Norepinephrine involvement
in antidepressant action

by
Frazer A
Department of Pharmacology,
The University of Texas Health Science Center
at San Antonio and
South Texas Veterans Health Care System, USA.
frazer@uthscsa.edu
J Clin Psychiatry 2000; 61 Suppl 10:25-30


ABSTRACT

Because of the introduction and popularity of the selective serotonin reuptake inhibitor (SSRI) antidepressants, much attention was centered on the indolealkylamine 5-hydroxytryptamine, or serotonin. To some extent, this focus on serotonin occurred at the expense of the catecholamine neurotransmitter norepinephrine. Nevertheless, it has been apparent for almost 40 years that selective blockers of norepinephrine reuptake may be antidepressants (e.g., desipramine). This brief review covers the acute pharmacologic effects that may be responsible for the efficacy of currently marketed antidepressants as well as that of reboxetine, a newly developed selective norepinephrine reuptake inhibitor. Also discussed is the fact that the acute pharmacologic profile of selective reuptake inhibitors often predicts effects they produce when given long term. For example, the long-term administration of SSRIs produces certain effects on serotonergic systems, but not noradrenergic ones. By contrast, selective norepinephrine reuptake inhibitors, when given long term, modify certain noradrenergic parameters, but not serotonergic indices. Finally, it is speculated how drugs that enhance central noradrenergic transmission might ameliorate the symptoms of depression.


Efficacy
Dopamine
Selectivity
Reboxetine
Desipramine
Noradrenaline
NARIs and SSRIs
Reboxetine: structure
Reboxetine and the rat
Reboxetine and the elderly
Reboxetine versus fluoxetine
Reboxetine and major depression
Reboxetine and social functioning
Noradrenaline/positive emotional bias
Depression, antidepressants and noradrenaline

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