Dopamine and Depression: Therapeutic Implications

Author: Rampello L.  

Publisher: Adis International

ISSN: 1172-7047

Source: CNS Drugs, Vol.13, Iss.1, 2000-01, pp. : 35-45

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Abstract

The mesolimbic dopaminergic system functions as a major reward pathway in the CNS and is an appropriate target for antidepressant drugs. This review describes the principal features of drugs such as amfebutamone (bupropion) which activate the mesolimbic system without inducing strong neuroadaptation and are therefore useful in the treatment of retarded (or inhibited) depression. The short latency of clinical action makes these drugs particularly suitable for the treatment of patients with severe depression or those who are poorly compliant with other medications. Additional dopaminergic antidepressants include minaprine and amisulpride. The latter drug potentiates dopaminergic transmission through an atypical mechanism, i.e. the inhibition of dopamine autoreceptors controlling the synthesis and release of dopamine. Finally, a number of drugs that are not considered as classical ‘dopaminergic’ antidepressants, such as tricyclic antidepressants or selective serotonin (5-hydroxytryptamine; 5-HT) reuptake inhibitors, can also affect dopaminergic transmission, as indicated for example by their ability to induce changes in brain dopamine receptor density. This further supports the importance of central dopaminergic transmission in the pathophysiology of depression.