Catecholaminergic strategies for the treatment of major depression
by
Tremblay P, Blier P.
Institute of Mental Health Research,
Lady Grey Building, suite 2043,
Royal Ottawa Hospital,
University of Ottawa, Ottawa, Canada.
Curr Drug Targets. 2006 Feb;7(2):149-58.


ABSTRACT

Although the selective serotonin reuptake inhibitors have become the first line medications for the treatment of depression, drugs primarily targeting the norepinephrine (NE) and/or the dopamine catecholaminergic systems are also effective. These include selective NE reuptake inhibitors, such as desipramine and reboxetine, the NE releaser bupropion and the alpha2-adrenergic antagonists mianserin and mirtazapine. Dopamine type 2 agonists are also effective in treating depression, although they are rarely used. Since the NE, dopamine and serotonin systems have reciprocal interactions, it is virtually impossible to act on a specific neuronal element without affecting in a cascade effect the two other systems. In this review, the primary actions of the catecholaminergic strategies upon their acute and long-term administration are described, as well as their impact on other systems. Their use in treatment-resistant depressed patients is also addressed.


TrkB
Efficacy
Selectivity
Reboxetine
Desipramine
NARIs and SSRIs
Noradrenaline and mood
Catecholamine depletion
Selectivity or multiplicity?
Reboxetine and the elderly
Noradrenaline reuptake inhibition
Sexual function on reboxetine v paroxetine
Residual depressive symptoms: fluoxetine v reboxetine



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