Dipartimento di Scienze per la Salute, Università degli Studi del Molise, Campobasso, Italy.
Curr Neuropharmacol. 2008 Dec;6(4):293-310. doi: 10.2174/157015908787386104.
The increase in serotonin (5-HT) neurotransmission is considered to be one of the most efficacious medical approach to depression and its related disorders. The selective serotonin reuptake inhibitors (SSRIs) represent the most widely antidepressive drugs utilized in the medical treatment of depressed patients. Currently available SSRIs include fluoxetine, sertraline, paroxetine, fluvoxamine, citalopram and escitalopram. The primary SSRIs pharmacological action's mechanism consists in the presynaptic inhibition on the serotonin reuptake, with an increased availability of this amine into the synaptic cleft. Serotonin produces its effects as a consequence of interactions with appropriate receptors. Seven distinct families of 5-HT receptors have been identified (5-HT(1) to 5-HT(7)), and subpopulations have been described for several of these. The interaction between serotonin and post-synaptic receptors mediates a wide range of functions. The SSRIs have a very favorable safety profile, although clinical signs of several unexpected pathologic events are often misdiagnosed, in particular, those regarding the eye. In all cases reported in the literature the angle-closure glaucoma represents the most important SSRIs-related ocular adverse event. Thus, it is not quite hazardous to hypothesize that also the other reported and unspecified visual disturbances could be attributed - at least in some cases - to IOP modifications. The knowledge of SSRIs individual tolerability, angle-closure predisposition and critical IOP could be important goals able to avoid further and more dangerous ocular side effects.
血清素(5-HT)神经递质的增加被认为是治疗抑郁症及其相关疾病最有效的医学方法之一。选择性 5-羟色胺再摄取抑制剂(SSRIs)是目前在抑郁症患者的医学治疗中应用最广泛的抗抑郁药物。目前可用的 SSRIs 包括氟西汀、舍曲林、帕罗西汀、氟伏沙明、西酞普兰和艾司西酞普兰。主要的 SSRIs 药理作用机制包括抑制 5-HT 的再摄取,从而增加这种胺在突触间隙中的可利用性。血清素通过与适当的受体相互作用产生其作用。已经确定了 7 种不同的 5-HT 受体家族(5-HT(1)至 5-HT(7)),并且已经描述了其中几种的亚群。血清素与突触后受体的相互作用介导了广泛的功能。SSRIs 具有非常有利的安全性特征,尽管经常误诊几种意外病理事件的临床迹象,特别是那些与眼睛有关的迹象。在文献中报告的所有病例中,闭角型青光眼是与 SSRIs 相关的最严重的眼部不良事件。因此,假设文献中报告的和未指定的其他视觉障碍至少在某些情况下可以归因于 IOP 改变,这并不是没有道理的。了解 SSRIs 的个体耐受性、闭角型倾向和临界 IOP 可能是避免进一步更危险的眼部副作用的重要目标。