Predicting response:
serotonin reuptake inhibition
by
Mendlewicz J
Free University of Brussels,
Department of Psychiatry, Belgium.
Int Clin Psychopharmacol 1999 May; 14 Suppl 1:S17-20
ABSTRACT
The introduction of selective serotonin reuptake inhibitors (SSRIs) has
helped clarify our understanding of the actions of serotonin in depression. The
serotonergic network of the central and peripheral nervous systems comprises
many different pathways and at least 14 distinct serotonin receptors. By using
our knowledge of neuroanatomy and the pharmacology of SSRIs, it is possible to
predict many of the therapeutic and non-therapeutic effects of modulating
serotonin levels. The efficacy of SSRIs in mild to moderate depression is well
established but their efficacy in severe depression varies, compared with
tricyclic antidepressants. The SSRIs also have predictable effects in a range of
other affective disorders including obsessive-compulsive disorder, anxiety and
bulimia, the efficacy varying between the different SSRIs. The adverse event
profile is different from that of the tricyclic antidepressants and again is
predictable through an understanding of the different serotonergic pathways.
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