An overview of literature data and of some author’s studies results is presented concerned the basic and closely interlinked pathophysiological mechanisms of depressive disorders, as well as mechanisms of action of contemporary antidepressants.
Pathogenetic mechanisms of depressions include: genetically caused disturbances of monoaminergic (serotoninergic, noradrenergic, dopaminergic) synaptic transmission; microstructural and macromorphological reconstructions of nervous tissue in limbic structures and in anterior cortical regions produced by citotoxicity of excitatory neurotransmitters and partially reversed under action of neurotrophic factors; impairments of functioning of some neurohormonal systems (namely, thyreoid, melatoninergic, hyperreactivity of hypothalamic-pituitry-adrenal axis); impairments of glutamatergic neurotransmission; neuroimmunological disturbances (“depression as inflammatory illness”), impairments of biologic rhythms, reorganization of interhemispheric relations with decreased activity of anterior regions of the left hemisphere and increased activation of the right hemisphere of brain.
In concordance with such systemic and multifactorial nature of depressive disorders some mechanisms of action of existing and perspective antidepressants, as well as of pathogenetically based non-pharmacological methods of treatment of depressions, are considered.
The study is supported by Russian Humanitarian Research Foundation (grant No. 12-06-00019). Динамика и соотношения нейробиологических показателей при терапии аффективно-бредовых состояний.