Changes

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

Line 145: Line 145:

==Fluoxetine==

−

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-HT1A into pre-synaptic neurons is highly selective and does not affect noradrenaline, dopamine, acetylcholine, histaminic or alpha-1 adrenergic receptors. 5-HT1A 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, Ca2+, cGMP, IP3) 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>.

−

Fluoxetine is largely metabolised in the liver by the cytochrome P450 enzyme system to norfluoxetine, also an SSRI.

−

===Uses===

Line 185: Line 182:

*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.

−

==References==

Jon Bowen

694

edits