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Selective Serotonin Reuptake Inhibitors (Clomipramine, Fluoxetine) (view source)

Revision as of 12:45, 12 September 2014

1,159 bytes removed ,  12:45, 12 September 2014
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==Fluoxetine==
 
==Fluoxetine==
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Fluoxetine is a selective serotonin reuptake inhibitor (SSRI) which functions by inhibiting the reuptake of serotonin in the pre-synaptic neuron. This inhibition of uptake of reuptake of 5-HT<sub>1A</sub> into pre-synaptic neurons is highly selective and does not affect noradrenaline, dopamine, acetylcholine, histaminic or alpha-1 adrenergic receptors. 5-HT<sub>1A</sub> receptors have an effect on mood and behaviour. SSRIs are derived from TCAs, such as [[Clomipramine]]. SSRIs act to bring about changes in conformation of receptors, this can take 3-5 weeks<ref>Overall, K.L., 2004. Paradigms for pharmacologic use as a treatment component in feline behavioural medicine. Journal of Feline Medicine and Surgery 6, 29–42</ref>. Regulation of second messengers (cAMP, Ca<sup>2+</sup>, cGMP, IP<sub>3</sub>) is responsible for the major effect. Their actions on protein kinases then act to change neuronal metabolism and receptor protein transcription<ref>Overall, K.L., 2001. Pharmacological Treatment in Behavioural Medicine: The Importance of Neurochemistry, Molecular Biology and Mechanistic Hypotheses. The Veterinary Journal, 162, 9–23</ref>.
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Fluoxetine is largely metabolised in the liver by the cytochrome P450 enzyme system to norfluoxetine, also an SSRI.
 
Fluoxetine is largely metabolised in the liver by the cytochrome P450 enzyme system to norfluoxetine, also an SSRI.
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===Uses===
 
===Uses===
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*Monoamine oxidase inhibitors (MAOI), or within a period of 2 weeks after discontinuation of treatment with a MAOI due to the risk of serotonin syndrome<ref>Brown, T.M., Skop, B.P., Mareth, T.R., 1996. Pathophysiology and management of the serotonin syndrome. The Annals of Pharmacotherapy 30, 527–533.</ref>
 
*Monoamine oxidase inhibitors (MAOI), or within a period of 2 weeks after discontinuation of treatment with a MAOI due to the risk of serotonin syndrome<ref>Brown, T.M., Skop, B.P., Mareth, T.R., 1996. Pathophysiology and management of the serotonin syndrome. The Annals of Pharmacotherapy 30, 527–533.</ref>
 
*Fluoxetine has not been evaluated with drugs that affect the cytochrome P450 enzyme, care should therefore be taken with any drug that affects the enzyme system eg. ketoconazole.
 
*Fluoxetine has not been evaluated with drugs that affect the cytochrome P450 enzyme, care should therefore be taken with any drug that affects the enzyme system eg. ketoconazole.
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==References==
 
==References==
Jon Bowen
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