Bases neuroquímicas de la depresión. Un modelo médico de la enfermedad depresiva

Knowledge of the mechanism of action of antidepressant drugs prompted intense research activity on monoamine involvement in the pathogenesis of depression. Over the last few decades and related to the technological means available and the “fashion effect” in scientific journals, sufficient knowledge has been generated to relate hypofunction of at least 4 neurotransmitters to what we call the core symptoms of depression. Serotonergic hypofunction has been linked to depressed mood, low stress tolerance and pain intolerance, while its metabolite melatonin has been linked to loss of sleep architecture and flattening of all circadian rhythms. Catecholamines, norepinephrine and dopamine have been related to cognitive dysfunction and an inability to feel pleasure, respectively. The development of these basic or core symptoms will lead to the constellation of symptoms characterizing depressive episodes.