Do noradrenergic reuptake inhibitors
affect serotonergic function in depression?

by
Cleare AJ, Murray RM, O'Keane V
Department of Psychological Medicine,
Institute of Psychiatry,
London, UK.
Psychopharmacology (Berl) 1997 Dec; 134(4):406-10


ABSTRACT

d-Fenfluramine, a specific 5-HT releasing agent without the catecholamine effects of d,l-fenfluramine, was used as a serotonergic neuroendocrine challenge in subjects with unipolar major depression. Prolactin and cortisol responses to 30 mg d-fenfluramine were measured in patients at baseline. Patients were then randomly assigned to treatment for 6 weeks with a specific noradrenergic reuptake inhibitor, a tricyclic antidepressant, or placebo. Response to antidepressant treatment was assessed, and patients underwent further testing with d-fenfluramine. Prolactin responses were increased by treatment, but this was independent of whether or not patients' depression responded to treatment. Seven patients were treated with a specific noradrenergic reuptake inhibitor. These patients showed a significant rise in 5-HT-mediated cortisol responses after treatment, independent of whether their depression improved. We conclude that antidepressants which selectively modify noradrenergic function also have effects on 5-HT function as measured by neuroendocrine testing.
SSRIs
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Options
Serotonin
Tryptophan
Reboxetine
Nefazodone
Mirtazapine
Venlafaxine
Fenfluramine
New antidepresants
Noradrenaline and serotonin
Noradrenergic plus serotonergic antidepressants

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