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. 2019 Oct;5(4):178-189.
doi: 10.1159/000500324. Epub 2019 May 21.

Strategies for Treatment-Resistant Depression: Lessons Learned From Animal Models

Free PMC article

Strategies for Treatment-Resistant Depression: Lessons Learned From Animal Models

Gislaine Zilli Réus et al. Mol Neuropsychiatry. .
Free PMC article


Around 300 million individuals are affected by major depressive disorder (MDD) in the world. Despite this high number of affected individuals, more than 50% of patients do not respond to antidepressants approved to treat MDD. Patients with MDD that do not respond to 2 or more first-line antidepressant treatments are considered to have treatment-resistant depression (TRD). Animal models of depression are important tools to better understand the pathophysiology of MDD as well as to help in the development of novel and fast antidepressants for TRD patients. This review will emphasize some discovery strategies for TRD from studies on animal models, including, antagonists of N-methyl-D-aspartate (NMDA) receptor (ketamine and memantine), electroconvulsive therapy (ECT), lithium, minocycline, quetiapine, and deep brain stimulation. Animal models of depression are not sufficient to represent all the traits of TRD, but they greatly aid in understanding the mechanism by which therapies that work for TRD exert antidepressant effects. Interestingly, these innovative therapies have mechanisms of action different from those of classic antidepressants. These effects are mainly related to the regulation of neurotransmitter activity, including general glutamate and increased connectivity, synaptic capacity, and neuroplasticity.

Keywords: Deep brain stimulation; Electroconvulsive therapy; N-methyl-D-aspartate antagonist; Quetiapine; Treatment-resistant depression.

Conflict of interest statement

The authors have no conflicts of interest to declare.

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