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The Antidepressant Effects of 5-HT Uptake Inhibitors

Published online by Cambridge University Press:  06 August 2018

Anna Åberg-Wistedt
Anna Åberg-Wistedt*
Affiliation:
Norrtälje Sector, Unit of Psychiatry, Danderyd Hospital, Stockholm
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Extract

The functional roles of monaminergic transmitters in depression have been widely studied during the past decade. Data from that research suggest that lower levels of the 5-HT metabolite, 5-HIAA, in the cerebrospinal fluid; 5-HT uptake in human platelets; and platelets [3H]-imipramine binding sites occur in depressed patients. In recent years several potent and selective 5-HT uptake inhibitors have become available for clinical studies. The first shown to have antidepressant effects, zimelidine, was followed by similar compounds such as femoxetine, fluvoxamine, Citalopram, indalpine, fluoxetine, paroxetine, and sertraline. The effectiveness of serotonin inhibitors in treating other disorders, such as obsessive–compulsive disorder, anxiety, and panic disorder, has also been demonstrated. This review reports the data from clinical studies with these agents. The 5-HT uptake inhibitors are devoid of anticholinergic properties and have not produced weight gain or sedative side-effects, but may have another profile of side-effects. Headache, nausea, and vomiting have been reported, however.

Type
Research Article
Information
The British Journal of Psychiatry , Volume 155 , Issue S8: SEROTONIN IN BEHAVIOURAL DISORDERS , December 1989 , pp. 32 - 40
Copyright
Copyright © Royal College of Psychiatrists, 1989 

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References

Åberg-Wistedt, A. (1982a) Comparison between zimelidine and desipramine in endogenous depression: a cross-over study. Acta Psychiatrica Scandinavica, 66, 129–138.CrossRefGoogle ScholarPubMed
Åberg-Wistedt, A. (1982b) A double-blind study of zimelidine, a serotonin uptake inhibitor, and desipramine, a noradrenaline uptake inhibitor, in endogenous depression. I: Clinical findings. Acta Psychiatrica Scandinavica, 66, 50–65.CrossRefGoogle ScholarPubMed
Ågren, H. (1981) Biological markers in major depressive disorders: a clinical and multivariate study. Acta Universitatis Upsaliensis, 405, 1–56.Google Scholar
Ahlberg, B., Palm, O. & Le Fevre Honoré, P. (1982) Femoxetine in the treatment of patients with depressive illness — A randomized comparison with amitriptyline. Nord. Psykiatr. Tidskr., 329–333.CrossRefGoogle Scholar
Amin, M. N., Ananth, J. V., Coleman, B. S., et al. (1984) Fluvoxamine: antidepressant effects confirmed in a placebo-controlled international study. In The Role of Serotonergic Systems in Suicide and Mood Disorders: Emphasis on Work With Fluvoxamine (ed Papwort, S. J.). New York: Raven Press.Google Scholar
Åsberg, M., Thorén, P., Träskman, L., et al (1976) ‘Serotonin depression’ — a biochemical subgroup within the affective disorders? Science, 191, 478–480.CrossRefGoogle ScholarPubMed
Banki, C. M. (1977) Correlation of anxiety and related symptoms with cerebrospinal fluid 5-hydroxyindoleacetic acid in depressed women. Journal of Neural Transmission, 41, 135–137.CrossRefGoogle ScholarPubMed
