Resumo

PEREZ ESPARZA, Rodrigo. Pharmacological treatment of depression: current and future directions. Rev. Fac. Med. (Méx.) [online]. 2017, vol.60, n.5, pp.7-16. ISSN 2448-4865.

Major depressive disorder represents one of the main causes of disability worldwide. Its neurobiology is complex, involving genetic, molecular, neurophysiological and psychosocial fac֊tors. Treatment options include psychotherapy, psychotropic medication, electroconvulsive therapy, and transcranial and deep magnetic stimulation. Currently available medication will only achieve modest response and remission rates. Current antidepressants have the common characteristic of regulating the monoaminergic neurotransmission systems (serotonin, noradrenaline, dopamine), regardless of their different mechanisms of action, and share similar efficacy. The choice of the antidepressant must be individualized and based on the symptomatic characteristics of the depressive episode, comorbidities, side effects, pharmacological interactions, and availability. For this reason, practitioners must be deeply familiar with the pharmacological profiles of the antidepressants. Recent advances in research on the neurobiology of depression have involved the glutamatergic system as a contributor. Also, the discovery of the antidepressant effects of ketamine, a glutamatergic NMDA receptor antagonist, has opened the doors to the development of strategies directed to new therapeutic targets

Palavras-chave : Depression; antidepressants; ketamine.