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Targeting the glutamatergic system to develop novel, improved therapeutics for mood disorders

TLDR
There is growing evidence that the glutamatergic system is central to the neurobiology and treatment of mood disorders and exciting new prospects for the development of improved therapeutics for these devastating disorders are discussed.
Abstract
Mood disorders are common, chronic, recurrent mental illnesses that affect the lives of millions of individuals worldwide. To date, the monoaminergic systems (serotonergic, noradrenergic and dopaminergic) in the brain have received the greatest attention in neurobiological studies of mood disorders, and most therapeutics target these systems. However, there is growing evidence that the glutamatergic system is central to the neurobiology and treatment of these disorders. Here, we review data supporting the involvement of the glutamatergic system in mood-disorder pathophysiology as well as the efficacy of glutamatergic agents in mood disorders. We also discuss exciting new prospects for the development of improved therapeutics for these devastating disorders.

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Major depressive disorder

TL;DR: An overview of the current evidence of major depressive disorder, including its epidemiology, aetiology, pathophysiology, diagnosis and treatment, is provided.
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Synaptic Dysfunction in Depression: Potential Therapeutic Targets

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TL;DR: Treatment with new agents results in an improvement in mood ratings within hours of dosing patients who are resistant to typical antidepressants, and these new agents have also been shown to reverse the synaptic deficits caused by stress.
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Antidepressant Efficacy of Ketamine in Treatment-Resistant Major Depression: A Two-Site Randomized Controlled Trial

TL;DR: Ketamine demonstrated rapid antidepressant effects in an optimized study design, further supporting NMDA receptor modulation as a novel mechanism for accelerated improvement in severe and chronic forms of depression.
References
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Journal ArticleDOI

Lifetime Prevalence and Age-of-Onset Distributions of DSM-IV Disorders in the National Comorbidity Survey Replication

TL;DR: Lifetime prevalence estimates are higher in recent cohorts than in earlier cohorts and have fairly stable intercohort differences across the life course that vary in substantively plausible ways among sociodemographic subgroups.
Journal ArticleDOI

Antidepressant effects of ketamine in depressed patients

TL;DR: A first placebo-controlled, double-blinded trial to assess the treatment effects of a single dose of an N-methyl-D-aspartate (NMDA) receptor antagonist in patients with depression suggests a potential role for NMDA receptor-modulating drugs in the treatment of depression.
Journal ArticleDOI

A Randomized Trial of an N-methyl-D-aspartate Antagonist in Treatment-Resistant Major Depression

TL;DR: Robust and rapid antidepressant effects resulted from a single intravenous dose of an N-methyl-D-aspartate antagonist; onset occurred within 2 hours postinfusion and continued to remain significant for 1 week.
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