Abstract
Neuropsychiatric sequelae following critical illness are increasingly recognized as major determinants of long-term morbidity and mortality. Depression affects approximately one-third of intensive care unit (ICU) survivors and contributes significantly to post-intensive care syndrome (PICS). Recent epidemiological data demonstrate substantial initiation of antidepressant therapy following ICU discharge, while clinical cohort studies confirm a high burden of depressive symptoms among survivors. Beyond their classical monoaminergic mechanisms, antidepressants exert profound neuroimmune regulatory effects, including suppression of pro-inflammatory cytokines, modulation of the NLRP3 inflammasome, and restoration of neuroplasticity. However, psychotropic drug use in critically ill populations carries safety challenges and complex pharmacokinetic considerations. This mini-review synthesizes epidemiological, clinical, and mechanistic evidence to examine the dual role of antidepressants in ICU survivors: as therapeutic agents for mood disorders and as modulators of neuroimmune dysregulation. The review highlights translational opportunities and identifies key areas for precision-based interventions in critical care psychiatry.
Keywords
Antidepressants, Depression, Neuroinflammation, Neuroimmune modulation, Critical illness, Psychotropic drugs, Translational psychiatry