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首页> 外文期刊>The journal of clinical psychiatry >Depression: the case for a monoamine deficiency.
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Depression: the case for a monoamine deficiency.

机译：抑郁症：单胺缺乏症。

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The monoamine hypothesis of depression predicts that the underlying pathophysiologic basis of depression is a depletion in the levels of serotonin, norepinephrine, and/or dopamine in the central nervous system. This hypothesized pathophysiology appears to be supported by the mechanism of action of antidepressants: agents that elevate the levels of these neurotransmitters in the brain have all been shown to be effective in the alleviation of depressive symptoms. However, intensive investigation has failed to find convincing evidence of a primary dysfunction of a specific monoamine system in patients with major depressive disorders. Understanding of the etiology of depression has been hampered by the absence of direct measurements of monoamines in humans. However, the monoamine depletion paradigm, which reproduces the clinical syndrome, allows a more direct method for investigating the role of monoamines. Results from such studies show that antidepressant responses are transiently reversed, with the response being dependent on the class of antidepressant. In contrast, monoamine depletion does not worsen symptoms in depressed patients not taking medication, nor does it cause depression in healthy volunteers with no depressive illness. In conclusion, it is clear that antidepressant agents in current use do indeed require intact monoamine systems for their therapeutic effect. However, some debate remains as to the precise role that a deficiency in monoamine system(s) may play in depression itself.
机译：抑郁症的单胺假说预测抑郁症的潜在病理生理基础是中枢神经系统中5-羟色胺，去甲肾上腺素和/或多巴胺水平的降低。这种假设的病理生理学似乎受到抗抑郁药作用机制的支持：提高大脑中这些神经递质水平的药物已被证明对缓解抑郁症状有效。但是，大量研究未能找到令人信服的证据，表明患有严重抑郁症的患者存在特定的单胺系统原发性功能障碍。对抑郁症病因的理解因缺乏对人体中单胺的直接测量而受到阻碍。然而，重现临床症状的单胺耗竭范式为研究单胺的作用提供了更直接的方法。这些研究的结果表明，抗抑郁药的反应是短暂逆转的，其反应取决于抗抑郁药的种类。相反，单胺消耗不会使没有服用药物的抑郁症患者的症状恶化，也不会在没有抑郁症的健康志愿者中引起抑郁症。总之，很明显，当前使用的抗抑郁药确实确实需要完整的单胺系统才能发挥治疗作用。然而，关于单胺系统缺乏可能在抑郁症本身中发挥的确切作用仍有一些争论。

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