Ishigooka J
Department of Psychiatry, Kitasato University School of Medicine.
Nihon Rinsho. 2001 Aug;59(8):1523-9.
Pharmacology, clinical efficacy and tolerability of serotonin noradrenaline reuptake inhibitors(SNRIs) are overviewed. They include milnacipran, venlafaxine, duloxetine, MCI-225 and nefazodone, however, only milnacipran is currently used in Japan. Pharmacology of SNRIs is characterized by inhibition of both serotonin and noradrenaline at the presynaptic membrane and by weak affinity with receptors at the postsynaptic membrane, which expects the same efficacy on major depressive disorder(MDD) as tricyclic antidepressant drugs(TCAs) with less adverse effects in clinical use. Currently available evidences show that SNRIs possess antidepressant effects on MDD at least similar potencies to TCAs with more potencies than selective serotonin reuptake inhibitors. SNRIs are well tolerated in general and safer than TCAs. SNRIs can be considered to be first-line antidepressant drugs.
本文综述了5-羟色胺去甲肾上腺素再摄取抑制剂（SNRIs）的药理学、临床疗效及耐受性。它们包括米那普明、文拉法辛、度洛西汀、MCI - 225和奈法唑酮，然而目前在日本仅米那普明被使用。SNRIs的药理学特征是在突触前膜抑制5-羟色胺和去甲肾上腺素，且与突触后膜受体的亲和力较弱，预计其对重度抑郁症（MDD）的疗效与三环类抗抑郁药（TCAs）相同，但临床使用时不良反应较少。现有证据表明，SNRIs对MDD具有抗抑郁作用，其效力至少与TCAs相似，且比选择性5-羟色胺再摄取抑制剂更强。一般来说，SNRIs耐受性良好且比TCAs更安全。SNRIs可被视为一线抗抑郁药物。
