Choosing Medications for Treatment-Resistant Depression Based on Mechanism of Action

Article Abstract Click to enlarge page Clinicians are often faced with depressed patients who do not respond to treatment or who continue to experience troublesome residual symptoms. For these patients, medications with different mechanisms of action may improve symptoms. By altering levels of dopamine, norepinephrine, and serotonin in the brain, clinicians theoretically may be able to target specific depressive symptoms, but they must be aware of the associated adverse effects. Follow a discussion by expert faculty as they review the mechanisms of action of the different antidepressant classes from the older tricyclic antidepressants and monoamine oxidase inhibitors to the newer selective serotonin reuptake inhibitors and dual-acting agents. From the Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia (Dr Thase) and the Department of Psychiatry, SUNY Upstate Medical University, Syracuse, New York (Dr Schwartz).