Question: We often hear about depression and mental health being a problem that many students face. Sometimes mental health and depression are discussed in news reports about suicides. We hear about treatments and medications for treating the disorder but also that these antidepressants do not work. My question is why are antidepressants not effective at treating depression?
Answer: Depression is described as a disorder that is believed to be caused by stress and a deficiency of the neurotransmitters serotonin, norepinephrine, and dopamine. According to the National Institute of Mental Health (NIMH), depression is a mood disorder that affects how you feel and think. These neurotransmitters (serotonin, norepinephrine, dopamine) need to be maintained at a certain level for the body to function properly, and in the case of depression, the levels of these neurotransmitters are not sufficient. Stress, if not coped with well enough, can contribute to depression and worsen the symptoms. Present medications for treating depression are selective serotonin reuptake inhibitors (SSRI), serotonin and norepinephrine reuptake inhibitors (SNRI), and monoamine oxidase inhibitors (MAOI) among other drugs. According to NIMH, these medications work by balancing the neurotransmitters to improve mood and emotions, therebytreating depression. According to a study done by Andrus et al., there is no association between stress and depression when examining gene expression profiles of neurotransmitter genes at the hippocampus and amygdala. This evidence suggests that different treatments are needed. The study done by Andrus et al. looked at the hippocampus and amygdala of Wistar-Kyoto rats, which are accepted models for depression, subjected to stress and no stress conditions. They measured the expression of the genes of the neurotransmitters and found that there was no significant difference between the two treatments. The findings of Andrus et al. that there was minimal overlap in gene expression suggest that new treatments are needed because the current drugs used to treat depression are essentially treating stress and not depression. Although the current treatment of depression using drugs are restoring the neurotransmitter levels, there are other underlying causes of depression that needs to be explored, according the Andrus et al. publication, and new treatments need to be developed.
3) Andrus, B M et al. “Gene Expression Patterns in the Hippocampus and Amygdala of Endogenous Depression and Chronic Stress Models.” Molecular Psychiatry 17.1 (2012): 49–61. PMC. Web. 16 June 2016.