Der Hippocampus ist eine von zwei Gehirnregionen, in der zeitlebens kontinuierlich neue Nervenzellen gebildet werden. Er spielt eine wichtige Rolle bei der Gedächtniskonsolidierung und wird mit der funktionellen Entstehung neurodegenerativer Erkrankungen in Verbindung gebracht. Strukturveränderungen im erwachsenen Gehirn, die mit einer Depression einhergehen, sind laut Literatur auf einen geringen Serotoninspiegel und reduzierte hippocampale Neurogenese zurückzuführen. Selektive Serotonin-Wiederaufnahmehemmer (SSRI) erhöhen die Serotoninkonzentration im synaptischen Spalt und üben einen positiven Effekt auf die adulte Neurogenese aus. In der vorliegenden Arbeit wird untersucht, wie Veränderungen in der Serotonin (5-HT)-Neurotransmission durch einmalige oder chronische Gaben von Fluoxetin und speziellen Agonisten und Antagonisten für die Serotoninrezeptoren 5-HT1a und 5-HT2 in der erwachsenen Maus die Proliferation und Differenzierung von neugebildeten Nervenzellen im Gyrus dentatus beeinflussen. Die Ergebnisse zeigen, dass ein konträres Agieren beider Rezeptoren zu einem ausgewogenen Serotoninspiegel führt. 5-HT1a- und 5-HT2c-Rezeptoren haben einen Einfluss auf das Überleben neugebildeter Nervenzellen, wobei sie unterschiedliche Entwicklungsstadien innerhalb der adulten Neurogenese kontrollieren. Die vorliegende Arbeit bekräftigt außerdem, dass die chronische Gabe von Fluoxetin die adulte Neurogenese steigert. / The hippocampus as one region with ongoing neurogenesis throughout life contributes to the formation of long-term memory and has also been implicated in the pathology of major depression. Studies suggest that depression might be due to decreased levels of serotonin and reduced neurogenesis in the adult brain and that the beneficial effects of selective serotonin reuptake inhibitors would require adult hippocampal neurogenesis. Here, I investigated how modulation of serotonergic neurotransmission by acute and chronic treatment with the antidepressant fluoxetine, and selective serotonin receptor agonists and antagonists in adult mice influences precursor cell activity during development. I focused on 5-HT1a and 5-HT2 receptors as major mediators of serotonin action. The present findings suggest that an opposed action of 5-HT1a and 5-HT2c receptor subtypes result in a balanced regulation of serotonin levels in the dentate gyrus. Both receptors differentially affect intermediate cell stages in adult hippocampal neurogenesis and play an important role in the survival of newly generated neurons. Furthermore, this study confirms that chronic fluoxetine treatment increases adult neurogenesis. In conclusion, the latency of onset of fluoxetine action can be explained by a balanced interplay of 5-HT1a and 5-HT2c receptor subtypes.

O objetivo deste estudo foi verificar a elaboração e a recontagem de histórias de crianças com o diagnóstico de depressão maior unipolar (DSM-IV, 1997), bem como a influência da terapia medicamentosa com fluoxetina em um estudo duplo-cego longitudinal controlado com placebo. Fizeram parte do estudo trinta sujeitos com idades entre 10 e 14 anos e diagnosticados com depressão, randomizados para o uso de fluoxetina ou placebo. Ambos os grupos foram avaliados quanto à elaboração livre de textos orais e escritos e à recontagem de textos (fábulas de Êsopo ou La Fontaine) na etapa 0 (sem o uso de medicação) e na etapa 3 (três meses após a introdução de medicação ou placebo). Os textos foram analisados de acordo com o modelo de Kintsch e Van Dijk (1978), baseado no número de macro e microestruturas produzidas e/ou recordadas e nos componentes relativos à superestrutura textual. A este modelo foi acrescida a análise do conteúdo proposicional (positivo, negativo ou neutro), com o intuito de observar o fenômeno da “memória condizente com o humor". Não foram observadas diferenças significativas com relação a esses critérios entre os grupos ou períodos analisados, nem quanto à produção e/ou recontagem de textos orais ou escritos, mesmo com a melhora da sintomatologia clínica observada por meio da escala CDRS (Poznanski & Mokros, 1996). / The aim of this study was to evaluate the textual production and recontagem of children with unipolar major depression (DSM-IV, 1997), and the influence of drug therapy with fluoxetine in a longitudinal, double-blinded, placebo-controlled study. Thirty subjects with depression, aged between 10 and 14 years, were selected and randomized for the use of fluoxetine or placebo. Both groups were analyzed regarding to spontaneous oral and written production and to the recontagem of the texts (Esopo’s or La Fontaine’s fables) in the period zero (without medication) and period 3 (three months after starting placebo or fluoxetine). The texts were analyzed according to Kintsch and Van Dijk’s model (1978), taking in account the number of macro and microstructures elaborated and/or recalled and the textual superstructure. We added to this model the proposition-content analysis (positive, negative or neutral), in order to observe the “mood-congruent memory" phenomenon. Regarding these criteria, no differences were found amongst the groups or periods analyzed, neither amongst the oral and written elaborated or recontados texts, even after the improvement of clinical symptoms evaluated by CDRS scale (Poznanski and Mokros, 1996).

