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
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