Disclosures Vladimir Maletic has served on the Speaker's Bureau or has been a consultant for Eli Lilly and Company and Cephalon. He did not receive any financial compensation for his work on this manuscript. His co-authors are each employees and/or shareholders of Eli Lilly and Company. Re-use of this article is permitted in accordance with the Creative Commons Deed, Attribution 2.5, which does not permit commercial exploitation.
Neurobiology of depression: an integrated view of key findings
Version of Record online: 7 NOV 2007
International Journal of Clinical Practice
Volume 61, Issue 12, pages 2030–2040, December 2007
How to Cite
Maletic, V., Robinson, M., Oakes, T., Iyengar, S., Ball, S. G. and Russell, J. (2007), Neurobiology of depression: an integrated view of key findings. International Journal of Clinical Practice, 61: 2030–2040. doi: 10.1111/j.1742-1241.2007.01602.x
- Issue online: 7 NOV 2007
- Version of Record online: 7 NOV 2007
- Paper received June 2007, accepted September 2007
Aims: The objectives of the present review were to summarise the key findings from the clinical literature regarding the neurobiology of major depressive disorder (MDD) and their implications for maximising treatment outcomes. Several neuroanatomical structures in the prefrontal and limbic areas of the brain are involved in affective regulation. In patients with MDD, alterations in the dynamic patterns of activity among these structures have profound implications for the pathogenesis of this illness.
Discussion: The present work reviews the evidence for the progressive nature of MDD along with associated changes in neuroanatomical structure and function, especially for the hippocampus. The role of glucocorticoids, inflammatory cytokines and brain-derived growth factors are discussed as mediators of these pathological alterations. From this integrated model, the role of antidepressant therapy in restoring normative processes is examined along with additional treatment guidelines.
Conclusion: Major depressive disorder is an illness with significant neurobiological consequences involving structural, functional and molecular alterations in several areas of the brain. Antidepressant pharmacotherapy is associated with restoration of the underlying physiology. Clinicians are advised to intervene with MDD using an early, comprehensive treatment approach that has remission as the goal.