Link to [[:wikitox:problems_for_discussion_1_psychiatric_drugs|Problems for Discussion]]

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====== Other antidepressants ======

===== NEWER ANTIDEPRESSANT AGENTS =====

After the introduction of the Serotonin Reuptake Inhibitors (SRIs), newer agents with a wider spectrum of action were developed in an attempt to match the efficacy of the Tricyclic Antidepressants and Monoamine Oxidase Inhibitors but with a better side effect and safety profile. As these drugs are relatively new it is not yet clear that these goals have been achieved.

**Venlafaxine** and **nefazodone** are serotonin noradrenergic reuptake inhibitors (SNaRIs), **Mirtazapine** is a noradrenergic and specific serotonergic antidepressant (NaSSA) and **Reboxetine** is a noradrenaline reuptake inhibitor (NaRI).

At low doses, where serotonin reuptake inhibition predominates **venlafaxine** is very similar in action to the SRIs; at higher doses, noradrenaline reuptake inhibition also occurs.

**Nefazodone** inhibits the 5-HT2 receptor and this is thought to increase the binding of serotonin to the 5-HT1A receptor. Additionally, **nefazodone** causes weak inhibition of noradrenaline and serotonin reuptake.

**Mirtazapine** inhibits α2-adreoreceptors, 5-HT2 and 5-HT3 receptors. These results in increased noradrenaline and serotonin release; the later having its main affect on 5-HT1A-mediated neurotransmission.

**Reboxetine** it is a selective inhibitor of noradrenaline reuptake and has no serotonin effects.

This group includes:

  * [[:wikitox:2.1.11.9.2.4.1_bupropion|2.1.11.9.2.4.1 Bupropion]]
  * [[:wikitox:2.1.11.9.2.4.2_mirtazapine|2.1.11.9.2.4.2 Mirtazapine]]
  * [[:wikitox:2.1.11.9.2.4.3_mianserin|2.1.11.9.2.4.3 Mianserin]]
  * [[:wikitox:2.1.11.9.2.4.4_venlafaxine|2.1.11.9.2.4.4 Venlafaxine]]