Selective serotonin reuptake 5-Hydroxytryptamine

Beginning in the 1960s, ben2odia2epiae anxiolytics and hypnotics rapidly became the standard prescription dmg treatment. In the 1980s, buspkone [36505-84-7] (3), which acts as a partial agonist at the serotonin [50-67-9] (5-hydroxytryptamine, 5-HT) type lA receptor, was approved as treatment for generali2ed anxiety. More recently, selective serotonin reuptake inhibitors (SSRIs) have been approved for therapy of panic disorder and obsessive—compulsive behavior. 

FDA, Combined Use of 5-Hydroxytryptamine Receptor Agonists (Triptans), Selective Serotonin Reuptake Inhibitors (SSRIs) or Selective Serotonin/Norepinephrine Reuptake Inhibitors (SNRIs) May Result in Life-Threatening Serotonin Syndrome , FDA Public Health Advisory (2006) http //www.fda.gov/Cder/Drug/advisory/ S SRI S S200607.htm... 

A life-threatening condition, when selective serotonin reuptake inhibitors (SSRIs) and 5-hydroxytryptamine receptor agonists (triptans) are used together. However, many other drugs have been implicated (see below). Signs and symptoms of serotonin syndrome include the following ... 

List of Abbreviations Ach, acetylcholine AMPA, a-amino-3-hydroxy-5-methylisoxazole-4-propionic acid CNS, central nervous system COMT, catechol-O-methyltransferase DA, dopamine DRP-2, dihy-dropyrimidinase-related protein 2 DSM, diagnostic and statistical manual of mental disorders GNAS1, guanine nucleotide-binding protein (G-protein) alpha stimulating activity polypeptide 1 5-HIAA, 5-hydroxyindole acetic acid 5-FIT, serotonin (5-hydroxytryptamine) MAO, monoamine oxidase MHPG, 3-methoxy-4-hydroxyphenylglycol NE, norepinephrine NMDA, N-methyl-D-aspartate PCP, phencyclidine SSRI, selective serotonin reuptake inhibitor SDS, schedule for the deficit syndrome... 

CGRP calcitonin gene-related peptide GABA y-aminobutyric acid 5-HT serotonin, 5-hydroxytryptamine IHS International Headache Society MAOIs monoamine oxidase inhibitors NSAIDs nonsteroidal anti-inflammatory drugs SSRI selective serotonin reuptake inhibitor TCA tricyclic antidepressant... 

The majority of patients need medication for the two main symptoms. Drugs with CNS-stimulating effects, mostly of the amphetamine type, are used to alleviate excessive sleepiness and sleep attacks. The resulting increased level of vigilance also decreases or abolishes cataplexy in a number of patients. If this is not achieved, tricyclic antidepressants, in the hrst instance, and selective serotonin (5-hydroxytryptamine 5-HT) reuptake inhibitors, in the second instance, can be used to control cataplexy and other rapid-eye-movement sleep-related symptoms. 

Serotonin (5-hydroxytryptamine) is produced from tryptophan by the indoleamine pathway. Serotonin is important for a feeling of wellbeing, and a deficiency of brain serotonin is associated with depression. The selective serotonin reuptake inhibitors (SSRIs) are a successful class of antidepressive drugs that prolong the presence of serotonin in the synaptic cleft, thereby stimulating synaptic transmission in neurones that produce a sense of euphoria. 

Serotonin, also known as 5-hydroxytryptamine (5-HT) is biosynthesized from tryptophan and is a neurotransmitter. Serotonin plays an important role in many behaviors including sleep, appetite, memory, and mood [52]. People with depressive disorders exhibit low levels of serotonin in the synapses. Protonated serotonin binds to a serotonin reuptake transporter protein, sometimes referred to as the serotonin transporter (SERT) and is then moved to an inward position on the neuron and subsequently released into the cjdoplasm. Selective serotonin reuptake inhibitors (SSRI) bind with high affinity to the serotonin binding site of the transporter. This leads to antidepressant effects by increasing extracellular serotonin levels which in turn enhances serotonin neurotransmission [53]. The SSRI class of antidepressants has fewer side effects than the monoamine oxidase inhibitors. 

Most antidepressants in clinical use today act by enhancing the neurotransmission of serotonin [5-hydroxytryptamine (5-HT)], norepinephrine [NE noradrenaline (NA)], or both. They do so either by blocking the reuptake (transport) of neurotransmitter, blocking the metabolism of neurotransmitter [i.e., monoamine oxidase (MAO) inhibitors], or by direct action on a neurotransmitter receptor. Hence, the antidepressants can be classified on the basis of their putative mechanisms of action (Table 8.2 and Figs. 8.1-8.4). Agents that block neurotransmitter reuptake can be further divided into those that are non-selective (e.g., tricyclic antidepressants with mixed action), serotonin-selective reuptake... 

In recent years, potential new antidepressants have been developed that inhibit serotonin (5-hydroxytryptamine 5-HT) and noradrenaline (norepinephrine) reuptake in a selective manner. Examples of these SNRIs are duloxetine, milnacipran, and venlafaxine. Controlled studies in depressed patients have shown an efficacy superior or comparable to tricyclic antidepressants (see Tables 5 through 7 and Figure 86). 

Serotonin has an effect on the hypothalamic control of pituitary function (see chapter 5), in central thermoregulation (attributed to the 5-HTj receptor), and in pain perception (probably the S-HTj receptor), where increased serotonergic function potentiates opiate analgesia. The administration of 5-HT reuptake inhibitors like fluoxetine increases the anorectic effect of 5-hydroxytryptamine and induces a selective suppression of nonprotein caloric intake in rats. The involvement of serotonin in endogenous psychiatric depression has been mentioned. 

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