The new antidepressants - Mechanisms of action

Abstract

Citalopram, fluvoxamine, nefazodone and venlafaxine have recently been introduced into Australian clinical practice. The first two drugs are selective serotonin reuptake inhibitors, while the others have different acute pharmacological effects. The role of somatodendritic 5HT(1A) autoreceptors in the therapeutic effect of the SSRIs is important. For venlafaxine and nefazodone, downregulation of the postsynaptic β1 adrenoceptor and 5HT receptor appears to be important. The adverse effects of these new medications can be understood in terms of their effects on central and peripheral serotonergic and adrenergic receptors. A mechanism of action common to all antidepressants is yet to be identifi..