Constantinidis J, Tissot R
Encephale. 1979;5(5 Suppl):689-700.
The tricyclic and related antidepressants reduce monoamine uptake at the synapses, block the presynaptic receptors and, after chronic administration, act upon the synthesis of the monoamines and the sensitivity of the post-synaptic receptors. The NA and 5-HT synapses are influenced to different degrees by the antidepressants: for example, desipramine has a preponderance of activity at NA synapses and clomipramine at 5-HT synapses. By combining these findings and by highlighting one or other of these properties, it is possible to come to diametrically opposite conclusions upon the effect of the antidepressants upon monoamine performance (activation or inhibition) and to develop many models of the mechanisms of antidepressant action. The authors describe some of these and stress the model which is at the basis of the studies being carried out at the Department of Psychiatry of the University of Geneva.
三环类及相关抗抑郁药可减少突触处单胺的摄取,阻断突触前受体,长期给药后,还会作用于单胺的合成及突触后受体的敏感性。去甲肾上腺素(NA)和5-羟色胺(5-HT)突触受抗抑郁药的影响程度不同:例如,地昔帕明在NA突触处活性占优,而氯米帕明在5-HT突触处活性占优。综合这些发现并突出其中某一特性,就可能在抗抑郁药对单胺功能的影响(激活或抑制)上得出完全相反的结论,并建立许多抗抑郁作用机制的模型。作者描述了其中一些模型,并着重介绍了日内瓦大学精神病学系正在进行的研究基础上的模型。