Biological aspects of treatment resistance in psychiatry and pharmacodynamic approaches to its management

Kozlovskii V.L.; Popov M.Yu.

doi:https://doi.org/10.17116/jnevro2020120101137

Kozlovskii V.L.

Bekhterev National Medical Research Centre of Psychiatry and Neurology

Popov M.Yu.

Bekhterev National Medical Research Centre of Psychiatry and Neurology

Biological aspects of treatment resistance in psychiatry and pharmacodynamic approaches to its management

Authors:

Kozlovskii V.L., Popov M.Yu.

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Journal: S.S. Korsakov Journal of Neurology and Psychiatry. 2020;120(10): 137‑142

DOI: 10.17116/jnevro2020120101137

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To cite this article:

Kozlovskii VL, Popov MYu. Biological aspects of treatment resistance in psychiatry and pharmacodynamic approaches to its management. S.S. Korsakov Journal of Neurology and Psychiatry. 2020;120(10):137‑142. (In Russ.)
https://doi.org/10.17116/jnevro2020120101137

Подписка 2026 Журнал неврологии и психиатрии им. С.С. Корсакова (S.S. Korsakov Journal of Neurology and Psychiatry)

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Abstract:

Treatment resistance is a persistent neurochemical condition characterized by the presence of «hybrid» metabolism, which combines both pathological and drug-dependent metabolisms. The difficulties in management and prevention of treatment resistance are associated with a lack of understanding of neurochemical aspects of the development of higher mental functions. The authors suggest that the basic types of species-preserving behavior are associated with the activity of monoaminergic systems while the modulation of their activity is predetermined by local neuronal networks in the rostral parts of the brain, where a variety of co-transmitters play an important role. It is emphasized that the mechanisms of the development of resistance after previous treatment with agonists (antidepressants, anxiolytics) or antagonists (antipsychotics) are different. Depending on drug actions on synaptic transmission, methodological aspects of treatment resistance management by means of «polar therapy», «sensitization» and combination strategies are considered.

Keywords:

psychotropic drugs

treatment resistance

neurochemical metabolism

resistance management

Authors:

Kozlovskii V.L.

Bekhterev National Medical Research Centre of Psychiatry and Neurology

Popov M.Yu.

Bekhterev National Medical Research Centre of Psychiatry and Neurology

Received:

22.01.2020

Accepted:

04.05.2020

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