Psychopharmacological Treatment in Adolescence: Neurobiological Basis for Long-Term Consequences
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Abstract
A significant increase in psychotropic drugs prescriptions to adolescents during the last decades raises concerns regarding long-term effects of psychopharmacological treatment. The aim of this paper is to analyze and summarize available neurobiological evidence to assess the risks of long-term neurodevelopmental consequences associated with psychotropic drugs exposure during adolescence. Neurobiological processes underlying brain development during adolescence, including the role of monoamine signaling in regulation of these processes, along with the results of relevant experimental studies, are reviewed. Taken together, the available data indicate that psychotropic drugs influencing monoaminergic signaling (e.g. antidepressants and antipsychotics) might affect normal development and functioning of the brain. On the other hand, the same drugs hypothetically might play a “protective” role, compensating for endo- and/or exogenous monoaminergic dysfunctions interfering with normal neurodevelopment during critical periods of ontogeny. Net effect of the monoaminergic drugs exposure on the developing brain is determined by three main factors: the developmental period during which the monoaminergic interference occurs; the monoamine system which is targeted; the direction of the interference (decreasing or increasing neurotransmission). Translation of neurobiological and experimental data into clinical practice requires further research, including the search for genetic and epigenetic biomarkers aimed at developing future algorithms of personalized treatment of mental disorders in adolescents.
Keywords
adolescence, psychopharmacological treatment, antidepressants, antipsychotics, monoamines, neurodevelopment
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