Endogenous opioid system dysregulation in depression: implications for new therapeutic approaches.

Autor: Peciña M; Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA, USA., Karp JF; Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA, USA., Mathew S; Menninger Department of Psychiatry & Behavioral Sciences, Baylor College of Medicine, Houston, TX, USA., Todtenkopf MS; Alkermes, Inc, Waltham, MA, USA., Ehrich EW; Alkermes, Inc, Waltham, MA, USA., Zubieta JK; Department of Psychiatry, University of Utah Health Sciences Center, Salt Lake City, UT, USA. jonkar.zubieta@hsc.utah.edu.
Jazyk: angličtina
Zdroj: Molecular psychiatry [Mol Psychiatry] 2019 Apr; Vol. 24 (4), pp. 576-587. Date of Electronic Publication: 2018 Jun 28.
DOI: 10.1038/s41380-018-0117-2
Abstrakt: The United States is in the midst of an opioid addiction and overdose crisis precipitated and exacerbated by use of prescription opioid medicines. The majority of opioid prescriptions are dispensed to patients with comorbid mood disorders including major depressive disorder (MDD). A growing body of research indicates that the endogenous opioid system is directly involved in the regulation of mood and is dysregulated in MDD. This involvement of the endogenous opioid system may underlie the disproportionate use of opioids among patients with mood disorders. Emerging approaches to address endogenous opioid dysregulation in MDD may yield novel therapeutics that have a low or absent risk of abuse and addiction relative to µ-opioid agonists. Moreover, agents targeting the endogenous opioid system would be expected to yield clinical benefits qualitatively different from conventional monaminergic antidepressants. The development of safe and effective agents to treat MDD-associated endogenous opioid dysregulation may represent a distinct and currently underappreciated means of addressing treatment resistant depression with the potential to attenuate the on-going opioid crisis.
Databáze: MEDLINE
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