Bjerkenstedt, L., Flyckt, L., Over⊘, K. F., et al (1985) Relationship between clinical effects, serum drug concentration and serotonin uptake inhibition in depressed patients treated with Citalopram: a double-blind comparison of three dose levels. European Journal of Clinical Pharmacology, 28, 553–557.CrossRefGoogle ScholarPubMed
Björk, K. (1983) The efficacy of zimelidine in preventing depressive episodes in recurrent major depressive disorders — a double-blind placebo-controlled study. Acta Psychiatrica Scandinavica, 68 (Suppl. 308), 182–189.CrossRefGoogle Scholar
Bremner, J. D. (1984) Fluoxetine in depressed patients: a comparison with imipramine. Journal of Clinical Psychiatry, 45, 414–419.Google ScholarPubMed
Chouinard, G. (1985) A double-blind controlled clinical trial of fluoxetine and amitriptyline in the treatment of outpatients with major depressive disorder. Journal of Clinical Psychiatry, 46, 32–37.Google ScholarPubMed
Chouinard, G. & Jones, B. (1984) No crossover of hypersensitivity between zimelidine and fluoxetine. Canadian Medical Association Journal, 131, 1190.Google ScholarPubMed
Claghorn, J., Gershon, S., Goldstein, B. J., et al (1983) A double-blind evaluation of zimelidine in a comparison to placebo and amitriptyline in patients with major depressive disorder. Progress in Neuro-Psychopharmacology and Biological Psychiatry, 7, 367–382.CrossRefGoogle Scholar
Cohn, J. B. & Wilcox, C. (1985) A comparison of fluoxetine, imipramine, and placebo in patients with major depressive disorder. Journal of Clinical Psychiatry, 46, 26–31.Google ScholarPubMed
Cooper, G. L. (1988) The safety of fluoxetine — An update. British Journal of Psychiatry, 153 (Suppl. 3), 77–86.CrossRefGoogle Scholar
Coppen, A. (1967) The biochemistry of affective disorders. British Journal of Psychiatry, 131, 1237–1264.CrossRefGoogle Scholar
Coppen, A., Swade, C. & Wood, K. (1978) Platelet 5-hydroxytryptamine accumulation in depressive illness. Clinica Chimica Acta, 87, 165–168.CrossRefGoogle ScholarPubMed
Coppen, A., Rama Rao, V. A., Swade, C. & Wood, K. (1979) Zimelidine: a therapeutic and pharmacokinetic study in depression. Psychopharmacologia 63, 199–202.CrossRefGoogle ScholarPubMed
Cronholm, B., Åsberg, M., Montgomery, S., et al (1977) Suicidal behaviour syndrome with low CSF 5-HIAA. British Medical Journal, 60, 776.CrossRefGoogle Scholar
de Wilde, J. E., Mertens, C. & Wakelin, J. S. (1983) Clinical trials of fluvoxamine vs chlorimipramine with single and three times daily dosing. British Journal of Clinical Pharmacology, 15, 427S–431S.CrossRefGoogle ScholarPubMed
Dick, P. & Ferrero, E. (1983) A double-blind comparative study of the clinical efficacy of fluvoxamine and chlorimipramine. British Journal of Clinical Pharmacology, 15, 419S–425S.CrossRefGoogle ScholarPubMed
Dominguez, R. A., Golstein, B. J., Jacobson, A. F., et al (1985) A double-blind placebo-controlled study of fluvoxamine and imipramine in depression. Journal of Clinical Psychiatry, 46, 84–87.Google ScholarPubMed
Doogan, D. P. & Caillard, V. (1988) Sertraline: a new antidepressant. Journal of Clinical Psychiatry, 49 (Suppl.), 46–51.Google ScholarPubMed
Emrich, H. M., Berger, M., Riemann, D., et al (1987) Serotonin reuptake inhibition vs. norepinephrine reuptake inhibition: a double-blind differential-therapeutic study with fluvoxamine and oxaprotiline in endogenous and neurotic depressives. Pharmacopsychiatria, 20, 60–63.CrossRefGoogle ScholarPubMed
