Should depression be treated with excitatory or inhibitory medications? Normally I have seen inhibitory drugs being prescribed for depression, hence my question.
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5$\begingroup$ Welcome. We generally encourage that questions are accompanied by evidence of prior research. Evidently, you have done so, given your 2nd line in the question body. What did you find and what makes you think these drugs are inhibitory? Are you talking about first line treatments only? If yes, exactly which (class of) compounds are you referring to? What do you define as 'inhibitory'? At which level are you thinking? The (sub)cellular (neuronal or synaptic) level, or the organismal level (mental state)... $\endgroup$– AliceD ♦Commented Oct 30, 2022 at 19:53
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5$\begingroup$ ...Addressing these items greatly clarifies the question and brings focus to your post. This, in turn, facilitates better answers. $\endgroup$– AliceD ♦Commented Oct 30, 2022 at 19:53
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Indeed most medication types of Antidepressants are inhibitory such as Selective serotonin reuptake inhibitors, Serotonin–norepinephrine reuptake inhibitors, Norepinephrine reuptake inhibitors, and Norepinephrine–dopamine reuptake inhibitors, etc.
However, surprisingly some research shows deprivation of REM sleep may at least temporarily improve depression. Thus if you count deprivation of sleep as "excitatory" generally in your dictionary then this could be such a case, albeit it's not the scientific sense as excitatory synapse defined in terms of increased probability of an action potential occurring in a subsequent postsynaptic cell or excitatory neurotransmitter molecules.
It has been suggested that acute REM sleep deprivation can improve certain types of depression—when depression appears to be related to an imbalance of certain neurotransmitters. Although sleep deprivation in general annoys most of the population, it has repeatedly been shown to alleviate depression, albeit temporarily.[89] More than half the individuals who experience this relief report it to be rendered ineffective after sleeping the following night. Thus, researchers have devised methods such as altering the sleep schedule for a span of days following a REM deprivation period[90] and combining sleep-schedule alterations with pharmacotherapy[91] to prolong this effect. Antidepressants (including selective serotonin reuptake inhibitors, tricyclics, and monoamine oxidase inhibitors) and stimulants (such as amphetamine, methylphenidate and cocaine) interfere with REM sleep by stimulating the monoamine neurotransmitters which must be suppressed for REM sleep to occur. Administered at therapeutic doses, these drugs may stop REM sleep entirely for weeks or months.
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$\begingroup$ I am not that proficient in neuroscience, so can you please elaborate on what you mean when you said "if you count deprivation of sleep as "excitatory" generally in your dictionary then this could be such a case, albeit it's not the scientific sense"? I hope I'm clear in what I'm trying to say, but the way I understand it, if you are stimulating the monoamine neurotransmitters which must be suppressed for REM sleep to occur, surely the suppression of REM sleep is an excitatory response to the stimulation of those monoamine neurotransmitters. Surely, this sleep deprivation is excitatory? $\endgroup$ Commented Nov 5, 2022 at 6:50
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$\begingroup$ @ChrisRogers moderator's comments above hinted OP didn't offer their exact level of definition of "excitatory" or "inhibitory". For the general public without special neurophysiological knowledge any medication to deprive sleep could count as "excitatory" colloquially. Although my above reference affirms stimulating the monoamine neurotransmitters is necessary to suppress REM sleep, monoamine is not solely excitatory, as one of its example dopamine could be excitatory, inhibitory and modulatory, while other examples such as serotonin or norepinephrine are just inhibitory or modulatory. $\endgroup$– cinchCommented Nov 6, 2022 at 0:04