With conversations
about depression coming to the forefront of mental health topics, the disease
has gained increased awareness and recognition on a global scale. With this
recognition has come treatments and therapies to combat the devastating
symptoms, and yet, it continues to be a pervasive issue. Some of these drugs
loose effectiveness over time and some never work for patients in the
first place. Furthermore, if the drugs do work, they can come with heavy and
harmful side effects. This goes especially for adolescents, who are in a time
of complex neurological changes as they go through puberty. According to a study
done by the College of Family Physicians of Canada, “Time-to-effect of
fluoxetine in children with depression”, author Dr. Ran D.Goldman found psychotherapy
to be the ideal treatment. However, this study also acknowledges that this type
of treatment does not work for every patient, and may not even be available to
some, especially in low-income areas. Antidepressants are the next method used
for adolescents, and only fluoxetine has shown significant results when
compared to placebos. Even with this SSRI, treatment may not be successful in
all patients, and can cause chance of increased suicide risk along with other
adverse side effects. Combined with the fact that SSRIs can take up to 4 weeks
to show full effects, this study shows that current methods are working, but
are far from ideal.
As stated, there are many intricate changes occurring in the brain
during adolescence, and some researchers have focused on this age group to tackle
depression. One such researcher, Dr. Lauren P. Shapiro investigates this unique
time of neural plasticity in her paper, “Rho-kinase has antidepressant-like
efficacy and expedites dendritic spine pruning in adolescent mice”. Here, she
uses an inhibitor of the cytoskeletal regulatory factor Rho-kinase (ROCK) to
initiate anti-depressant like effects in adolescent mice. She specifically
targets the ventromedial prefrontal cortex (vmPFC), as this is an area closely
linked to emotional control that undergoes extensive restructuring in the
adolescent brain. She mentions that research indicates it is this time of structural
change, specifically with dendritic spine pruning, that can lead to a susceptibility
for mental disorders. The results show that treatment by ROCK inhibitors does
not negatively affect the typical learning and developmental changes happening in
adolescent minds and does positively affect dendritic spine pruning in the vmPFC.
By comparing this treatment to traditional medication like fluoxetine and newer
approaches such as ketamine, she showed that not only does this ROCK inhibitor have
anti-depressant like effects, it has shown minimal side effects and fast onset
responses, paving a new path for possible low-risk adolescent depression therapies.
Works Cited
Shapiro, L. P., Kietzman, H. W., Guo, J., Rainnie, D.
G., & Gourley, S. L. (2019). Rho-kinase inhibition has antidepressant-like
efficacy and expedites dendritic spine pruning in adolescent mice. Neurobiology
of Disease, 124, 520–530. https://doi.org/10.1016/j.nbd.2018.12.015
Yan, Tyler, and Ran D Goldman. “Time-to-effect of
fluoxetine in children with depression.” Canadian
family physician Medecin de famille canadien vol.
65,8 (2019): 549-551. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6693597/
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