What long term changes do SSRI and SARI drugs cause?

In summary, the conversation discusses the long term effects of antidepressant use on the brain, particularly the monoamine neurotransmitter pathways. The main mechanism of action for SSRIs is inhibiting reuptake of serotonin, which can lead to downregulation of 5-HT receptors. TCAs and SNRIs may also lead to downregulation of adrenaline receptors, but it is unclear why SSRIs would have this effect. SARIs, such as trazodone and mirtazapine, have a different binding profile and their long term effects are not well understood. The conversation ends with a request for more information from a neurobiology expert.
  • #1
I read about long term use of these kinda antidepressants causing hippocampal neurogenesis and stuff like that but I'm focusing more on what long term use does to the various monoamine neurotransmitter pathways. I'll start with SSRIs because they are the simplest. Their main mechanism of action is inhibiting reuptake of serotonin. Would I be right in assuming that the surplus of serotonin in the synapse causes downregulation of 5-HT receptors? In my pharmacology book, they claimed that long term use of antidepressants cause downregulation of two of the subtypes (α2 and β1 I think it was) of adrenergic receptors but they didn't state what class of antidepressants do this. I can see why TCAs and other SNRIs would downregulate α and β receptors but I don't see why SSRIs would cause significant downregulation of adrenaline receptors. However, I know very little about what long term use of an SSRI does.

SARIs (serotonin antagonist reuptake inhibitors) are an even bigger mystery to me. Two that I'm familiar with are trazodone and mirtazapine. Trazodone binds strongly (and antagonises) various 5-HT receptors, as well as α1 receptors. It also has mild affinity for the serotonin transporter. Mirtazapine has a similar binding profile but its much less selective (i.e. it has significant anticholinergic and antihistamine properties). Since these drugs block various monoamine receptors, what kinda long term effects do they produce? I can't see how they would downregulate receptors (since the antagonism should counteract the reuptake inhibition) or produce long term trophic effects such as hippocampal neurogenesis.
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  • #2
@BillTre may have an answer. Our neurobiology members are not very active lately.

Related to What long term changes do SSRI and SARI drugs cause?

What long term changes do SSRI and SARI drugs cause?

1. What are SSRI and SARI drugs?
SSRI (Selective Serotonin Reuptake Inhibitors) and SARI (Serotonin Antagonist and Reuptake Inhibitors) are two types of antidepressant medications commonly used to treat depression and other mental health disorders.2. How do SSRI and SARI drugs work?
SSRI and SARI drugs work by increasing the levels of neurotransmitters such as serotonin in the brain. This helps to regulate mood and emotions, leading to improved symptoms of depression and anxiety.3. What are the potential long term side effects of SSRI and SARI drugs?
Some potential long term side effects of SSRI and SARI drugs may include weight gain, sexual dysfunction, sleep disturbances, and gastrointestinal issues. These may vary from person to person and can be managed with proper medical guidance.4. Can SSRI and SARI drugs cause addiction?
SSRI and SARI drugs are not known to cause addiction. However, they may lead to dependence, especially if taken for a long time. It is important to follow the prescribed dosage and consult a doctor before stopping the medication.5. Are there any risks associated with taking SSRI and SARI drugs for a long time?
Long term use of SSRI and SARI drugs may increase the risk of developing certain health conditions, such as osteoporosis, bleeding disorders, and heart problems. It is essential to regularly monitor these potential risks with a doctor while taking these medications.

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