Do Antidepressants Cure or Create Abnormal Brain States 英文参考文献.docVIP

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Do Antidepressants Cure or Create Abnormal Brain States 英文参考文献.doc

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Do Antidepressants Cure or Create Abnormal Brain States 英文参考文献

sasyE Do Antidepressants Cure or Create Abnormal Brain States? Joanna Moncrieff , David Cohen * T he term antidepressant refers to a drug that helps to rectify speci?c biological abnormalities tricAle Summary if (1) the pathology of psychiatric conditions or symptoms had been delineated independently from the characterisation of drug action, and drug action could be extrapolated from that pathology; (2) rating scales used to evaluate drug treatment in clinical trials reliably detected changes in the manifestations of an underlying disease process rather than detecting drug- induced effects; (3) animal models of psychiatric conditions selected speci?c drugs; (4) drugs thought to have a speci?c action in certain conditions were shown to be superior to drugs thought to have nonspeci?c effects; (5) healthy volunteers showed different or absent patterns of effects, compared with diagnosed patients, since drugs would be expected to exert their therapeutic effects only in an abnormal nervous system Antidepressants are assumed to work on the speci?c neurobiology of depressive disorders according to a “disease-centred” model of drug action. However, little evidence supports this idea. An alternative, “drug-centred,” model suggests that psychotropic drugs create abnormal states that may coincidentally relieve symptoms. Drug- induced effects of antidepressants vary widely according to their chemical class—from sedation and cognitive impairment to mild stimulation and occasionally frank agitation. Results of clinical trials may be explained by drug-induced effects and placebo ampli?cation. No evidence shows that antidepressants or any other drugs produce long-term elevation of mood or other effects that are particularly useful in treating depression. (See Text S1 for French translation.) that give rise to the symptoms of depression. This exempli?es what we have called the “disease-centred” model of psychotropic drug action [1]. Modelled on paradigmatic situations in gene