Eriksson E
Department of Pharmacology, University of Goteborg, Sweden.
Acta Psychiatr Scand Suppl. 2000;402:12-7. doi: 10.1034/j.1600-0447.2000.00003.x.
The current popularity of the selective serotonin reuptake inhibitors (SSRIs) for the treatment of depression should not conceal the fact that noradrenergic neurones also seem to influence depressed mood. Selective noradrenaline reuptake inhibitors (NRIs) such as reboxetine thus seem to be at least as effective as the SSRIs. It has been suggested that NRIs influence depression by indirectly facilitating serotonergic transmission, or that SSRIs act by facilitating noradrenaline; however, the marked differences between SSRIs and NRIs with respect to effects and side-effect profile do not support any of these assumptions, but rather suggest that SSRIs and NRIs influence depression by parallel, independent pathways. In this review the possibility that certain symptoms within the depressive syndrome (and certain subtypes of depression) respond better to NRIs, whereas other symptoms (and subtypes) respond better to SSRIs, will be discussed. In addition, the putative usefulness of NRIs for indications other than depression will be commented upon.
目前选择性5-羟色胺再摄取抑制剂（SSRI）在治疗抑郁症方面的广泛应用不应掩盖去甲肾上腺素能神经元似乎也会影响抑郁情绪这一事实。因此，如瑞波西汀这类选择性去甲肾上腺素再摄取抑制剂（NRI）似乎至少与SSRI一样有效。有人提出，NRI通过间接促进5-羟色胺能传递来影响抑郁，或者SSRI通过促进去甲肾上腺素起作用；然而，SSRI和NRI在作用和副作用方面的显著差异并不支持这些假设，而是表明SSRI和NRI通过平行、独立的途径影响抑郁。在这篇综述中，将讨论抑郁综合征中的某些症状（以及某些抑郁症亚型）对NRI反应更好，而其他症状（和亚型）对SSRI反应更好的可能性。此外，还将对NRI在抑郁症以外适应症的假定效用进行评论。