Evans, L., Kenardy, J., Schneider, P., et al (1986) Effect of a selective serotonin uptake inhibitor in agoraphobia with panic attacks: a double-blind comparison of zimelidine, imipramine and placebo. Acta Psychiatrica Scandinavica, 73, 49–53.CrossRefGoogle ScholarPubMed
Escobar, J. (1980) Controlled clinical trial with trazodone, a novel antidepressant. A South American experience. Journal of Clinical Pharmacology, 20, 124–130.CrossRefGoogle ScholarPubMed
Fabre, L. F. & Crismon, L. (1985) Efficacy of fluoxetine in outpatients with major depression. Current Therapeutic Research, 37, 115–123.Google Scholar
Feighner, J. P. (1980) Traxodone a triazolopyridine derivative, in primary depressive disorder. Journal of Clinical Psychiatry, 41, 250–255.Google ScholarPubMed
Feldman, H. S. & Denber, H. C. B. (1982) Long-term study of fluvoxamine: a new rapid-acting antidepressant. International Pharmacopsychiatry, 17, 114–122.CrossRefGoogle Scholar
Fieve, R. R., Goodnick, P. J., Peselow, E. D., et al (1986) Pattern analysis of antidepressant response to fluoxetine. Journal of Clinical Psychiatry, 11, 560–562.Google Scholar
Fontaine, R. & Chouinard, G. (1986) An open clinical trial of fluoxetine in the treatment of obsessive—compulsive disorder. Journal of Clinical Psychopharmacology, 6, 98–101.CrossRefGoogle ScholarPubMed
Glowinski, J. & Axelrod, J. (1964) Inhibition of uptake of tritiated noradrenaline in the intact rat brain by imipramine and related compounds. Nature (London), 204, 1318–1319.CrossRefGoogle ScholarPubMed
Gram, L. F., et al (1986) Citalopram: Clinical effect profile in comparison with clomipramine. A controlled study. Psychopharmacology, 90, 131–138.CrossRefGoogle Scholar
Gravem, A., Amthor, K. F., Astrup, C., et al (1987) A double-blind comparison of Citalopram (Lu 10-171) and amitriptyline in depressed patients. Acta Psychiatrica Scandinavica, 75, 478–486.CrossRefGoogle ScholarPubMed
Guelfi, J. D., Dreyfus, J. F. & Pichot, P. (1983) The G.E.P.E.C.E.P.: a double-blind controlled clinical trial comparing fluvoxamine with imipramine. British Journal of Clinical Pharmacology, 15, 411S–417S.CrossRefGoogle ScholarPubMed
Guy, W., Wilson, W. H., Ban, T. A. et al (1984) A double-blind clinical trial of fluvoxamine and imipramine in patients with primary depression. Drug Development Research, 4, 143–148.CrossRefGoogle Scholar
Heym, J. & Koe, B. K. (1988) Pharmacology of sertraline: a review. Journal of Clinical Psychiatry, 49 (Suppl.), 40–45.Google ScholarPubMed
Hiramatsu, K.-I., Takahashi, R., Mori, A., et al (1983) A multicentre double-blind comparative trial of zimelidine and imipramine in primary major depressive disorders. Acta Psychiatrica Scandinavica, 68 (Suppl. 308), 41–54.CrossRefGoogle Scholar
Holsboer, F., von Bardeleben, U., Gerken, A. et al (1986) Antidepressant efficacy of fluoxetine in a diagnostically homogeneous in-patient population. British Journal of Clinical Practice, 40 (Suppl. 47), 8–16.Google Scholar
Huitfeldt, B. & Montgomery, S. A. (1983) Comparison between zimelidine and amitriptyline of efficacy and adverse symptoms: A combined analysis of four British clinical trials in depression. Acta Psychiatrica Scandinavica, 68 (Suppl. 308), 55–69.CrossRefGoogle Scholar
Itil, T. M., Shrivastava, R. K., Mukherjee, S., et al (1983) A double-blind placebo-controlled study of fluvoxamine and imipramine in out-patients with primary depression. British Journal of Clinical Pharmacology, 15, 433S–438S.CrossRefGoogle ScholarPubMed
