The Rise of Depression and its Treatments

    Major depressive disorder, commonly known as depression, is a mental disorder which is still not completely understood. It is characterized by fatigue and persistent feelings of hopelessness, sadness and pessimism. Depression rates among adults have been on the rise for years. I have family members who suffer from MDD and are currently on SSRIs or SNRIs. These two types of medications surfaced in the 80s and 90s, and were created with the monoamine hypothesis in mind. This hypothesis states that depression is likely caused by a decrease in monoamine function, which causes a depletion of serotonin, norepinephrine, and/or dopamine levels in the CNS. This hypothesis has been the basis for most depression research over the years, but with the rise of MDD, a lot more has come to question. SNRIs and SSRIs, much like any other medication, can have negative side effects for the patient. This includes nausea, dizziness, insomnia, drowsiness, diarrhea, weight gain or loss, decreased libido, and the list goes on. In addition, the efficacy of SSRIs and SNRIs and the length it takes for the medications to take effect varies within each patient. Many patients do not experience a positive change in their mood unless they are medicated for a prolonged period of time and/or they still experience residual symptoms of MDD. New hypotheses have formed, such as the glutamate hypothesis, the neuroplasticity hypothesis, the cholinergic hypothesis, the stress/ HPA-axis hypothesis, and many others. Many of these hypotheses work in addition to the monoamine hypothesis, or they work hand-in-hand like the glutamate and neuroplasticity hypothesis. With these hypotheses came several new drug developments to either replace, supplement, or augment current medications. This includes triple-uptake inhibitors, which block all three monoamine transporters rather than just norepinephrine or serotonin. Many MDD treatments are still being tested and are waiting for approval by the FDA. 

Works Cited:

Dale, E., Bang‐Andersen, B., & Sánchez, C. (2015). Emerging mechanisms and treatments for depression beyond SSRIs and SNRIs. Biochemical Pharmacology, 95(2), 81–97. https://doi.org/10.1016/j.bcp.2015.03.011