Selective serotonin reuptake inhibitors Blister pack of Prozac (fluoxetine), a selective serotonin reuptake inhibitor Selective serotonin reuptake inhibitors (SSRIs) are believed to increase the extracellular level of the neurotransmitter serotonin by limiting its reabsorption into the presynaptic cell, increasing the level of serotonin in the synaptic cleft available to bind to the postsynaptic receptor. They have varying degrees of selectivity for the other monoamine transporters, with pure SSRIs having only weak affinity for the norepinephrine and dopamine transporters. SSRIs are the most widely prescribed<unk> s in many countries. The efficacy of SSRIs in mild or moderate cases of depression has been disputed. Serotonin–norepinephrine reuptake inhibitors The chemical structure of venlafaxine (Effexor), an SNRI Serotonin–norepinephrine reuptake inhibitors (SNRIs) are potent inhibitors of the reuptake of serotonin and norepinephrine. These neurotransmitters are known to play an important role in mood. SNRIs can be contrasted with the more widely used selective serotonin reuptake inhibitors (SSRIs), which act mostly upon serotonin alone. The human serotonin transporter (SERT) and norepinephrine transporter (NET) are membrane proteins that are responsible for the reuptake of serotonin and norepinephrine. Balanced dual inhibition of monoamine reuptake can possibly offer<unk> vantages over other<unk> s drugs by treating a wider range of symptoms. SNRIs are sometimes also used to treat anxiety disorders, obsessive–compulsive disorder (OCD), attention deficit hyperactivity disorder <unk> HD), chronic neuropathic pain, and fibromyalgia syndrome (FMS), and for the relief of menopausal symptoms. Serotonin modulators and stimulators Serotonin modulator and stimulators (SMSs), sometimes referred to more simply as "serotonin modulators", are a type of drug with a multimodal action specific to the serotonin neurotransmitter system. To be precise, SMSs simultaneously modulate one or more serotonin receptors and inhibit the reuptake of serotonin. The term was coined in reference to the mechanism of action of the serotonergic<unk>  vortioxetine, which acts as a serotonin reuptake inhibitor (SRI), partial agonist of the 5-HT1A receptor, and antagonist of the 5-HT3 and 5-HT7 receptors. However, it can also technically be applied to vilazodone, which is an<unk>  as well and acts as an SRI and 5-HT1A receptor partial agonist. An alternative term is serotonin partial agonist/reuptake inhibitor (SPARI), which can be applied only to vilazodone. Serotonin antagonists and reuptake inhibitors Serotonin antagonist and reuptake inhibitors (SARIs) while mainly used as<unk> s, are also anxiolytics and hypnotics. They act by antagonizing serotonin receptors such as 5-HT2A and inhibiting the reuptake of serotonin, norepinephrine, and/or dopamine.<unk> ditionally, most also act as α1-adrenergic receptor antagonists. The majority of the currently marketed SARIs belong to the phenylpiperazine class of compounds. They include trazodone and nefazodone. Norepinephrine reuptake inhibitors Norepinephrine reuptake inhibitors (NRIs or NERIs) are a type of drug that acts as a reuptake inhibitor for the neurotransmitter norepinephrine (noradrenaline) by blocking the action of the norepinephrine transporter (NET). This in turn leads to increased extracellular concentrations of norepinephrine. NRIs are commonly used in the treatment of conditions like<unk> HD and narcolepsy due to their psychostimulant effects and in obesity due to their appetite suppressant effects. They are also frequently used as<unk> s for the treatment of major depressive disorder, anxiety and panic disorder.<unk> ditionally, many drugs of abuse such as cocaine and methylphenidate possess NRI activity, though it is important to mention that NRIs without combined dopamine reuptake inhibitor (DRI) properties are not significantly rewarding and hence are considered to have a negligible abuse potential. However, norepinephrine has been implicated as acting synergistically with dopamine when actions on the two neurotransmitters are combined (e.g., in the case of NDRIs) to produce rewarding effects in psychostimulant drugs of abuse. Norepinephrine-dopamine reuptake inhibitors The only drug used of this class for depression is bupropion. Tricyclic<unk> s The majority of the tricyclic<unk> s (TCAs) act primarily as serotonin–norepinephrine reuptake inhibitors (SNRIs) by blocking the serotonin transporter (SERT) and the norepinephrine transporter (NET), respectively, which results in an elevation of the synaptic concentrations of these neurotransmitters, and therefore an enhancement of neurotransmission. Notably, with the sole exception of amineptine, the TCAs have weak affinity for the dopamine transporter (DAT), and therefore have low efficacy as dopamine reuptake inhibitors (DRIs). Although TCAs are sometimes prescribed for depressive disorders, they have been largely replaced in clinical use in most parts of the world by newer<unk> s such as selective serotonin reuptake inhibitors (SSRIs), serotonin–norepinephrine reuptake inhibitors (SNRIs) and norepinephrine reuptake inhibitors (NRIs).<unk> verse effects have been found to be of a similar level between TCAs and SSRIs. Tetracyclic<unk> s Tetracyclic<unk> s (TeCAs) are a class of<unk> s that were first introduced in the 1970s. They are named after their chemical structure, which contains four rings of atoms, and are closely related to the tricyclic<unk> s (TCAs), which contain three rings of atoms. Monoamine oxidase inhibitors Monoamine oxidase inhibitors (MAOIs) are chemicals which inhibit the activity of the monoamine oxidase enzyme family. They have a long history of use as medications prescribed for the treatment of depression. They are particularly effective in treating atypical depression. They are also used in the treatment of Parkinson's disease and several other disorders. Because of potentially lethal dietary and drug interactions, monoamine oxidase inhibitors have historically been reserved as a last line of treatment, used only when other classes of<unk>  drugs (for example selective serotonin reuptake inhibitors and tricyclic<unk> s) have failed. MAOIs have been found to be effective in the treatment of panic disorder with agoraphobia, social phobia, atypical depression or mixed anxiety and depression, bulimia, and post-traumatic stress disorder, as well as borderline personality disorder. MAOIs appear to be particularly effective in the management of bipolar depression according to a retrospective-analysis. There are reports of MAOI efficacy in obsessive–compulsive disorder (OCD), trichotillomania, dysmorphophobia, and avoidant personality disorder, but these reports are from uncontrolled case reports. MAOIs can also be used in the treatment of Parkinson's disease by targeting MAO-B in particular (therefore affecting dopaminergic neurons), as well as providing an alternative for migraine prophylaxis. Inhibition of both MAO-A and MAO-B is used in the treatment of clinical depression and anxiety disorders. NMDA receptor antagonists NMDA receptor antagonists like ketamine and esketamine are rapid-acting<unk> s and seem to work via blockade of the ionotropic glutamate NMDA receptor. Others See the list of<unk> s and management of depression for other drugs that are not specifically characterized.
Antidepressant
Antipsychotic
Appetite stimulant
Mood stabilizer
Tetracyclic antidepressant
Tricyclic antidepressant
Atypical antidepressant
Antimanic drugs