Kellams, J. J., Klapper, M. H., & Small, J. G. (1979) Trazodone, a new antidepressant: efficacy and safety in endogenous depression. Journal of Clinical Psychiatry, 40 (Suppl. 9), 390–395.Google ScholarPubMed
Klok, C. J., Brouwer, G. J., van Praag, H. M. et al (1981) Fluvoxamine and clomipramine in depressed patients: a double-blind clinical study. Acta Psychiatrica Scandinavica, 64, 1–11.CrossRefGoogle ScholarPubMed
Koczkas, S., Holmberg, G. & Wedin, L. (1981) A pilot study of the effect of the 5-HT-uptake inhibitor, zimelidine, on phobic anxiety. Acta Psychiatrica Scandinavica, 63 (Suppl. 290), 328–341.CrossRefGoogle Scholar
Korpi, E. R., Kleinman, J. E., Goodman, S. I., et al (1986) Serotonin and 5-hydroxyindoleacetic acid in brains of suicide victims: comparison in chronic schizophrenic patients with suicide as cause of death. Archives of General Psychiatry, 43, 594–600.CrossRefGoogle ScholarPubMed
Kragh-S⊘rensen, P. (1985) Clinical comparison of selective 5HT reuptake inhibitors with tricyclic antidepressants. Presented at the Fourth International Meeting on Clinical Pharmacology in Psychiatry, Bethesda, September 5–7, 1985.Google Scholar
Lapin, I. P. & Oxenkrug, G. F. (1969) Intensification of the central serotoninergic processes as a possible determinant of the thymoleptic effect. Lancet, i, 132–136.CrossRefGoogle Scholar
Laursen, A. L., Mikkelsen, P. L., Rasmussen, S., et al (1985) Paroxetine in the treatment of depression: a randomized comparison with amitriptyline. Acta Psychiatrica Scandinavica, 71, 249–255.CrossRefGoogle ScholarPubMed
Levine, S., Deo, R. & Mahadevaa, K. (1987) A comparative trial of a new antidepressant, fluoxetine. British Journal of Psychiatry, 150, 653–655.CrossRefGoogle ScholarPubMed
Lingjærde, O., Bratfos, O., Bratlid, T., et al (1983) A double-blind comparison of zimelidine and desipramine in endogenous depression. Acta Psychiatrica Scandinavica, 68, 22–30.CrossRefGoogle ScholarPubMed
Mann, J. J. (1980) A controlled study of trazodone, imipramine, and placebo in outpatients with endogenous depression. Journal of Clinical Psychopharmocology, 1, 75–80.CrossRefGoogle Scholar
Meredith, C. H. & Feighner, J. P. (1983) A double-blind controlled evaluation of zimelidine, imipramine and placebo in patients with primary affective disorders. Acta Psychiatrica Scandinavica, 68 (Suppl. 308), 70–79.CrossRefGoogle Scholar
Montgomery, S. A., Montgomery, D. B., McAuley, R., et al (1982) Profile of antidepressant action of zimelidine nad norzimelidine compared with amitriptyline. In Typical and Atypical Antidepressants: Clinical Practice (eds Costa, E. & Racagni, G.). New York: Raven Press.Google Scholar
Montgomery, S. A., Dufour, H., Brion, S., et al (1988) The prophylactic efficacy of fluoxetine in unipolar depression. British Journal of Psychiatry, 153 (Suppl. 3), 69–76.CrossRefGoogle Scholar
Naylor, G. J. & Martin, B. (1985) A double-blind out-patient trial of indalpine vs mianserin. British Journal of Psychiatry, 147, 306–309.CrossRefGoogle ScholarPubMed
Nicholson, A. N. & Pascoe, P. A. (1986) 5-Hydroxytryptamine and noradrenaline uptake inhibition: studies on sleep in man. Neuropharmacology, 25, 1079–1083.CrossRefGoogle ScholarPubMed
Norman, T. R., Burrows, G. D., Marriot, P. F., et al (1983) Zimelidine: a placebo-controlled trial in depression. Psychiatry Research, 8, 95–103.CrossRefGoogle ScholarPubMed
