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PSIHOFARMACOLOGIA CLINICĂ A TERAPIEI ANTIDEPRESIVE<br />

C. Friedmann<br />

Universitatea Ovidius Constanţa, Facultatea <strong>de</strong> Medicină<br />

Rezumat<br />

Noile anti<strong>de</strong>presive au o bună eficienţă terapeutică, dar nu cu mult faţă <strong>de</strong> cele din<br />

generaţiile mai vechi, cele <strong>de</strong> acum 40-50 <strong>de</strong> ani. Noile anti<strong>de</strong>presive au un pr<strong>of</strong>il<br />

mai bun <strong>de</strong> efecte secundare, îmbunătăţind în mod prognostic complianţa pacienţilor<br />

<strong>de</strong>presivi <strong>de</strong> astăzi.<br />

De asemenea, graţie progreselor în studiul actual al circuitelor cerebrale şi al<br />

neuroştiinţelor, o multitudine <strong>de</strong> tulburări anxioase au pr<strong>of</strong>itat <strong>de</strong> un beneficiu real,<br />

cum e cazul cu tulburarea <strong>de</strong> panică anxioasă prin observaţiile <strong>de</strong> mare<br />

perspicacitate clinică, făcute în urmă cu mai bine <strong>de</strong> 30 <strong>de</strong> ani <strong>de</strong> Donald F. Klein.<br />

Şi acesta este doar unul din exemplele noilor orientări şi piste ce se <strong>de</strong>schid în noile<br />

abordări, în <strong>de</strong>scoperirea noilor ţinte, a noilor acţiuni farmacologice a<br />

anti<strong>de</strong>presivelor conducând la modificări în mesagerii secundari, la expresia<br />

genelor precocissime, a sintezei proteinelor, a modificărilor în sinaptogeneză,<br />

neurogeneză, a secreţiei hormonului <strong>de</strong> stress, etc.<br />

Întrebări provocatoare aşteaptă noi răspunsuri care urmează să ne fie <strong>of</strong>erite în<br />

viitorul foarte apropiat.<br />

Cuvinte cheie: <strong>de</strong>presie, anti<strong>de</strong>presive vechi şi noi, efecte secundare, neurohormoni,<br />

noi molecule anti<strong>de</strong>presive.<br />

CLINIC PSYCHOPHARMACOLOGY OF ANTIDEPRESSANT THERAPY<br />

Abstract<br />

The new anti<strong>de</strong>pressants have good efficacy, but no better than the old ones,<br />

discovered – most <strong>of</strong> them – in the last 40-50 years. The new anti<strong>de</strong>pressants have a<br />

better pr<strong>of</strong>ile <strong>of</strong> si<strong>de</strong> effects, improving more pragmatically the compliance <strong>of</strong> today<br />

<strong>de</strong>pressive patients. Also thanks to the advances in the study <strong>of</strong> brain circuitry and<br />

neurosciences, several anxiety disor<strong>de</strong>rs are benefiting really, as is the case with<br />

panic disor<strong>de</strong>rs by the astute observations ma<strong>de</strong> more than 30 years ago by Donald<br />

F. Klein.<br />

And this 15 only one example <strong>of</strong> the new trends and new directions in the<br />

<strong>de</strong>velopment <strong>of</strong> new approaches, discovery <strong>of</strong> new targets, new pharmacological<br />

actions <strong>of</strong> anti<strong>de</strong>pressants leading to changes in secondary messengers, in the<br />

expression <strong>of</strong> early genes, synthesis <strong>of</strong> proteins, changes in synaptogenesis and<br />

neurogenesis, secretion <strong>of</strong> stress hormone, etc.<br />

Challenging questions are awaiting new replies witch are due to come in the very<br />

near future.<br />

Key words: <strong>de</strong>pression, old and new anti<strong>de</strong>pressants, si<strong>de</strong> effects, neurohormones,<br />

new anti<strong>de</strong>pressant molecules.<br />

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