By Kerstin Bingefors, Lisa Ekselius, Lars von Knorring (auth.), Prof. Brian E. Leonard (eds.)
Important scientific matters because the consequence of long-term remedy with antidepressants, the time of onset of the antidepressant reaction and the restrictions of the antidepressants at the moment on hand are lined during this monograph. major researchers within the zone of medical and experimental psychopharmacology severely examine the growth of their professional fields. The mechanisms of motion of antidepressants are thought of, by means of scientific learn into the function of the hypothalamic-pituitary-adrenal axis and the immune approach within the biology of melancholy and in line with remedy. the ultimate bankruptcy offers with the real chemical entities now present process improvement as antidepressants. the aim of this monograph is not just to notify but additionally to stimulate study into the biology of melancholy and the mechanisms in the back of the motion of potent antidepressants. This monograph is of curiosity to psychiatrists, psychologists, pharmacologists, neuroscientists and endocrinologists.
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In addition, approximately 30% of patients treated with a therapeutic dose of an antidepressant fail to respond after several weeks of treatment. There is a need therefore for the development of other novel antidepressants with a more rapid onset of action and a reduced side effect profile than those currently available. 48 C. McGrath and T. R. Norman Can an early onset of antidepressant action be detected? According to Montgomery, 1992, the onset of antidepressant activity is defined as "the time at which statistical separation is first seen between an antidepressant and a comparator, either active or placebo, and at which there is concomitant, clinically relevant decrease on the scale for the user" (cited in Derivan, 1995).
J Psychiatry Neurosci 19 (I): 30-44 DeVane CL (1994) Pharmacogenetics and drug metabolism of newer antidepressant agents. J Clin Psychiatry 55: 38-45 Daly AK (1995) Molecular basis of polymorphic drug metabolism. J Mol Med 73 (11): 539553 Eichelbaum M, Evert B (1996) Influence of pharmacogenetics on drug disposition and response. Clin Exp Pharmacal Physiol23 (10-11): 983-985 Greenhouse JB, Stangl 0, Bromberg J (1989) An introduction to survival analysis: statistical methods for analysis of clinical trial data.
Thus, antidepressants are important therapeutic agents in the armentarium of psychopharmacology. On the other hand, numerous distinct limitations exist for these agents which future antidepressants will hopefully surmount. Five such limitations are discussed in this chapter. Firstly, current antidepressants have a slow onset of therapeutic action, taking about 2 months for a therapeutic response and up to 24 months to cause symptomatic remission. e. e. elimination of symptoms). Since a return to full function and "normality" are the real goals of antidepressant treatment, this is indeed a serious limitation for those patients who fail to remit.