Background: Since long-term treatment is a need in many patients with mood disorders, knowledge
on mechanisms of action in the prevention of recurrence is of major relevance. Methods: Follow-up studies, which are best suited to prove the linkage of causal factors and
mechanisms with the clinical course of the disorders, are rare. Another approach to
search for preventive mechanisms is to address actions of pharmacological agents,
which are effective in prophylactic treatment of mood disorders. Studies over the
past several years have indicated that intracellular signaling cascades mediate long-term
pharmacological effects via modulation of transcription factors and gene expression
of neurotrophic and neuroprotective factors which may interfere with recurrence of
affective illness. Results: The impact of treatment on stress responsive systems varies with different therapeutic
strategies and the relevance of a treatment-related modification of stress reliability
for the course of the disease is not clear. Functional and structural actions of mood
stabilizers and of antidepressants on mood-relevant anatomical circuits and modulation
of chronobiological alteraltions also appear to be involved in preventive mechanisms
in mood disorders. Moreover, cognitive mediators of prophylactic effects have been
described. Conclusion: Combined clinical and biological studies should assess the relevance of those modes
of action for the long-term course of mood disorders.
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Bruno Baumann, MD
Department of Psychiatry
Psychotherapy and Psychosomatic Medicine
Otto-von-Guericke-University of Magdeburg
Leipziger Strasse 44
39120 Magdeburg
Germany
Phone: +49 391 67 15019
Fax: +49 391 67 190367
Email: baumann@med.uni-magdeburg.de
