**10.2. Depression and anxiety**

Increases the prevalence of stress related mood disorders [209] combined with metanalyses reporting that current treatments for depression may not be effective for mild to moderate depression [210] make a compelling argument that a new approach is needed in depression and anxiety research. Both the animal and human studies suggest that AVP is involved in the development of depression and anxiety disorders, and several reports indicate that AVP has gender specific roles. Continuing development of AVP targeted treatments should consider these gender specific actions. It is possible that while V1a antagonists may work for alleviating depression and/or anxiety symptoms in males, AVP or AVP agonists may be more effective in females. As noted by Manning et al. there has been little success with the development of non-peptide agonists and antagonists for AVP despite substantial investments by pharmaceutical companies. In contrast, some progress has been made with OXT peptide based treatments [194, 195]. The recent studies on AVP and maternal behavior in animals suggest that increased focus on AVP in human studies is warranted, especially on stress, maternal behavior, and postpartum depression. One valuable use for non-peptide ligands that have not been successful in clinical trials is as research tools, including the development of specific AVP and OXT ligands for imaging studies [194].

The animal and human data on OXT support the hypothesis that this peptide hormone is also a valid target for novel maternal mood disorder treatments. An interesting implication in this area is that synthetic OXT is already commonly used to induce labor, yet little is known about how this treatment may affect maternal behavior and/or offspring. OXT or OXT antagonists may also be effective in treating melancholic depression and seasonal affective disorder. There are also interesting non-pharmaceutical interventions which can manipulate OXT levels, such as physical touch and modified birthing practices and procedures (cesarean sections and induced labor vs. natural childbirth). Greater collaboration between animal and clinical researchers will accelerate the development of safe and effective AVP and OXT targeted treatments for depression and anxiety disorders, including postpartum depression, seasonal affective disorder, and PTSD. Projects that involve consistent interactions between animal and clinical researchers throughout the developmental process will be most effective. Another potential therapeutic application of AVP and OXT is in relationship counseling. Both of these hormones are likely to be involved in the mechanisms of establishing and maintaining the social bond necessary for a strong and stable relationship. AVP and OXT targeted treatments may be effective in treating the adverse effects of chronic social conflict, or the effects of other chronic stressors, especially in combination with behavioral cognitive therapy.
