AssessmentsSerotonin and norepinephrine reuptake inhibitors
Serotonin and norepinephrine reuptake inhibitors
The preferred pharmacologic management of panic disorder consists of benzodiazepines for acute management and (medication class) or venlafaxine for long-term options.
Content Reviewers:Yifan Xiao, MD
This disorder causes a persistent feeling of sadness and loss of interest in everyday activities.
Alright, now within the brain, there are many different types of neurons, but we’re going to focus only on two: serotonergic neurons which produce serotonin, and noradrenergic neurons which produces norepinephrine.
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 in 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.
As long as there’s a high enough concentration of neurotransmitters in the synaptic cleft, the postsynaptic neurons will continue to fire.
These membrane proteins transport the serotonin and norepinephrine in the synaptic cleft back into presynaptic neurons.
This leads to decreased neurotransmitter concentration within the synaptic cleft, causing the postsynaptic neurons to stop firing.
Other conditions that can be treated with SNRIs include anxiety and neuropathic pain like peripheral neuropathy.
For medication specific indications, duloxetine can be used to treat urinary incontinence, which is an uncontrollable leakage of urine; and fibromyalgia, which is a condition characterized by chronic muscle pain, fatigue, and sleep problems.
Lastly, venlafaxine can treat postmenopausal hot flashes, which are sudden feelings of heat, usually most intense over the face, neck, and chest.
The most dangerous, however, are suicidal ideations, especially in individuals under 25, and serotonin syndrome, which is a life-threatening condition caused by serotonin accumulation and over stimulation of the nervous system.
This syndrome is characterized by skin flushing, hyperthermia, agitation, muscle rigidity, seizure, and coma.
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