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Image BankDepression

The mechanism of action of selective serotonin and noradrenaline re-uptake inhibitors (SNRIs)

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The mechanism of action of selective serotonin and noradrenaline re-uptake inhibitors (SNRIs)

Depression is associated with reduced levels of the monoamines in the brain, such as 5-HT. The selective 5-HT and noradrenaline re-uptake inhibitors (SNRIs) are thought to restore the levels of 5-HT and noradrenaline in the synaptic cleft by binding at their re-uptake transporters preventing the re-uptake and subsequent degradation of 5-HT and noradrenaline. This re-uptake blockade leads to the accumulation of monoamines in the synaptic cleft and the concentration returns to within the normal range. Selective 5-HT and noradrenaline re-uptake inhibitors have demonstrated clinical efficacy in the treatment of depression In the presence of the SNRIs, small amounts of 5-HT and noradrenaline continue to be degraded in the synaptic cleft.

References

  1. Drugs used in affective disorders. In: Pharmacology, 4th edition. Rang HP, Dale MM, Ritter JM and Gardner P. Edinburgh, UK: Harcourt Publishers Ltd, 2001:550–565

  2. Modern bioanalytical methods for the rapid detection of antidepressants: SNRIs and SSRIs in human biological samples. Samanidou V, Kourti P. Bioanalysis. 2009 May;1(2):451-88

  3. Comparative affinity of duloxetine and venlafaxine for serotonin and norepinephrine transporters in vitro and in vivo, human serotonin receptor subtypes, and other neuronal receptors. Bymaster FP, Dreshfield-Ahmad LJ, Threlkeld PG et al. Neuropsychopharmacology. 2001 Dec; 25(6):871-80

  4. Selective serotonin reuptake inhibitors pathway. Sangkuhl K, Klein TE, Altman RB. Pharmacogenet Genomics. 2009 Nov;19(11):907-9

  5. Other peripheral mediators: 5-hydroxytryptamine and purines. In: Pharmacology, 4th edition. Rang HP, Dale MM and Ritter JM. Edinburgh, UK: Harcourt Publishers Ltd, 2001:165–176.

  6. Noradrenergic transmission. In: Pharmacology, 4th edition. Rang HP, Dale MM and Ritter JM. Edinburgh, UK: Harcourt Publishers Ltd, 2001:139–163.

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