A Systematic Review and Meta-Analysis on the Neurogenic theory Underlying the effects of antidepressants drugs on behavior

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Description: The consumption of antidepressant drugs used in psychiatric treatments doubled according to the Organization for Economic Cooperation and Development (OECD) between 2000 and 2015. Current treatments using antidepressant drugs are very effective; even with the mechanism of action of these drugs not being fully understood. Recently, advances in the area are based on theories of reversal of hippocampal cell loss with the treatment of depression. The basis of study is anchored in the causes of psychic disorders and neurochemical deficiencies. For many years, we believed that the CNS became a rigid, unmodifiable structure, and in case of injury, its cells were neither reconstituted nor reorganized. However, in recent years, we have discussed the ability to modify and adapt the Central Nervous System (CNS) in an attempt to regenerate from scientific advances. In this sense, we call it "neuroplasticity" with the capacity of existing neural circuitries, addition of new neurons or remodeling of synapses. With the evolution of neuroscience, hypotheses have emerged that neuroplasticity is involved with the efficacy of antidepressant drugs (in this study, the class of Selective Serotonin Reuptake Inhibitors - SSRI). For the author, there is challenging evidence regarding the hypothesis related to monoamines, proposing that such efficacy may originate in the high concentration of serotonin, noradrenaline, dopamine or in monoaminergic neurotransmissions. There is evidence that the morphological loss of neurons is related to long-term hippocampal depression or that the neuroplasticity, monoaminergic, neurotransmitter and neurogenesis processes of this region may interfere with the effect of drugs in the depressive state. The structural plasticity of the hippocampus depends on the process of neurogenesis - origin of new neurons - acting on the mechanism of action of antidepressants. Due to this relationship, we understand that neurogenesis in the hippocampal region has effects underlying antidepressants. Therefore, the objective of this study is to systematically review the evidence supporting the contribution of different neurobiological mechanisms to the effects of antidepressants on behavior.

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