SSNRI

DUAL SELECTIVE SEROTONIN AND NOREPINEPHRINE REUPTAKE INHIBITORS (SSNRIs)... 

Regarding side-effect profiles, all three SSNRIs are generally well tolerated, most adverse events occurring early in treatment, with a mild to moderate severity and a tendency to decrease or disappear with continued treatment. Venlafaxine (1) seems to be the least weU-toIerated SNRI, combining a higher level of serotonergic adverse events (nausea, sexual dysfunction, withdrawal problems) with dose-dependent hypertension. In contrast, milnacipran (2) and duloxetine (3) appear better tolerated and essentially devoid of cardiovascular toxicity. 

The first major groups of antidepressant medications are the tricyclics, also known as the TCAs. Discovered in the late 1950s, these drugs are considered the oldest in the treatment of depression and have historically been used as the first line of medication intervention for the treatment of unipolar depression (Austrian, 1995). The side-effect profile that accompanies this group of medications, however, has recently caused them to fall into disfavor. For years, these medications were often considered the first choice for the client who suffers from depressed mood. Today, however, the antidepressant medications known as the selective serotonin inhibitors (SSRIs), and the selective serotonin norepinephrine inhibitors (SSNRIs) are often considered as the first-line medications. 

The last 30 years have seen tremendous progress in the treatment of depression beginning with the discovery of the neurochemicals norepinephrine, serotonin and dopamine, and the medications that utilize them (tricyclics, MAOs and later the SSRIs and the SSNRIs). No one, however, could have predicted the changes and treatment gains over the last 10 years. The phenomenal advances made possible by the discovery of the SSRIs and SSNRIs have revolutionized traditional treatments for the depressed client (Moller, 2(XX)). This new emphasis on mental health treatment is directly linked to pharmacological strides that make the knowledge of medications a practice necessity. 

Mirtazapine (brand name Remeron) An antidepressant that functions as an SSNRI used for the treatment of depression. 

Nefazodone hydrochloride (brand name Serzone) An antidepressant that functions as an SSNRI used in the treatment of severe depression. Some side effects include blurred or abnormal vision, dry mouth, nausea, and weakness. This medication may be considered the drag of choice for those with depression who also have a lack of sexual interest and difficulty with performance. 

Selective serotonin norepinephrine reuptake inhibitors (SSNRIs) The newest group of medicines that have successfully been used to treat emotional and behavioral problems such as depression, panic disorder, obsessive-compulsive disorder (OCD), similar to their counterparts, the SSRIs. Some examples of the SSNRIs include Effexor, Serzone, and Remeron. 

Thiophene seems to be very popular in Li Lilly drugs. Its dual selective serotonin and norepinephrine reuptake inhibitor (SSNRI) for depression, duloxetine (Cymbalta), contains a thiophene. And its atypical antipsychotic drug olanzapine (Zyprexa) has a fused thiophene as its core structure. 

In 2004,17 years after the introduction of Prozac , duloxetine hydrochloride (Cymbalta , Lilly) was approved in the U.S. Duloxetine has a chiral carbon and is the S enantiomer. Duloxetine is a dual reuptake inhibitor of serotonin and norepinephrine (SSNRI). It is effective against depression and... 

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