O objetivo deste estudo foi verificar a elaboração e a recontagem de histórias de crianças com o diagnóstico de depressão maior unipolar (DSM-IV, 1997), bem como a influência da terapia medicamentosa com fluoxetina em um estudo duplo-cego longitudinal controlado com placebo. Fizeram parte do estudo trinta sujeitos com idades entre 10 e 14 anos e diagnosticados com depressão, randomizados para o uso de fluoxetina ou placebo. Ambos os grupos foram avaliados quanto à elaboração livre de textos orais e escritos e à recontagem de textos (fábulas de Êsopo ou La Fontaine) na etapa 0 (sem o uso de medicação) e na etapa 3 (três meses após a introdução de medicação ou placebo). Os textos foram analisados de acordo com o modelo de Kintsch e Van Dijk (1978), baseado no número de macro e microestruturas produzidas e/ou recordadas e nos componentes relativos à superestrutura textual. A este modelo foi acrescida a análise do conteúdo proposicional (positivo, negativo ou neutro), com o intuito de observar o fenômeno da “memória condizente com o humor”. Não foram observadas diferenças significativas com relação a esses critérios entre os grupos ou períodos analisados, nem quanto à produção e/ou recontagem de textos orais ou escritos, mesmo com a melhora da sintomatologia clínica observada por meio da escala CDRS (Poznanski & Mokros, 1996). / The aim of this study was to evaluate the textual production and recontagem of children with unipolar major depression (DSM-IV, 1997), and the influence of drug therapy with fluoxetine in a longitudinal, double-blinded, placebo-controlled study. Thirty subjects with depression, aged between 10 and 14 years, were selected and randomized for the use of fluoxetine or placebo. Both groups were analyzed regarding to spontaneous oral and written production and to the recontagem of the texts (Esopo’s or La Fontaine’s fables) in the period zero (without medication) and period 3 (three months after starting placebo or fluoxetine). The texts were analyzed according to Kintsch and Van Dijk’s model (1978), taking in account the number of macro and microstructures elaborated and/or recalled and the textual superstructure. We added to this model the proposition-content analysis (positive, negative or neutral), in order to observe the “mood-congruent memory” phenomenon. Regarding these criteria, no differences were found amongst the groups or periods analyzed, neither amongst the oral and written elaborated or recontados texts, even after the improvement of clinical symptoms evaluated by CDRS scale (Poznanski and Mokros, 1996).

Background: Antidepressants are widely used in the treatment of chronic pain. Applied doses are lower than those needed to unfold an antidepressive effect. While efficacy of antidepressants for chronic pain has been reported in large randomized-controlled trials (RCT), there is inconsistent data on adverse effects and tolerability. We aimed at synthesizing data from RCT to explore adverse effect profiles and tolerability of antidepressants for treatment of chronic pain. Methods: Systematic literature research and meta-analyses were performed regarding side effects and safety of different antidepressants in the treatment of chronic pain according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. The National Center for Biotechnology Information library and MEDLINE were searched. Randomized placebo-controlled trials were included in quantitative data synthesis. results: Out of 1,975 screened articles, 33 papers published between 1995 and 2015 were included in our review and 23 studies were included in the meta-analyses. A higher risk for adverse effects compared to placebo was observed in all antidepressants included in our analyses, except nortriptyline. The most prevalent adverse effects were dry mouth, dizziness, nausea, headache, and constipation. Amitriptyline, mirtazapine, desipramine, venlafaxine, fluoxetine, and nortriptyline showed the highest placebo effect-adjusted risk of adverse effects. Risk for withdrawal due to adverse effects was highest in desipramine (risk ratio: 4.09, 95%-confidence interval [1.31; 12.82]) followed by milnacipran, venlafaxine, and duloxetine. The most common adverse effects under treatment with antidepressants were dry mouth, dizziness, nausea, headache, and constipation followed by palpitations, sweating, and drowsiness. However, overall tolerability was high. Each antidepressant showed distinct risk profiles of adverse effects. conclusion: Our synthesized data analysis confirmed overall tolerability of low-dose antidepressants for the treatment of chronic pain and revealed drug specific risk profiles. This encompassing characterization of adverse effect profiles might be useful in defining multimodal treatment regimens for chronic pain which also consider patients’ comorbidities and co-medication.

