685 [DNLM: 1. Depressive Disorder--drug therapy. 2. Depressive Disorder--psychology. 3. Antidepressive Agents--therapeutic use. W1 MO168P v.27 2010 / WM 171] RM332.D47 2010 616.85'27061--dc22 2010038840 Bibliographic Indices. This publication is listed in bibliographic services, including Current Contents and Index Medicus. Disclaimer. The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publisher and the editor(s). The appearance of advertisements in the book is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements. Drug Dosage. The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any change in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug. All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher. Copyright 2010 by S. Karger AG, P.O. Box, CH 4009 Basel (Switzerland) www.karger.com Printed in Switzerland on acid-free and non-aging paper (ISO 9706) by Reinhardt Druck, Basel ISSN 1662 2685 ISBN 978 3 8055 9605 3 e-isbn 978 3 8055 9606 0

Section Title Contents VII Preface Antidepressants: Past and Present 1 Antidepressant Compounds: A Critical Review Tang, S.W.; Helmeste, D.M. (Irvine, Calif.); Leonard, B.E. (Galway) Basic and Clinical Aspects of Depression Research 20 The Hypothalamic-Pituitary-Adrenal Axis in Depression Julio-Pieper, M.; Dinan, T.G. (Cork) 32 Dysfunctional Circadian Rhythms and Mood Disorders: Opportunities for Novel Therapeutic Approaches Norman, T.R. (Heidelberg, Vic.) 53 The Concept of Depression as a Dysfunction of the Immune System Leonard, B.E. (Galway/Munich) 72 The Role of Polyunsaturated Fatty Acids in the Pathology and Treatment of Depression Song, C. (Charlottetown, P.E.I.) 89 Overcoming Antidepressant Treatment Resistance: Focus on Glutamate Murrough, J.W. (New York, N.Y.); Mathew, S.J. (Houston, Tex.) 101 Neuroimaging and the Pathophysiology and Treatment of Depression: Recent Advances and Future Needs Cannon, D.M. (Galway) Experimental Models of Depression and the Mechanisms of Action of Antidepressants 124 Animal Models of Depression Where Are We Going? Slattery, D.A. (Regensburg); Cryan, J.F. (Cork) 139 Genetic Models of Depression and Antidepressant Response Lucki, I. (Philadelphia, Pa.) 155 The Role of 5-HT 2C Receptors in the Antidepressant Response: A Critical Review Martin, C.B.P.; Hamon, M.; Lanfumey, L.; Mongeau, R. (Paris) 182 Chromatin-Based Treatments for Affective Disorders Insight or Utopia Covington, H.E. III, (Durham, N.C.); Berton, O. (Philadelphia, Pa.) V

199 Neurotrophic Factors and Antidepressant Action: Recent Advances O Leary, O.F. (Cork); Castrén, E. (Helsinki) 224 Neurogenic Basis of Antidepressant Action: Recent Advances Tanti, A.; Belzung, C. (Tours) The Future of Antidepressants 243 The Nature and Treatment of Therapy-Resistant Depression Kennedy, S.H.; Rizvi, S.J.; Giacobbe, P. (Toronto, Ont.) 254 Optimizing Antidepressant Management of Depression: Current Status and Future Perspectives Schwartz, T.L. (Syracuse, N.Y.); Stahl, S.M. (San Diego, Calif./Cambridge) 268 Author Index 269 Subject Index VI Contents

Section Title Preface Melancholy Sits on me as a cloud along the sky, Which will not let the sunbeams through, nor yet Descend in rain and end; but spreads itself Twixt heaven and earth, like envy between man And man, and is an everlasting mist' Lord Byron Throughout recorded history, depression has been recognised as a disorder of the brain and the body. In the Old Testament of the Bible, the book of Job (4th century BC) describes the severe melancholy that afflicted Job following the sudden deaths of his children and the loss of his possessions. Recurring depression also afflicted Michelangelo (1474 1564), while Martin Luther (1483 1546) described the doubts and despair, despondency, feelings of guilt and anxiety, accompanied by physical ill health, that accompanied the consolidation of the Protestant Church in Germany. Other famous theologians, philosophers, writers, composers and artists who suffered from severe depression include Ignatius de Loyola (founder of the Jesuits), the philosophers Arthur Schopenhauer and Immanual Kant, and the composers Mozart and Beethoven to name but a few. In recent times, Winston Churchill was famous for the black dog that affected his mood throughout his adult life. But perhaps the earliest and most influential description of depression was provided by the Oxford theologian Robert Burton (1577 1640). In his famous book The Anatomy of Melancholy of 1620, Burton gives a description of the sad fate of many scholars who, with their windy melancholy (described as windy vapours that ascend to the brain there to trouble the imagination, cause fear, sorrow, dullness and many terrible conceits!), have ultimately caught nothing but wind. He concludes that such scholars have sacrificed their lives to science, but their sacrifice yielded nothing temporary for themselves and nothing lasting for the world. In evidence, he recommends Go to Bedlam and ask (see the cartoon by Hogarth of the interior of Bedlam hospital of 1735). Perhaps those of us who have spent a professional lifetime trying to understand the causes of depression and how antidepressants might work should heed Burton s VII

advice least the frustration caused by our limited success in understanding this disorder lead to our demise with windy melancholy. It is against this background, and to prevent the onset of windy melancholy, that the editors have gathered a group of international researchers to demonstrate the significant advances that are being made in understanding the psychopathology of depression and the mechanism of action of antidepressant drugs, advances that will contribute to more effective treatments of this terrible disorder in the future. To achieve this, the authors have critically assessed the developments being made in both the basic and clinical aspects of depression. A brief perusal of the titles of the 15 chapters that compose this book will illustrate the breadth of the research that has been covered. The editors hope that this book will become a reference text for basic and clinical neuroscientists, pharmacologists and psychiatrists. The editors express their appreciation to all the authors for their contributions and hope that you, the readers, will gain as much pleasure from reading the text as we have in bringing this book to fruition. John F. Cryan Brian E. Leonard VIII Preface