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Cited by 263Treatment of Major DepressionElectroconvulsive Therapy StudiesTranscranial Magnetic Stimulation Studies

The timing of antidepressant effects: a comparison of diverse pharmacological and somatic treatments

Open access
Machado-Vieira, Rodrigo, Baumann, Jacqueline, Wheeler-Castillo, Cristina, Latov, David, Henter, Ioline D., Salvadore, Giacomo, Zarate, Carlos A.·2010·Pharmaceuticals
DOI 10.3390/ph3010019PMC PMC3991019
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Abstract

Currently available antidepressants used to treat major depressive disorder (MDD) unfortunately often take weeks to months to achieve their full effects, commonly resulting in considerable morbidity and increased risk for suicidal behavior. Our lack of understanding of the precise cellular underpinnings of this illness and of the mechanism of action of existing effective pharmacological treatments is a large part of the reason that therapies with a more rapid onset of antidepressant action (ROAA) have not been developed. Other issues that need to be addressed include heterogeneous clinical concepts and statistical models to measure rapid antidepressant effects. This review describes the timing of onset of antidepressant effects for various therapies used to treat MDD. While several agents produce earlier improvement of depressive symptoms (defined as occurring within one week), the response rate associated with such agents can be quite variable. These agents include both currently available antidepressants as well as other pharmacological and non-pharmacological interventions. Considerably fewer treatments are associated with ROAA, defined as occurring within several hours or one day. Treatment strategies for MDD whose sustained antidepressant effects manifest within hours or even a few days would have an enormous impact on public health.

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  • The definition of rapid onset of antidepressant effects ranges from significant response rates within a few hours to 20% symptom reduction up to 2 weeks.

    “Characteristically, the definition of rapid onset of antidepressant effects ranges from significant response rates within a few hours to 20% symptom reduction up to 2 weeks (57).”

    From Total Sleep Deprivation Followed by Bright Light Therapy as Rapid Relief for Depression: A Pragmatic Randomized Controlled Trial (2021) · cites this paper as [57]

    Section 2 distinguishes rapid onset from early improvement: it defines rapid-onset antidepressant effects as significant response within a few hours or one day, not up to two weeks. It separately discusses 20% improvement over one to two weeks as a measure of improvement that may be less clinically meaningful than the same change within hours. The Future Directions section repeats that distinction. (LLM, conf=0.86)

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  • Ketamine has demonstrated remarkable and rapid anti-depressant effects, manifesting as early as a day after administration, in contrast to the response lag observed with traditional antidepressants.

    “Ketamine has also demonstrated remarkable and rapid anti-depressant effects, manifesting as early as a day after administration, in contrast to the “response lag” observed with traditional antidepressants (37, 42, 64).”

    From Examining the Potential Synergistic Effects Between Mindfulness Training and Psychedelic-Assisted Therapy (2021) · cites this paper as [64]

  • Our intervention should reduce the high level of psychological strain to achieve early improvements of depressive symptoms.

    “Therefore, it should reduce the high level of psychological strain to achieve early improvements of depressive symptoms (58).”

    From Computer-assisted avatar-based treatment for dysfunctional beliefs in depressive inpatients: A pilot study (2021) · cites this paper as [58]

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Authors
Machado-Vieira, R., Baumann, J., Wheeler-Castillo, C., Latov, D., Henter, I. D., Salvadore, G., & Zarate, C. A.
Affiliations
  • Experimental Therapeutics, Mood and Anxiety Disorders Program, National Institute of Mental Health, and Department of Health and Human Services, Bethesda, MD 20892, USA
  • National Institutes of Health (US)
Corresponding author
Zarate, Carlos A.
ORCID
Venue
Pharmaceuticals
Publisher
MDPI AG
Published
2010-01-06
Volume
3
Issue
1
Pages
19-41
ISSN
1424-8247 (ISSN-L)
DOI
10.3390/ph3010019
PMC
PMC3991019
OpenAlex
W1989757811
Cited by
263
References
140
Citations by year
2026: 23 · 2025: 29 · 2024: 28 · 2023: 40 · 2022: 26 · 2021: 31 · 2020: 29 · 2019: 25 · 2018: 9 · 2017: 7 · 2016: 3 · 2015: 3 · 2014: 3 · 2013: 2 · 2012: 1
FWCI
0.22
Type
journal article
Language
en
Open access
Licence
Locations
  • Pharmaceuticals (publishedVersion, cc-by)
  • Europe PMC (PubMed Central) (publishedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
Funders
  • National Alliance for Research on Schizophrenia and Depression
  • National Institutes of Health
  • National Institute of Mental Health
Topics
  • Health Sciences › Medicine › Pharmacology › Treatment of Major Depression
  • Health Sciences › Medicine › Psychiatry and Mental health › Electroconvulsive Therapy Studies
  • Life Sciences › Neuroscience › Neurology › Transcranial Magnetic Stimulation Studies
Keywords
major depressive disorder, antidepressant effects, antidepressants, somatic treatment, non-pharmacological treatment, mechanism of action, response rate, suicidal behavior

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