Norton, K. R. W., Sireling, L. I., Bhat, A. V., et al (1984) A double-blind comparison of fluvoxamine, imipramine and placebo in depressed patients. Journal of Affective Disorders, 7, 297–308.CrossRefGoogle ScholarPubMed
Nyström, C. & Hällström, T. (1985) Double-blind comparison between a serotonin and a noradrenaline reuptake blocker in the treatment of depressed outpatients: clinical aspects. Acta Psychiatrica Scandinavica, 72, 6–15.CrossRefGoogle Scholar
Nyström, C., Ross, S. B., Hällström, T. et al (1986) Comparison between a serotonin and a noradrenaline reuptake blocker in the treatment of depressed outpatients: biochemical aspects. Acta Psychiatrica Scandinavica, 73, 133–138.CrossRefGoogle Scholar
Nyström, C., & Hällström, T. (1987) Comparison between a serotonin and a noradrenaline reuptake blocker in the treatment of depressed outpatients: a cross-over study. Acta Psychiatrica Scandinavica, 75, 377–382.CrossRefGoogle Scholar
Paul, S. M., Rehavi, M., Skolnick, P., et al (1981) Depressed patients have decreased binding of tritiated imipramine to platelet serotonin ‘transporter”. Archives of General Psychiatry, 38, 1315–1317.CrossRefGoogle ScholarPubMed
Pedersen, O. L., Kragh-S⊘rensen, P., Bjerre, M., et al (1982) Citalopram, a selective serotonin reuptake inhibitor: clinical antidepressive and long-term effect — a phase II study. Psychopharmacology, 77, 199–204.CrossRefGoogle ScholarPubMed
Perse, T. L., Greist, J. H., Jefferson, J. W., et al (1987) Fluvoxamine treatment of obsessive—compulsive disorder. American Journal of Psychiatry, 144, 1543–1548.Google ScholarPubMed
Reimherr, F. W., Wood, D. R., Byerley, B., et al (1984) Characteristics of responders of fluoxetine. Psychopharmacology Bulletin, 20, 70–72.Google ScholarPubMed
Reimherr, F. W., Byerley, W. F., Ward, M. F., et al (1988) Sertraline, a selective inhibitor of serotonin uptake for the treatment of outpatients with major depressive disorder. Psychopharmacology Bulletin, 24, 200–205.Google ScholarPubMed
Riblet, L., Hatewood, C. & Mayol, R. (1979) Comparative effects of trazodone and tricyclic antidepressants on uptake of selected neurotransmitters by isolated rat brain synaptosomes. Psychopharmacology 63, 99–101.CrossRefGoogle ScholarPubMed
Rydin, E., Schalling, D. & Åsberg, M. (1982) Rorschach ratings in depressed and suicidal patients with low levels of 5-hydroxyindoleacetic acid in cerebrospinal fluid. Psychiatry Research, 7, 229–243.CrossRefGoogle ScholarPubMed
Shaw, D. M., Camps, F. E. & Eccleston, E. G. (1967) 5-Hydroxytryptamine in the hind-brain of depressive suicides. British Journal of Psychiatry, 113, 1407–1411.CrossRefGoogle ScholarPubMed
Sheehan, D. V., Zak, J. P., Miller, J. A. Jr., et al (1988) Panic disorder: The potential role of serotonin reuptake inhibitors. Journal of Clinical Psychiatry, 49 (Suppl.), 30–36.Google ScholarPubMed
Schildkraut, J. J. (1965) The catecholamine hypothesis of affective disorders: a review of supporting evidence American Journal of Psychiatry, 122, 509–522.CrossRefGoogle ScholarPubMed
Silverstone, T. (1986) Appetite suppressant drugs in the management of obesity — the current view. Alim Nutr Metab 7.Google Scholar
Simpson, R. J., Lawton, D. J., Watt, M. H., et al (1981) Effect of zimelidine a 5-HT uptake blocker, on appetite and body weight. British Journal of Clinical Pharmacology, 11.CrossRefGoogle Scholar
