This review examines both clinical and preclinical studies regarding the antidepressant efficacy of SSRIs in young people and adolescents (already less effective than in adults). There is general agreement that the function and expression of SERT is lower in young people and adolescents compared to adults. First of all, a gap in knowledge is highlighted: the ontogeny of neural systems must be better understood and better preclinical models are needed in which to study the efficacy of antidepressants. From clinical studies, the usefulness of SSRIs in pediatric patients is not yet clear and preclinical research can provide valuable information. Studies on SERT expression and function reveal a dichotomy in the effect of chronically taken SSRIs: in adults, SERT is downregulated (decreases SERT expression/function), while in children and adolescents it is upregulated. In addition, an increasing role of OCTs and PMATs (vesicular monoaminergic transporters) in the regulation of monoamine neurotransmission.
Ultimately, differences from adults in SERT and, presumably, other serotonin transporters may provide a mechanistic basis for the relative inefficiency of SSRIs in the pediatric population.
Year: 2019
Nationality: USA
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