In clinical practice it is still useful to follow a categorical approach at the first stage (diagnostic utility), but bearing in mind that bipolar depressions and nonbipolar depressions have a fluctuating course and also have mixed episodes of depression and superimposed manic/hypomanic symptoms. The impact on treatment of these findings may be important for bipolar disorders and depressive disorders. If, when, and how long to use antidepressants and moodstabilizing agents in Inhibitors,research,lifescience,medical the light of the spectrum concept of mood disorders have to be defined, setting the stage for a new series of studies. Notes I wish

to thank Professor Jules Angst for his support and for his suggestions.
Decades of basic and clinical neuroscience research have greatly improved our understanding of the neurobiology of depression. Clinical studies have helped establish which treatments Inhibitors,research,lifescience,medical are effective, and have led to evidence-based treatment algorithms that can be readily applied to the “real-world” situation.1 Basic research has yielded insights into the genetic, molecular, cellular, and neuroanatomical bases of depression. Based on these findings, there is a growing acceptance of depression, Inhibitors,research,lifescience,medical and other mood disorders, as diseases of the brain rather

than purely aberrations of “mind.” Despite these advances, depression remains a common and inadequately treated illness, with few strategies for prevention or cure. The lifetime prevalence of depression approaches 17% in the United States,2 and depression is recognized Inhibitors,research,lifescience,medical to be one of the leading causes of disability worldwide.3,4 Available treatments for depression – including pharmacotherapy, evidence-based psychotherapy, and electroconvulsive therapy (ECT) – are Inhibitors,research,lifescience,medical effective in reducing symptoms in the majority of patients with an acute depressive episode, and the combination of these treatments may be more LY2603618 ic50 efficacious than individual treatments alone.5 However,

up to 40% of patients continue to have clinically significant symptoms despite optimized treatment,6 and up to 20% of patients may show little to no response to the most aggressive management (including the use of ECT).7-9 Even for patients Physiological Reviews who do respond to treatment, the illness tends to be highly recurrent, with up to 80% of patients experiencing at least one subsequent episode.10 Psychotherapy and/or maintenance antidepressant medications may substantially decrease the risk of relapse but do not eliminate it.11 In the face of these clear challenges, the continued neurobiological investigation of depression offers reason for optimism. Based on a solid foundation, basic and clinical neuroscience research is progressing rapidly, with many exciting developments on the horizon. Importantly, as the pathophysiology of depression becomes better understood, a number of novel treatment targets are being identified.