Most people know that some antidepressants need to be taken for a few weeks before you start to see improvement, and a new study now sheds light on this delay.
Scientists have found that this is due to physical changes in the brain that occur during the first weeks of using selective serotonin reuptake inhibitors (SSRIs) and lead to greater brain plasticity.
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SSRIs include a range of common antidepressants such as Paxil, Prozac, Celexa, Lexapro and Zoloft.
“The delay in the therapeutic action of antidepressants has been an enigma for psychiatrists since their first discovery, more than 50 years ago. So this new data in humans that uses cutting-edge brain imaging to demonstrate an increase in brain connections developing over the period in which depression resolves is very exciting,” said David Nutt from Imperial College. from London, who was not involved in the research. “Furthermore, they provide more evidence [that] Improving serotonergic function in the brain may have lasting health benefits.
Researchers studied this in a randomized, double-blind, placebo-controlled trial in a group of healthy volunteers.
Researchers gave 17 volunteers a daily dose of 20 milligrams (mg) of the SSRI escitalopram (Lexapro). Fifteen other volunteers received a placebo.
About three to five weeks later, the volunteers’ brains were scanned using a positron emission tomography (PET) scanner.
The scans made it possible to see the amount of glycoprotein 2A in synaptic vesicles in the brain. The more this protein is present in an area, the more nerve cell connections are present.
The investigators found significant differences in the change in synaptic density over time in the two groups.
“We found that in those who took SSRIs, there was a progressive increase in synapses in the neocortex and hippocampus of the brain over time, compared to those who took a placebo. We saw no effect in those who took a placebo,” said researcher Gitte Knudsen of Copenhagen University Hospital in Denmark.
The neocortex is a complex brain structure that manages higher functions such as sensory perception, emotions and cognition. The hippocampus is involved in memory and learning.
The study results were presented Monday at the European College of Neuropsychopharmacology conference in Barcelona and simultaneously published online in the journal Molecular Psychiatry.
“This leads to two main conclusions,” Knudsen said in a press release. “First, it indicates that SSRIs increase synaptic density in brain areas critically involved in depression. “This would indicate to some extent that synaptic density in the brain might be involved in how these antidepressants work, which would give us a target for developing new drugs for depression,” she said.
“The second point is that our data suggests that synapses develop over a period of weeks, which would explain why the effects of these drugs take time to become evident,” she added.
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