Serotonin and drug-induced therapeutic responses in major depression, obsessive-compulsive and panic disorders

The therapeutic effectiveness of antidepressant drugs in major depression w as discovered by pure serendipity. It took over 20 years before the neurobi ological modifications that could mediate the antidepressive response were put into evidence. Indeed, whereas the immediate biochemical effects of the se drugs had been well documented, their antidepressant action generally do es not become apparent before 2 to 3 weeks of treatment. The different clas ses of antidepressant treatments were subsequently shown to enhance seroton in neurotransmission albeit via different pre- and postsynaptic mechanisms. Clinical trials based on this hypothesis Zed to the development of treat m ent strategies producing greater efficacy and more rapid onset of antidepre ssant action; that, is lithium addition and pindolol combination, respectiv ely. It is expected that the better understanding recently obtained of the mechanism of action of certain antidepressant drugs in obsessive-compulsive and panic disorders will also lend to more effective treatment strategies for those disorders. (C) 1999 American College of Neuropsychopharmacology. Published by Elsevier Science Inc.