Depression.
Question: What is the role of norepinephrine and serotonin in depression and its treatment?
Dr. David Hellerstein: The basic thought would be with depression is that the brain has deficient levels of transmitters most prominently norepinephrine and serotonin and it's not just the amount of transmitters, but it's how the brain is processing the transmitter.
Dr. Herndon P. Harding Jr.: The specific role is they are some of the chemicals that mediate all the messages that go on between the nerves which are the basics for all your thinking, all your feeling, all your behavioral action, starts with those kinds of chemical messages in the brain. If any of those are out of whack and what I mean by that is if there is too little or too much or even too little in comparison to something else. So it maybe a normal amount but if something else is going on that's changing the ratio of those things, that might interfere with the normal attachment to a receptor site, then you've got a basic relative a lessening of the amount of that neurotransmitter, even though it's the same as what you had before.
Dr. David Hellerstein: In depression, there is abnormal functioning regarding the transmitter system. So you kind of run out of gas, you don't have enough transmitter around, but it's basically because your brain is cycling through too much transmitter, it's running out of norepinephrine, it's running out of serotonin, because it's in an agitated kind of stressed-out state.
So the antidepressant medicines actually increase the amount of transmitter system, but they also stop the brain from cycling so much. They sort of calm things down, they're not sedatives, but they calm down those kind of hyper-excited system and return it to a more normal state. And this is true whether this kind of re-normalization of the brain state can occur with medicines that you referred norepinephrine or serotonin.
Dr. Herndon P. Harding Jr.: The idea is how do you get that proportionality back to where it works harmoniously.
Dr. David Hellerstein: The word is not completely out, whether the dual mechanism drugs, the serotonin and the norepinephrine are conclusively better than the serotonin rise. I think that both classes work in this disorder, I think it will be established over time whether this was really pronounced difference with serotonin or norepinephrine rise. I think it's possible that that would be found as well as it has been with depression.
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