A significant number of patients with major depression do not respond optimally to current antidepressant drugs. As depression is likely to be a heterogeneous disorder, it is possible that existing neurotransmitter-based antidepressant drugs do not fully address other pathologies that may exist in certain cases. Biological pathologies related to depression that have been proposed and studied extensively include inflammation and immunology, hypercortisolemia, oxidative stress, and impaired angiogenesis. Such pathologies may induce neurodegeneration, which in turn causes cognitive impairment, a symptom increasingly being recognized in depression. A neurotoxic brain hypothesis unifying all these factors may explain the heterogeneity of depression as well as cognitive decline and antidepressant drug resistance in some patients. Compared with neurotransmitter-based antidepressant drugs, many botanical compounds in traditional medicine used for the treatment of depression and its related symptoms have been discovered to be anti-inflammatory, immunoregulatory, anti-infection, antioxidative, and proangiogenic. Some botanical compounds also exert actions on neurotransmission. This multitarget nature of botanical medicine may act through the amelioration of the neurotoxic brain environment in some patients resistant to neurotransmitter-based antidepressant drugs. A multitarget multidimensional approach may be a reasonable solution for patients resistant to neurotransmitter-based antidepressant drugs.

中文翻译：

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重度抑郁症的多靶点植物药物治疗：有毒的大脑假说。

大量重度抑郁症患者对当前的抗抑郁药没有最佳反应。由于抑郁症很可能是一种异质性疾病，因此现有的基于神经递质的抗抑郁药可能无法完全解决某些情况下可能存在的其他疾病。已经提出并广泛研究了与抑郁有关的生物学病理学，包括炎症和免疫学，高皮质醇血症，氧化应激和血管生成受损。此类病理可能诱发神经退行性变，继而引起认知障碍，这种症状在抑郁症中越来越多地被认识到。统一所有这些因素的神经毒性大脑假说可能解释了某些患者抑郁的异质性以及认知能力下降和抗抑郁药耐药性。与基于神经递质的抗抑郁药相比，传统医学中用于治疗抑郁症及其相关症状的许多植物性化合物被发现具有抗炎，免疫调节，抗感染，抗氧化和促血管生成的作用。一些植物化合物也对神经传递起作用。植物药的这种多靶点性质可能通过改善对基于神经递质的抗抑郁药有抵抗力的某些患者的神经毒性脑环境而起作用。对于基于神经递质的抗抑郁药耐药的患者，多目标多维方法可能是合理的解决方案。已发现传统医学中用于治疗抑郁症及其相关症状的许多植物性化合物具有抗炎，免疫调节，抗感染，抗氧化和促血管生成的作用。一些植物化合物也对神经传递起作用。植物药物的这种多靶点性质可能通过改善对基于神经递质的抗抑郁药有抵抗力的某些患者的神经毒性脑环境而起作用。对于基于神经递质的抗抑郁药耐药的患者，多目标多维方法可能是合理的解决方案。已发现传统医学中用于治疗抑郁症及其相关症状的许多植物性化合物具有抗炎，免疫调节，抗感染，抗氧化和促血管生成的作用。一些植物化合物也对神经传递起作用。植物药物的这种多靶点性质可能通过改善对基于神经递质的抗抑郁药有抵抗力的某些患者的神经毒性脑环境而起作用。对于基于神经递质的抗抑郁药耐药的患者，多目标多维方法可能是合理的解决方案。植物药物的这种多靶点性质可能通过改善对基于神经递质的抗抑郁药有抵抗力的某些患者的神经毒性脑环境而起作用。对于基于神经递质的抗抑郁药耐药的患者，多目标多维方法可能是合理的解决方案。植物药物的这种多靶点性质可能通过改善对基于神经递质的抗抑郁药有抵抗力的某些患者的神经毒性脑环境而起作用。对于基于神经递质的抗抑郁药耐药的患者，多目标多维方法可能是合理的解决方案。