The University of Colorado Anschutz Medical Campus researchers have created a new framework for understanding the effectiveness of traditional antidepressants in treating major depressive disorder (MDD). The goal is to highlight the importance of these antidepressants and change the way they are discussed in clinical settings.The cause of MDD has been studied for many years. Traditional antidepressants, like SSRIs (selective serotonin reuptake inhibitors, such as Prozac), increase the levels of the brain chemical messenger, serotonin. This led to the belief that antidepressants work by fixing a chemical imbalance, such as a lack of serotonin. However, further research has not shown a significant decrease in serotonin in people with depression. Experts have moved away from this idea due to a lack of solid evidence, which has changed public opinion on the effectiveness of these medications.
AntThe use of antidepressants, such as SSRIs and SNRIs, continues to be effective in reducing depressive episodes in many patients. Researchers have introduced a new framework for understanding the effectiveness of antidepressants in treating MDD in a paper published in Molecular Psychiatry. This framework helps to clarify how antidepressants like SSRIs can still be beneficial, even if MDD is not solely caused by a lack of serotonin.
“The most compelling evidence of changes in the brain in individuals with MDD is that certain brain regions are not communicating with each other normally,” explained Scott Thompson, PhD, a professor.The senior author from the University of Colorado School of Medicine’s department of psychiatry explains that when certain parts of the brain responsible for emotions and problem solving are not communicating effectively, they are unable to perform their functions properly. Antidepressants, such as SSRIs, and newer treatments like esketamine and psychedelics work by strengthening the connections between these brain regions. This type of neuroplasticity helps to release the brain circuits from being stuck in a diseased state.
“This approach offers a promising way to help improve brain health and function,” explained Thompson.
Thompson and his team compare this concept to a car veering off the road and becoming trapped in a ditch, needing the assistance of a tow truck to pull it out and allow it to move freely again.
The researchers anticipate that medical professionals will utilize these analogies to enhance discussions with anxious patients about these treatments, assisting them in gaining a better grasp of their condition and its treatment.
“We aim to give clinicians a new framework for explaining how these treatments operate in a way that is easy for patients to understand,” stated Thompson.Combatting MDD is a complex challenge,” according to C. Neill Epperson, MD, Robert Freedman endowed professor and chair of the department of psychiatry at the University of Colorado School of Medicine and co-author of the paper. “There has been a lot of negative and potentially harmful public discourse about the effectiveness of antidepressants and the role of serotonin in diagnosing and treating MDD. While MDD is a diverse disorder with no one-size-fits-all solution, it’s important to emphasize that if a treatment or medication is effective for an individual, it can be life-saving. Understanding how these medications promote neuroplasticity can help reinforce this message.
