Serotonin antagonist reuptake inhibitor

Serotonin antagonist reuptake inhibitor Nefazodone (Serzone)... 

As of yet, the pharmacological actions of Serzone and Desyrel are not completely understood. Like SSRIs they inhibit serotonin uptake. There is also evidence that they antagonize 5-HT2 serotonin receptors. Because of these two functions, Serzone and Desyrel are often referred to as SARIs (serotonin antagonists/reuptake inhibitors). Serzone also inhibits norepinephrine reuptake while Desyrel slightly stimulates alpha-adrenergic receptors. These small differences in pharmacological action can cause widely varying side effects, which will be discussed later on. 

FIGURE 9—2. Various treatments can be given in combination for obsessive-compulsive disorder (OCD) (i.e., OCD combos). The basis of all combination treatments is a serotonin selective reuptake inhibitor (SSRI) or clomipramine. Added to this basis may be a serotonin 1A partial agonist, a serotonin 2A antagonist, lithium, a benzodiazepine or a sedative-hypnotic, a conventional antipsychotic or an atypical antipsychotic, or behavioral psychotherapy. 

SARI (serotonin 2 antagonist/reuptake inhibitor) antidepressant... 

Opioids, benzodiazepines, barbiturates, corticosteroids, dopamine agonists (e.g., amantadine, bromocriptine, levodopa, pergolide, pramipexole, ropinirole), H2-receptor antagonists, anticholinergics (e.g., diphenhydramine, trihexylphenidyl), P-adrenergic blockers, clonidine, methyldopa, carbamazepine, phenytoin, baclofen, cyclobenzaprine, lithium, antidepressants (e.g., tricyclic antidepressants, selective serotonin reuptake inhibitors), and interleukin-2... 

MAOI, monoamine oxidase inhibitor SARI, serotonin antagonist and reuptake inhibitor SNRI, serotonin and norepinephrine reuptake inhibitor SSRI, selective serotonin reuptake inhibitor TCA, tricyclic antidepressant. 

Listing of antidepressants grouped by principal mechanism of action in the synapse. Abbreviations MAOI—irreversible = irreversible monoamine oxidase inhibitor MAOI—reversible = reversible monoamine oxidase inhibitor NDRl = norepinephrine/ dopamine reuptake inhibitor NRI = norepinephrine reuptake inhibitor NSRl = norepinephrine/serotonin reuptake inhibitor NSSA = norepinephrine/specific serotonin agonist SRI = serotonin reuptake inhibitor SRl/serotonin-2 blocker = serotonin reuptake inhibitor and serotonin-2 receptor antagonist. 

As we move forward with our discussion, we ll devote a section of this chapter to each of the key neurotransmitter systems that psychotropic medications interact with. We will discuss the following systems norepinephrine, dopamine, serotonin, GABA, acetylcholine, and histamine. Within each of the sections is a description of the effects that can be anticipated when a medication enhances the activity of that transmitter (reuptake inhibitors or agonists), and the effects to expect when a medication interferes (receptor antagonists) with the activity of that same transmitter. We will then describe strategies that can be implemented to help minimize and/or manage these side effects. 

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