Goodwin G M
University Department of Psychiatry, Royal Edinburgh Hospital, U.K.
J Clin Psychiatry. 1996;57 Suppl 4:9-13.
The serotonin selective reuptake inhibitors (SSRIs) have proved to be an important development in the treatment of depression because of both their greater practical ease of use and their selective primary action on a single binding site. Their efficacy in depressive illness of a range of severities, but also in obsessive-compulsive disorder and panic, is largely established. The onset of action of the SSRIs may be delayed by autoinhibition at the cell bodies of raphe neurons. This suggests that blockade of autoreceptors may speed the onset of antidepressant action by SSRIs. The main unwanted effects of the SSRIs occur in relation to gastrointestinal, sleep, and orgasmic disturbances. However, the total side effect burden is less than that associated with the older, less selective compounds, and there are clear hypotheses for how the side effects that do occur may be mediated and hence how they may be reduced by either adjunctive treatment or design of new compounds.
血清素选择性再摄取抑制剂（SSRIs）已被证明是抑郁症治疗领域的一项重要进展，这是因为它们在实际使用中更加简便，并且对单一结合位点具有选择性的主要作用。它们在一系列严重程度的抑郁症中有效，同时在强迫症和恐慌症中也有疗效，这一点在很大程度上已得到证实。SSRIs的起效可能会因中缝神经元细胞体的自身抑制而延迟。这表明阻断自身受体可能会加快SSRIs抗抑郁作用的起效。SSRIs的主要不良作用与胃肠道、睡眠和性高潮障碍有关。然而，总的副作用负担比与较老的、选择性较低的化合物相关的副作用负担要小，并且对于确实出现的副作用如何介导以及因此如何通过辅助治疗或新化合物设计来减少这些副作用，有明确的假说。
