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major depressive disorder p. 584
mechanism p. 598
nicotine withdrawal p. 595
seizures with p. 252
bupropion effect p. 600
bupropion toxicity p. 600
bupropion effect on p. 600
bupropion p. 600
bupropion for cessation p. 600
Atypical antidepressants are mainly used to treat major depressive disorder. This disorder causes a persistent feeling of sadness and loss of interest in everyday activities. Even though the exact cause of depression is still unknown, there's some evidence that suggests it’s related to low levels of neurotransmitters like serotonin, norepinephrine, and dopamine. Typical antidepressants like selective serotonin reuptake inhibitors or tricyclic antidepressants work by increasing the levels of serotonin and norepinephrine, while atypical antidepressants often have multiple mechanisms of action.
All right, now within the brain, there are many different types of neurons, but we’re going to focus only on three: serotonergic neurons, which produce serotonin; noradrenergic neurons, which produce norepinephrine; and dopaminergic neurons, which produce dopamine. Each of these neurons synthesizes and stores their neurotransmitters in small vesicles. So, when an action potential reaches the presynaptic membrane, these vesicles fuse with the membrane, releasing neurotransmitters into the synaptic cleft. Once released, serotonin (or 5-HT) binds to 5-HT2 receptors on the postsynaptic membrane, thereby increasing neural stimulation, and regulating mood, feeding, and reproductive behavior. On the other hand, norepinephrine binds to norepinephrine receptors on the postsynaptic membrane, boosting alertness. And finally, dopamine binds to dopamine receptors, thereby stimulating cognitive functions, motivation, and awakeness.
Atypical antidepressants are a class of antidepressant drugs that are distinguished from traditional, older antidepressant medications by their unique mechanism of action. They are generally reserved for cases that do not respond to other antidepressants. The atypical antidepressants include drugs like agomelatine, mirtazapine, and bupropion.
Atypical antidepressants are generally better tolerated than older drugs, and they are often just as effective. They are not without their side effects, however. The most common side effects of atypical antidepressants include nausea, headaches, anxiety, insomnia, and sexual dysfunction.
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