NRSC 4132 Blog

Antidepressants are a part of everybodyâ??s life. Whether its watching multiple brands flash across the TV screen, or you personally take them, the development of effective and quick antidepressants has been the mission of many drug manufacturers in an effort to help the 17% of the population with mood disorders finally get some relief.
People with depression that choose to use medication as treatment are forced to choose between a group of relatively ineffective drugs with adverse side effects including weight gain, constipation, tremors, and many more. In the article â??Silver Bullet for The treatment for Depression?â?? (http://www.sciencedirect.com/science/article/pii/S089662730700623X) by Ronald S. Duman, a study of the 5-HT4 receptor and depression is reviewed an analyzed for the possibility of a faster acting treatment with less side effects.
According to the article, the 5-HT reuptake inhibitors, also known as SSRIs, are the most commonly prescribed class of antidepressant on the market. Although SSRIs initially react within hours or days of a person starting the treatment, due to speculated adaptations in the pre-and post-synaptic clefts; it can take weeks or months for SSRIs to reach their full potential. According to Duman, the reason it takes so long for the drug to reach its full potential is because the treatment must first overcome the desensitization of the inhibitory 5-HT1A autoreceptor. After several weeks of treatment the 5-HT neurotransmitter will continuously fire and release.
The first initial idea came from a previous study that demonstrated that the 5-HT4 receptor agonist reached its maximal effect within three days. This means that the drug can rapidly overcome desensitization of the 5-HT1A autoreceptor. This discovery lead to a more in-depth look at the 5-HT4 receptor agonist with the hope that it could be the quick fix to depression.
Within the deeper research the 5-HT4 receptor agonist was found to have â??a rapid and robust response,â?? (Duman). Not only can this drug mimic the effects of the common SSRIs, it could do it in three days versus several weeks and magnitude was twice as strong in comparison. Beyond just the strong and rapid antidepressant response, the 5-HT4 receptor agonist quickly increases the neurogenesis in the hippocampus. While this is by no means more effective than the antidepressant effects in SSRIs, neurogenesis along with an antidepressant effect can yield to more responsive effects in less time. Also, the 5-HT4 receptor agonists can produce rapid firing and releasing for several weeks without desensitization, which is not common with other antidepressant medications.
Although these mechanism adjustments will yield faster and more successful treatment, a question for anyone starting any medication is in regard to the side effects of the medication. With SSRIs there are many adverse side effects such as: nausea, insomnia, anxiety, weight gain, tremors, sweating, sleepiness, dry mouth, and headaches. Some of these will be persistent, while others will go away within a few weeks. Despite these general side effects of all SSRIs, there are multiple brands of SSRIs. This means that the consumer has the option to pick which medication works best with their symptoms. In the 5-HT4 receptor agonist, however, some of the adverse side effects, like loss of libido, that are seen in SSRIs are speculated to not be present. More research needs to be done with regard to the specifics of the side effects. Despite most of the side effects being unknown, it is known that the 5-HT4 receptor agonist are associated with atrial arrhythmias. Also the 5-HT4-receptor agonist is used as a treatment of gastrointestinal motility, which depending on pre-existing conditions could or could not be a problem.
Although the 5-HT4 receptor agonist seems like a wonder drug, the association with atrial arrhythmias could be a worse side effect than potential for sleeping problems and low libido. However, with the potential for increased risk of suicide as seen sometimes SSRIs, the 5-HT4 agonist could be a better solution. Both SSRIs and the 5-HT4 agonist have an ability to treat depression on two different time scales. However, without more research into the exact side effects of the 5-HT4 receptor agonist, no one can make a confident call on whether this new type of treatment will actually be a better choice than the common SSRIs.