Potential strategies to optimize the efficacy of antidepressants: Beyond the monoamine theory
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1 Department of Clinical Pharmacy and Pharmacy Practice, Faculty of Pharmacy, Yarmouk University, Irbid, JORDAN2 Department of Medicinal Chemistry and Pharmacognosy Faculty of Pharmacy, Yarmouk University, Irbid, JORDAN* Corresponding Author
Abstract
Depression is characterized by a feeling of sadness and a lack of pleasure, with impaired daily functioning and poor quality of life. The neurobiology and the pathogenesis of depression are not fully understood yet. Several hypotheses have been discussed including, monoamine theory, neurotransmission, oxidation, inflammation, glutamatergic transmission, neurotrophic factors, and others. Reviewing three decades of randomized controlled trials of antidepressants revealed that the antidepressants response rate is about 54% compared to a placebo response rate of 37%. Treatment-resistant depression (TRD) could be defined as an inadequate response to two different of antidepressants. In TRD, a combination strategy of using two FDA-approved antidepressants is used, which may predispose patients to adverse effects. Therefore, there is a compelling need to explore the potential “out of the box” adjuvants to antidepressants to provide higher and consistent response rates with high tolerability. These adjuvants could be medications available for other indications, food supplements, or even experimental drugs. This review will highlight potentially beneficial adjuvants to antidepressants such as nitric oxide modulators, NMDA antagonists, anti-inflammatory, antioxidants, mitochondrial modulators, insulin sensitizers, opioids, probiotics, and GABA agonists.
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Article Type: Review Article
ELECTRON J GEN MED, 2023, Volume 20, Issue 5, Article No: em513
https://doi.org/10.29333/ejgm/13295
Publication date: 01 Sep 2023
Online publication date: 21 May 2023
Article Views: 991
Article Downloads: 747
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How to cite this article
Vancouver
Gammoh OS, Bashatwah R. Potential strategies to optimize the efficacy of antidepressants: Beyond the monoamine theory. ELECTRON J GEN MED. 2023;20(5):em513. https://doi.org/10.29333/ejgm/13295
APA
Gammoh, O. S., & Bashatwah, R. (2023). Potential strategies to optimize the efficacy of antidepressants: Beyond the monoamine theory. Electronic Journal of General Medicine, 20(5), em513. https://doi.org/10.29333/ejgm/13295
AMA
Gammoh OS, Bashatwah R. Potential strategies to optimize the efficacy of antidepressants: Beyond the monoamine theory. ELECTRON J GEN MED. 2023;20(5), em513. https://doi.org/10.29333/ejgm/13295
Chicago
Gammoh, Omar Salem, and Rasha Bashatwah. "Potential strategies to optimize the efficacy of antidepressants: Beyond the monoamine theory". Electronic Journal of General Medicine 2023 20 no. 5 (2023): em513. https://doi.org/10.29333/ejgm/13295
Harvard
Gammoh, O. S., and Bashatwah, R. (2023). Potential strategies to optimize the efficacy of antidepressants: Beyond the monoamine theory. Electronic Journal of General Medicine, 20(5), em513. https://doi.org/10.29333/ejgm/13295
MLA
Gammoh, Omar Salem et al. "Potential strategies to optimize the efficacy of antidepressants: Beyond the monoamine theory". Electronic Journal of General Medicine, vol. 20, no. 5, 2023, em513. https://doi.org/10.29333/ejgm/13295