[Mechanisms of action of antidepressive pharmacotherapy: brain and mind-body and environment].
Moritz Spangemacher, Jonathan R Reinwald, Hana Adolphi, Laura Kärtner, Lea J. Mertens, Christian N. Schmitz, Gerhard Gründer
Der Nervenarzt March 1, 2025 DOI: 10.1007/s00115-024-01786-3 (opens in new tab)
Study at a glance
AI-extracted from the abstract| Characteristics | Review Peer reviewed |
|---|---|
| Topics | Neuroplasticity |
| Keywords | Extrapharmacological factors Antidepressants ssris Antidepressive agents Mood elevators Neuroplasticity neural plasticity Environmental factors context Setting Surroundings |
| Key findings | Classical and novel antidepressants may share mechanisms favoring long-term neuroplasticity and correcting negative emotional bias, with extrapharmacological factors being necessary for antidepressant effects. |
Abstract
Novel antidepressive substances are challenging the explanations for the mechanisms of action of traditional psychopharmacology. What could be the shared effects of various antidepressants and in this context what role do extrapharmacological factors, such as the body and environment, play? The available literature on clinical and preclinical data for assumed combined active factors of serotonergic psychedelic drugs, (es)ketamine, monoaminergic antidepressants and zuranolone are presented and the influence of context factors on the individual mechanisms of action is discussed. There are many indications that classical and novel pharmacological approaches could share similar mechanisms of action in the treatment of depression. These mechanisms favor long-term neuroplasticity, which can trigger subsequent molecular cascades and vice versa. Furthermore, an improvement in the negative bias in emotional processing could be detected for most antidepressive substances. The influence of extrapharmacological factors appears to be necessary so that the biopsychological alterations can have an antidepressive effect. Instead of attributing factors such as environment, body and social interaction to placebo effects, they should be tested as essential components of the antidepressive effect and considered in the clinical practice.
Comparable studies
Other narrative reviews on neuroplasticity, most cited first.
| Study | Year | Design | Participants |
|---|---|---|---|
| A neurotrophic hypothesis of depression: role of synaptogenesis in the actions of NMDA receptor antagonists | 2012 | Review | |
| Towards an understanding of psychedelic-induced neuroplasticity. Review of preclinical and clinical studies | 2023 | Review | |
| Buddha's Brain: Neuroplasticity and Meditation [In the Spotlight] | 2008 | Review | |
| Neuroplasticity as a convergent mechanism of ketamine and classical psychedelics | 2021 | Review | |
| Psychedelics in Psychiatry: Neuroplastic, Immunomodulatory, and Neurotransmitter Mechanisms | 2020 | Review |
Citations in the library
Cites 16
- Synaptic Dysfunction in Depression: Potential Therapeutic Targets Science October 4, 2012
- The Subjective Effects of Psychedelics Are Necessary for Their Enduring Therapeutic Effects. ACS Pharmacology & Translational Science December 10, 2020
- Psychedelic effects of psilocybin correlate with serotonin 2A receptor occupancy and plasma psilocin levels Neuropsychopharmacology January 26, 2019
- Psychedelics promote plasticity by directly binding to BDNF receptor TrkB Nature Neuroscience June 1, 2023
- Psychedelics reopen the social reward learning critical period Nature June 14, 2023
and 11 more in the library