Specific serotonin and noradrenaline reuptake inhibitors (SNRIs). A review of their pharmacology, clinical efficacy and tolerability

✍ Scribed by M. Briley

• Publisher: John Wiley and Sons
• Year: 1998
• Tongue: English
• Weight: 188 KB
• Volume: 13
• Category: Article
• ISSN: 0885-6222
• DOI: 10.1002/(sici)1099-1077(199803)13:2<99::aid-hup954>3.0.co;2-2

✦ Synopsis

Considerable progress has been made in improving the tolerability of antidepressant drugs. The classical tricyclic antidepressants (TCA) are still, however, the standard for ecacy. The selective serotonin reuptake inhibitors are better tolerated that the tricyclics, but their ecacy in major depression is, at best, equivalent to the earlier compounds and probably inferior in certain cases. Recently a new class of antidepressants has been developed that inhibit selectively the reuptake of both serotonin and noradrenaline with no anity for the receptors responsible for the adverse eects of the TCAs. These compounds are referred to as the speci®c serotonin and noradrenaline reuptake inhibitors or SNRIs. This article reviews the pharmacological and clinical characteristics of the two principal compounds of this class, milnacipran (Ixel 1 ) and venlafaxine (Eexor 1 ). This new class of antidepressants, as represented by these two compounds, presents an ecacy comparable to TCAs with a more benign side-eect pro®le. Certain trials suggest that they may have ecacy superior to SSRIs, especially in more severe depression, with a tolerability which is globally similar. This class therefore appears to oer a potential useful addition to the therapeutic arsenal of antidepressant drugs.