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Tomasetti C, Montemitro C, Fiengo AL, Santone C, Orsolini L, Valchera A, Carano A, Pompili M, Serafini G, Perna G, Vellante F, Martinotti G, Giannantonio MD, Kim YK, Nicola MD, Bellomo A, Ventriglio A, Fornaro M, Berardis DD. Novel Pathways in the Treatment of Major Depression: Focus on the Glutamatergic System. Curr Pharm Des 2019; 25:381-387. [DOI: 10.2174/1381612825666190312102444] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2019] [Accepted: 03/06/2019] [Indexed: 12/28/2022]
Abstract
Depressive disorders represent protean psychiatric illnesses with heterogeneous clinical manifestations
and a multitude of comorbidities leading to severe disability. In spite of decades of research on the
pathophysiogenesis of these disorders, the wide variety of pharmacotherapies currently used to treat them is based
on the modulation of monoamines, whose alteration has been considered the neurobiological foundation of depression,
and consequently of its treatment. However, approximately one third to a half of patients respond partially
or become refractory to monoamine-based therapies, thereby jeopardizing the therapeutic effectiveness in
the real world of clinical practice. Recent scientific evidence has been pointing out the essential role of other
biological systems beyond monoamines in the pathophysiology of depressive disorders, in particular, the glutamatergic
neurotransmission. In the present review, we will discuss the most advanced knowledge on the involvement
of glutamatergic system in the molecular mechanisms at the basis of depression pathophysiology, as well as
the glutamate-based therapeutic strategies currently suggested to optimize depression treatment (e.g., ketamine).
Finally, we will mention further “neurobiological targeted” approaches, based on glutamate system, with the
purpose of promoting new avenues of investigation aiming at developing interventions that overstep the monoaminergic
boundaries to improve depressive disorders therapy.
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Affiliation(s)
- Carmine Tomasetti
- NHS, Department of Mental Health ASL Teramo, Psychiatric Service of Diagnosis and Treatment, Hospital “Maria SS dello Splendore”, Giulianova, Italy
| | - Chiara Montemitro
- Department of Neuroscience, Imaging and Clinical Science, University , Italy
| | - Annastasia L.C. Fiengo
- NHS, Department of Mental Health ASUR Marche AV5, Mental Health Unit, Ascoli Piceno, Italy
| | - Cristina Santone
- NHS, Department of Mental Health ASL Teramo, Psychiatric Service of Diagnosis and Treatment, Hospital “Maria SS dello Splendore”, Giulianova, Italy
| | | | | | - Alessandro Carano
- Department of Mental Health, Psychiatric Service of Diagnosis and Treatment, Hospital “Madonna Del Soccorso,” NHS, San Benedetto del Tronto, Ascoli Piceno, Italy
| | - Maurizio Pompili
- Department of Neurosciences, Mental Health and Sensory Organs, Suicide Prevention Center, S. Andrea Hospital, Sapienza University, Rome, Italy
| | - Gianluca Serafini
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, Section of Psychiatry, University of Genoa, IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - Giampaolo Perna
- Department of Clinical Neurosciences, Hermanas Hospitalarias, Villa San Benedetto Menni Hospital, FoRiPsi, Albese con Cassano, Como, Italy
| | - Federica Vellante
- Department of Neuroscience, Imaging and Clinical Science, University , Italy
| | - Giovanni Martinotti
- Department of Neuroscience, Imaging and Clinical Science, University , Italy
| | | | - Yong-Ku Kim
- Department of Psychiatry, Korea University College of Medicine, Seoul, Korea
| | - Marco D. Nicola
- Institute of Psychiatry and Psychology, Catholic University of Sacred Heart, Rome, Italy
| | - Antonello Bellomo
- Department of Clinical and Experimental Medicine, University of Foggia, Foggia, Italy
| | - Antonio Ventriglio
- Department of Clinical and Experimental Medicine, University of Foggia, Foggia, Italy
| | - Michele Fornaro
- Department of Psychiatry, University Medical School “Federico II”, Naples, Italy
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