"Killing the Blues": a role for cellular suicide (apoptosis) in depression and the antidepressant response?

Prog Neurobiol. 2009 Aug;88(4):246-63. doi: 10.1016/j.pneurobio.2009.04.006. Epub 2009 May 7.

Abstract

Apoptosis or programmed cell death is a critical regulator of tissue homeostasis and emerging evidence is focused on the role of apoptosis mechanisms in the central nervous system. Generally, apoptosis is necessary to prevent cancerous growths. However, excessive apoptosis in post-mitotic cells such as neurons leads to neurodegeneration. Chronic stress, which can precipitate depression, has been shown to increase the susceptibility of certain populations of neurons to cell death while antidepressant treatment, in general, shows the ability to oppose these effects and promote neuroprotection. Here, we discuss the major players in cell death pathways, the physiological implications of chronic stress and depression, chronic stress models in animals which result in cell death and the different classes of antidepressants and mood stabilizers that have been shown to prevent cell death. We discuss the cellular effects of antidepressants and possible modes of action in preventing apoptosis. Investigations on the role of apoptosis in mediating the molecular, physiological and behavioural effects of antidepressants may help gain a better mechanistic insight into drug action and allow refinement of current therapeutics in order to target these pathways in a specific manner.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Animals
  • Antidepressive Agents / pharmacology*
  • Apoptosis / drug effects*
  • Apoptosis / physiology
  • Apoptosis Regulatory Proteins / drug effects
  • Apoptosis Regulatory Proteins / metabolism
  • Brain / drug effects*
  • Brain / metabolism
  • Brain / physiopathology*
  • Depressive Disorder / drug therapy*
  • Depressive Disorder / metabolism
  • Depressive Disorder / physiopathology*
  • Humans
  • Nerve Degeneration / drug therapy
  • Nerve Degeneration / etiology
  • Nerve Degeneration / physiopathology
  • Neurons / drug effects
  • Neurons / metabolism
  • Neurons / pathology
  • Stress, Psychological / complications
  • Stress, Psychological / metabolism
  • Stress, Psychological / physiopathology

Substances

  • Antidepressive Agents
  • Apoptosis Regulatory Proteins