How antidepressants really work

The paper presents the current state of research on the mechanisms of action of antidepressants (AD). The neuropsychological cognitive theory of antidepressant action is summarised, as well as the results of studies on the effects of antidepressants on anger, irritability, and aggression in depression. The common point of these studies is the assumption of two phases in which medication leads to an improvement in depressive symptoms, including an improvement in mood. In the first phase, antidepressant treatment decrease the negative bias in the processing of emotionally salient information, and leads to improvement in the negative emotions like anger. In the second phase, these changes, caused by AD within hours after first dose, cause changes in the social interaction of the treated person. This new positive bias needs to be “enacted” by interactions with the social environment. Overall, changes occurring at both levels lead to an improvement in mood, observed as a clinical effect of treatment.