Three Key Neurotransmitter Systems of Antidepressants

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Presentation transcript:

Three Key Neurotransmitter Systems of Antidepressants Norepinephrine Dopamine Serotonine

NOREPINEPHRINE RECEPTORS presynaptic alpha 2 autoreceptor postsynaptic alpha 2 receptor alpha 1 receptor postsynaptic beta 1 receptor 5-19 Stahl S M, Essential Psychopharmacology (2000)

presynaptic autorecptor DOPAMINE RECEPTORS presynaptic autorecptor dopamine transporter D2 D3 D1 D4 D5 5--33 Stahl S M, Essential Psychopharmacology (2000)

serotonin transporter SEROTONIN RECEPTORS 5HT1D autoreceptor alpha 2 hetero receptor serotonin transporter 5HT3 5HT4 5HT2C 5HTX 5HT2A 5HTY 5HT1A 5HTZ 5--36 Stahl S M, Essential Psychopharmacology (2000)

SSRI Pharmacological Profile Powerful 5HT disinhibition in key passways from midbrain raphe to prefrontal cortex from midbrain raphe to basal ganglia from midbrain raphe to limbic cortex and hippocampus from midbrain raphe to hypothalamus from midbrain raphe to spinal cord

Serotonin Pathways Raphe Nucleus 5--51 Stahl S M, Essential Psychopharmacology (2000)

Frontal Cortex Mood Stahl S M, Essential Psychopharmacology (2000) 5--52 Stahl S M, Essential Psychopharmacology (2000)

OCD Akathisia/ Agitation Basal Ganglia 5--53 Stahl S M, Essential Psychopharmacology (2000)

Limbic Anxiety 5--54 Stahl S M, Essential Psychopharmacology (2000)

Hypothalamus Appetite/bulimia 5--55 Stahl S M, Essential Psychopharmacology (2000)

Sleep Centers Insomnia 5--56 Stahl S M, Essential Psychopharmacology (2000)

serotonin transporter SEROTONIN RECEPTORS 5HT1D autoreceptor alpha 2 hetero receptor serotonin transporter 5HT3 5HT4 5HT2C 5HTX 5HT2A 5HTY 5HT1A 5HTZ 5--36 Stahl S M, Essential Psychopharmacology (2000)

NOREPINEPHRINE RECEPTORS presynaptic alpha 2 autoreceptor postsynaptic alpha 2 receptor alpha 1 receptor postsynaptic beta 1 receptor 5-19 Stahl S M, Essential Psychopharmacology (2000)

norepinephrine neuron serotonin neuron postsynaptic alpha 2 hetero receptor 5HT accelerator 5HT brake presynaptic alpha 2 autoreceptor alpha 1 receptor presynaptic alpha 2 autoreceptor norepinephrine neuron 5--48 Stahl S M, Essential Psychopharmacology (2000)

5HT1A antidepressant anxiolytic sleep restoring anxiolytic 5HT2A no sexual dysfunction 5HT2C anxiolytic weight gain 5HT3 no GI problems no nausea 7-11 Stahl S M, Essential Psychopharmacology (2000)

H1 TCA SRI M1 NRI 6-27 Stahl S M, Essential Psychopharmacology (2000)

5-HT1A Antidepressant Anxiolytic Lowering temperature

SRI inserted NRI inserted depression lifts NRI inserted depression lifts 6-28 6-29 Stahl S M, Essential Psychopharmacology (2000)

weight gain drowsiness H1 inserted blurred vision constipation LAXATIVE constipation dry mouth blurred vision drowsiness M1 inserted 6-30 6-31 Stahl S M, Essential Psychopharmacology (2000)

decreased blood pressure dizziness decreased blood pressure inserted 6-32 Stahl S M, Essential Psychopharmacology (2000)