抑郁症对患者，朋友或家人和医生来说是一个艰难的敌人。它使某物的核心是生命的核心，即感到愉悦的能力。不幸的是，抑郁是相当普遍的，并且是全球残疾的主要原因。我们拥有的最好的治疗方法只有大约三分之一的抑郁症患者在第一次治疗后完全反应，使用多种治疗方法常见和残留症状，而不是例外。
未经治疗的抑郁症可以在自杀中达到顶峰。因此，很明显需要创新选择;“精神病学”旨在扩展精神病学中其他临床专业基础的先进诊断和治疗技术。
第一种抗抑郁药是在1950年代通过偶然性发现的。结核病患者接受iproniazid治疗suddenly showed a new vitality and even began dancing in the hospital halls. Imipramine, another early antidepressant, was first tested as an antihistamine, and unexpected effects on mood were observed.
Early research found that these all were targeting the monoamine system, and these findings ushered in a new era in the treatment of depression. An era we are still living in to a large extent.
The message from these stories is that an advance in one given area can carry secrets and new information relevant to another area. Its sadly true that this has been a far more fruitful avenue for the discovery of the psychiatric therapies that we use today than approaches primarily developed from the molecular level.
However, contrary to the monoamine system case, the idea that drugs targeting the renin-angiotensin system can treat depression has deep roots in both worlds. It has a serendipity component, with case reports that date from the 1980’s showing that drugs that target the renin-angiotensin system may have effects on mood. And this story also began with a strong molecular argument, with a solid rationale based on effects on the stress response system and inflammation. A recent large epidemiological study suggested a protective effect of these agents on the development of depression [1,2].
Several anti-inflammatory drugs such as celecoxib, aspirin or statins may exhibit antidepressant properties.
One exciting direction regarding these drugs that we explore in这篇评论是抑郁症的压力反应和炎症假说。Inflammatory markers are elevated during a depressive episode和at least some tend to normalize after it remits.
Drugs that target the renin-angiotensin system like the angiotensin receptor blockers (ARBs) and angiotensin-converting enzyme inhibitors (ACEIs) are well established in the treatment of hypertension, but they also have anti-inflammatory properties. Several anti-inflammatory drugs such as celecoxib, aspirin or statins may exhibit antidepressant properties.
Furthermore, drugs that target the renin-angiotensin system have been studied and tested in large samples and for long periods of time and have been compared to other antihypertensive drugs without the anti-inflammatory properties [3,4,5]. The anti-depressant action appears unrelated to the lowering of blood pressure as other anti-hypertensive drugs such as beta-blockers or calcium channel blockers do not lower the risk of depression.
通过填补偶然观察和有针对性的分子解释之间的差距，我们希望为抑郁症治疗的新时代的开始做出贡献，并激发新的临床试验和生物标志物研究。由于这些药物相对安全并且已经广泛使用，因此可以迅速重新利用它们，并在遭受沉重的发病率负担和巨大的疗法发展困扰的地区提供缓解。
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