Fluoxetin är den aktiva substansen i många serotoninreglerande läkemedel som förs in i vattendrag. Substansen har visats påverka beteende av vattenlevande organismer som fiskar, mollusker och kräftdjur genom att öka deras djärvhet. I denna studie undersöktes fluoxetins akuta (på vildfångade individer) och kroniska (på labbuppfödda individer) effekter av koncentrationerna 0, 3 och 30 ng L-1 på Asellus aquaticus (sötvattengråsugga) antipredatorbeteende. Detta gjordes genom tre beteendetest: (1) tid att lämna refug, (2) spontan aktivitet samt (3) flyktbeteende under predationsrisk. Överlag hittades få eller inga effekter på A. aquaticus från fluoxetin. De effekter som dock påverkade individer signifikant visade att exponerade individer flydde en signifikant kortare (30 %) tidsperiod från en simulerad predatorattack. Utöver denna huvudeffekt av fluoxetin hittades även signifikanta skillnader i fluoxetins påverkan på de två grupperna, när individer blev utsatta för den högsta koncentrationen ökade vildfångade individer sin aktivitet (38 % fler stopp och 49 % mer rörelse) medan labbuppfödda individer sänkte sin aktivitet (43 % färre stopp och 37 % mindre rörelse). Individer som inte var exponerade visade signifikanta skillnader i alla beteendetest för de två grupperna. Det är troligt att beteendeskillnader är en följd av olika uppfödningsmiljöer, dock går det inte att utesluta att ändrade genfrekvenser uppkommit. Studien lyser sken på behovet av fler studier av långtidsexponering av läkemedelsrester, de är sällan akut giftiga men har däremot subletal påverkan i låga doser. / Fluoxetine is the active substance in many selective serotonin reuptake inhibitive pharmaceuticals that currently enters surface waters. The substance has been shown to affect behaviors of water living organism such as fish, molluscs and crustaceans by making them less cautious. This study investigated the acute (on wild caught individuals) and chronic (on lab reared individuals) effects of fluoxetine on the antipredator behavior of Asellus aquaticus for three concentrations; 0,3 and 30 ng L-1. Three tests were used to determine the effects: (1) time to leave a shelter, (2) spontaneous activity and (3) escape behavior under predation risk. Few statistically significant effects of fluoxetine on A. aquaticus were found. However, individuals exposed to fluoxetine had a significantly shorter (30 %) escape period. Besides this main effect of fluoxetine, significant interactions between the two groups and fluoxetine were also found. When exposed to the highest concentration wild caught individuals increased their spontaneous activity (38 % more stops and 49 % more movement), while lab reared individuals reduced their activity (43 % fewer stop and 37 % less movement). Furthermore, non-exposed individuals from the two groups behaved significantly different in all the tests. It is likely that the differences in behavior occurred due to environmental effects of laboratory rearing, although altered gene frequencies cannot be excluded. This study emphasizes the need for development of methods for more chronic testing of pharmaceuticals, especially considering that pharmaceuticals are seldom acutely toxic but often has sub lethal effects in low doses.

Background: Antidepressants are widely used in the treatment of chronic pain. Applied doses are lower than those needed to unfold an antidepressive effect. While efficacy of antidepressants for chronic pain has been reported in large randomized-controlled trials (RCT), there is inconsistent data on adverse effects and tolerability. We aimed at synthesizing data from RCT to explore adverse effect profiles and tolerability of antidepressants for treatment of chronic pain. Methods: Systematic literature research and meta-analyses were performed regarding side effects and safety of different antidepressants in the treatment of chronic pain according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. The National Center for Biotechnology Information library and MEDLINE were searched. Randomized placebo-controlled trials were included in quantitative data synthesis. results: Out of 1,975 screened articles, 33 papers published between 1995 and 2015 were included in our review and 23 studies were included in the meta-analyses. A higher risk for adverse effects compared to placebo was observed in all antidepressants included in our analyses, except nortriptyline. The most prevalent adverse effects were dry mouth, dizziness, nausea, headache, and constipation. Amitriptyline, mirtazapine, desipramine, venlafaxine, fluoxetine, and nortriptyline showed the highest placebo effect-adjusted risk of adverse effects. Risk for withdrawal due to adverse effects was highest in desipramine (risk ratio: 4.09, 95%-confidence interval [1.31; 12.82]) followed by milnacipran, venlafaxine, and duloxetine. The most common adverse effects under treatment with antidepressants were dry mouth, dizziness, nausea, headache, and constipation followed by palpitations, sweating, and drowsiness. However, overall tolerability was high. Each antidepressant showed distinct risk profiles of adverse effects. conclusion: Our synthesized data analysis confirmed overall tolerability of low-dose antidepressants for the treatment of chronic pain and revealed drug specific risk profiles. This encompassing characterization of adverse effect profiles might be useful in defining multimodal treatment regimens for chronic pain which also consider patients’ comorbidities and co-medication.