Major Depressive Disorder and Oxidative Stress: In Silico Investigation of Fluoxetine Activity against ROS.

Featured Application: Due to the seriousness of depressive disorders and their social implications, any strategy to improve clinical symptoms are of considerable importance. It is recognized that oxidative stress negatively impacts on this and other psychiatric diseases. Fluoxetine, a well-known and largely prescribed antidepressant drug, has antioxidant capacity, but, based on our analysis, this is due to its efficiency in increasing the concentration of free serotonin, rather than its direct ROS scavenging activity. Major depressive disorder is a psychiatric disease having approximately a 20% lifetime prevalence in adults in the United States (U.S.), as reported by Hasin et al. in JAMA Psichiatry 2018 75, 336–346. Symptoms include low mood, anhedonia, decreased energy, alteration in appetite and weight, irritability, sleep disturbances, and cognitive deficits. Comorbidity is frequent, and patients show decreased social functioning and a high mortality rate. Environmental and genetic factors favor the development of depression, but the mechanisms by which stress negatively impacts on the brain are still not fully understood. Several recent works, mainly published during the last five years, aim at investigating the correlation between treatment with fluoxetine, a non-tricyclic antidepressant drug, and the amelioration of oxidative stress. In this work, the antioxidant activity of fluoxetine was investigated using a computational protocol based on the density functional theory approach. Particularly, the scavenging of five radicals (HO^•, HOO^•, CH₃OO^•, CH₂=CHOO^•, and CH₃O^•) was considered, focusing on hydrogen atom transfer (HAT) and radical adduct formation (RAF) mechanisms. Thermodynamic as well as kinetic aspects are discussed, and, for completeness, two metabolites of fluoxetine and serotonin, whose extracellular concentration is enhanced by fluoxetine, are included in our analysis. Indeed, fluoxetine may act as a radical scavenger, and exhibits selectivity for HO^• and CH₃O^•, but is inefficient toward peroxyl radicals. In contrast, the radical scavenging efficiency of serotonin, which has been demonstrated in vitro, is significant, and this supports the idea of an indirect antioxidant efficiency of fluoxetine. [ABSTRACT FROM AUTHOR]