Efficacy of noradrenergic-selective agents
in the treatment of neuropsychiatric diseases

Kasper SF, Resinger E.
Department of General Psychiatry,
University of Vienna,
Vienna, Austria.
CNS Spectr. 2001 Aug;6(8):710-3


In recent years, a number of antidepressants with varying degrees of selectivity for the noradrenergic neurotransmitter system have become available. However, these agents represent a pharmacologically heterogeneous group and differ in terms of their precise side-effect profile and, possibly, their clinical efficacy. Bupropion, which is thought to act on both the dopamine and norepinephrine (NE) systems, has not been widely used as an antidepressant and has more recently been licensed as adjunctive therapy for smoking cessation. The serotonin-NE reuptake inhibitors venlafaxine and nefazodone, the noradrenergic and specific serotonergic antidepressant mirtazapine, and the selective NE reuptake inhibitor reboxetine (the only truly NE-selective agent available) have all demonstrated efficacy in the treatment of depressive disorders. Evidence is now emerging for their use in the treatment of anxiety and panic disorders. There is some suggestion of a role for noradrenergic agents in other disorders, including attention-deficit/hyperactivity disorder and social phobia. The full range of disorders for which noradrenergic agents can be used remains to be seen and further research in this area is necessary.
Biogenic amines
Noradrenaline and mood
Alpha2-receptor antagonism
The noradrenaline transporter
Cholinergic-adrenergic balance
Noradrenaline and dopamine co-release
The locus coeruleus-noradrenergic system
The catecholamine hypothesis of depression

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