Opiates as antidepressants
by
Berrocoso E, Sánchez-Blázquez P, Garzón J, Mico JA.
Pharmacology and Neuroscience Research Group,
Department of Neuroscience (Pharmacology and Psychiatry),
School of Medicine, University of Cádiz,
Plaza Fragela 9, Cádiz, Spain.
Curr Pharm Des. 2009;15(14):1612-22.

ABSTRACT

The pathophysiology of mood disorders involves several genetic and social predisposing factors, as well as a dysregulated response to a chronic stressor, i.e. chronic pain. Our present view that depression involves a dysfunction of the monoaminergic system is a result of important clinical and preclinical observations over the past 40 years. In fact, current pharmacological treatment for depression is based on the use of drugs that act mainly by enhancing brain serotonin and noradrenaline neurotransmission by the blockade of the active reuptake mechanism for these neurotransmitters. However, a substantial number of patients do not respond adequately to antidepressant drugs. In view of this, there is an intense search to identify novel targets (receptors) for antidepressant therapy. Opioid peptides and their receptors are potential candidates for the development of novel antidepressant treatment. In this context, endogenous opioid peptides are co-expressed in brain areas known to play a major role in affective disorders and in the action of antidepressant drugs. The actions of endogenous opioids and opiates are mediated by three receptor subtypes (mu, delta and kappa), which are coupled to different intracellular effector systems. Also, antidepressants which increase the availability of noradrenaline and serotonin through the inhibition of the reuptake of both monoamines lead to the enhancement of the opioid pathway. Tricyclic antidepressants show an analgesic effect in neuropathic and inflammatory pain that is blocked by the opioid antagonist naloxone. A compilation of the most significant studies will illustrate the actual and potential value of the opioid system for clinical research and drug development.

Psychoactive aspirin?
Prozac and the opioid pathways
Is morphine an antidepressant?
Depression, opioids and the HPA
Endomorphins as antidepressants?
Buprenorphine as an antidepressant
Morphine for endogenous depressives
Endogenous opioids mediate basal hedonic tone
Antidepressive response and depression subtypes
The opioid connection: venlafaxine and mirtazapine
Use of oxycodone and oxymorphone to treat major depression
Kappa opioid antagonists as antidepressants : norbinaltorphimine

Refs
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