Siwers, B., Ringberger, V.-A., Tuck, J. R., et al (1977) Initial clinical trial based on biochemical methodology of zimelidine (a serotonin uptake inhibitor) in depressed patients. Clinical Pharmacology and Therapeutics, 21, 194–200.CrossRefGoogle ScholarPubMed
Skrumsager, B. K. & Jeppesen, K. (1986) Femoxetine and amitriptyline in general practice: A randomized double-blind group comparison. Pharmacopsychiat, 19, 368–377.CrossRefGoogle ScholarPubMed
Stark, P. & Hardison, C. D. (1985) A review of multicenter controlled studies of fluoxetine vs. imipramine and placebo in outpatients with major depressive disorder. Journal of Clinical Psychiatry, 46, 53–58.Google ScholarPubMed
Tamminen, T., Salminen, J. K. & Skrumsager, B. K. (1982) A double-blind controlled trial of the selective serotonin uptake inhibitor femoxetine and amitriptyline in depression. Nord Psykiatr. Tidskr., 335–339.CrossRefGoogle Scholar
Thorén, P., Åsberg, M., Bertilsson, L., et al (1980a) Clomipramine treatment of obsessive—compulsive disorder. II: Biochemical aspects. Archives of General Psychiatry, 37, 1289–1294.CrossRefGoogle ScholarPubMed
Thorén, P., Åsberg, M., Cronholm, B., et al (1980b) Clomipramine treatment of obsessive—compulsive disorder. I: A controlled clinical trial. Archives of General Psyciatry, 37, 1281–1285.CrossRefGoogle Scholar
Tuomisto, J. & Tukiainen, E. (1976) Decreased uptake of 5-hydroxytryptamine in blood platelets from depressed patients. Nature, 262, 596–598.CrossRefGoogle ScholarPubMed
van Praag, H. M. (1981) Management of depression with serotonin precursors. Biological Psychiatry, 16 291–310.Google ScholarPubMed
Wålinder, J., Skott, A., Carlsson, A., et al (1976) Potentiation of the antidepressant action of clomipramine by tryptophan. Archives of General Psychiatry, 33, 1384–1389.CrossRefGoogle ScholarPubMed
Wålinder, J., Carlsson, A. & Persson, R. (1981) 5-HT reuptake inhibitors plus tryptophan in endogenous depression. Acta Psychiatrica Scandinavica, 69 (Suppl. 290), 179–190.CrossRefGoogle Scholar
Wernicke, J. F. & Bremner, J. D. (1986) Fluoxetine important in the long-term treatment of depression. British Journal of Clinical Practice, 7, 17–23.Google Scholar
Wernicke, J. F., Dunlop, S. R., Dornseif, B. E., et al (1988) Low-dose fluoxetine therapy for depression. Psychopharmacology Bulletin, 24, 183–188.Google ScholarPubMed
White, K., Keck, P. E. Jr. & Lipinski, J. (1986) Serotonin-uptake inhibitors in obsessive-compulsive disorder: a case report. Comprehensive Psychiatry, 27, 211–214.CrossRefGoogle ScholarPubMed
Wood, K. M., Swade, C. C. & Coppen, A. J. (1982) Zimelidine: a pharmacokinetic and pharmacodynamic study in depressive illness. British Journal of Clinical Practice, 19 (Suppl.), 42–47.Google Scholar
Wurtman, J. J. (1988) Carbohydrate craving, mood changes, and obesity. Journal of Clinical Psychiatry, 49 (Suppl.), 37–39.Google ScholarPubMed
R., Young J. P., Coleman, A. & Lader, M. H. (1987) A controlled comparison of fluoxetine and amitriptyline in depressed outpatients. British Journal of Psychiatry, 150, 337–340.Google Scholar
Zak, J. P., Miller, J. A. Jr., Sheehan, D. V., et al (1988) The potential role of serotonin reuptake inhibitors in the treatment of obsessive compulsive disorder. Journal of Clinical Psychiatry, 49 (Suppl.), 23–29.Google ScholarPubMed
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