SSRIs and SNRIs: broad spectrum
of efficacy beyond major depression

by
Gorman JM, Kent JM
Department of Clinical Psychobiology,
New York State Psychiatric Institute,
College of Physicians and Surgeons of Columbia University,
New York 10032, USA.
J Clin Psychiatry 1999; 60 Suppl 4:33-8; discussion 39


ABSTRACT

Originally studied and introduced for the treatment of depression, the selective serotonin reuptake inhibitors (SSRIs) and serotonin/norepinephrine reuptake inhibitors (SNRIs) have proven effective for a broad range of psychiatric illnesses, including several anxiety disorders, bulimia, and dysthymia. These drugs have in common important effects on the serotonergic (5-HT) neurotransmission system, which is involved in mediating a substantial number of important functions, including mood, aggression, sexual behavior, and pain. In addition, some of the new antidepressants, like venlafaxine/venlafaxine XR, also have effects on the noradrenergic neurotransmission system, which also appears important in mood and anxiety disorders. These new drugs, because of their specificity for the serotonin and norepinephrine reuptake proteins, lack most of the adverse side effects of tricyclic antidepressants and monoamine oxidase inhibitors. Consequently, in addition to being the usual first-line treatments for major depression, they are also first-line for panic disorder, obsessive-compulsive disorder, social phobia, posttraumatic stress disorder, and bulimia. They may also be the best medication treatments for dysthymia and generalized anxiety disorder. Further advances in psychopharmacology will be driven by discoveries from brain imaging and molecular biological research.
OCD
SSRIs
SNRIs
Serotonin
Dysthymia
Duloxetine
Mirtazapine
Binge-eating
Social phobia
Medifoxamine
Noradrenaline
SSRIs v venlafaxine
Anxiety and depression
SNaRIs, NaSSAs, and NaRIs
Venlafaxine and depression
Noradrenaline and dopamine
Duloxetine for pain-ridden depressives
Are 'broad spectrum' antidepressants best?
SSRIs compared with tricyclic antidepressants
Selective serotonin reuptake inhibitors (SSRIs): binding profiles