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A monoamine reuptake inhibitor (MRI) [1] is a drug that acts as a reuptake inhibitor of one or more of the three major monoamine neurotransmitters serotonin, norepinephrine, and dopamine by blocking the action of one or more of the respective monoamine transporters (MATs), which include the serotonin transporter (SERT), norepinephrine transporter (NET), and dopamine transporter (DAT).
The UK National Institute for Health and Care Excellence (NICE)'s 2022 guidelines indicate that antidepressants should not be routinely used for the initial treatment of mild depression, "unless that is the person's preference". [29] The guidelines recommended that antidepressant treatment be considered:
Most antidepressants will hinder the breakdown of serotonin, norepinephrine, and/or dopamine. A commonly used class of antidepressants are called selective serotonin reuptake inhibitors (SSRIs), which act on serotonin transporters in the brain to increase levels of serotonin in the synaptic cleft . [ 22 ]
Bupropion, formerly called amfebutamone, [16] and sold under the brand name Wellbutrin among others, is an atypical antidepressant that is US FDA-approved to treat major depressive disorder, seasonal affective disorder and to support smoking cessation.
A 2006 review suggests that the widespread use of antidepressants in the new "SSRI-era" appears to have led to a highly significant decline in suicide rates in most countries with traditionally high baseline suicide rates. The decline is particularly striking for women who, compared with men, seek more help for depression.
Sertraline, sold under the brand name Zoloft among others, is an antidepressant of the selective serotonin reuptake inhibitor (SSRI) class. [10] The effectiveness of sertraline for depression is similar to that of other antidepressants such as Fluoxetine or Paroxetine. Sertraline is better tolerated than the older tricyclic antidepressants.
Dapoxetine is absorbed and distributed rapidly in the body. Greater than 99% of dapoxetine is bound to the plasma protein. The mean steady-state volume is 162 L. Its initial half-life is 1.31 hours (30 mg dose) and 1.42 hours (60 mg dose), and its terminal half life is 18.7 hours (30 mg dose) and 21.9 hours (60 mg dose). [27] Metabolism
Mirtazapine, sold under the brand name Remeron among others, is an atypical tetracyclic antidepressant, and as such is used primarily to treat depression. [11] [12] Its effects may take up to four weeks but can also manifest as early as one to two weeks.