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Ssri sexual dysfunction remedy herbicide

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Selective serotonin [5-hydroxytryptamine 5-HT ] reuptake inhibitors SSRIs and the 5-HT noradrenaline reuptake inhibitor, venlafaxine, are mainstays in treatment for depression. The highly specific actions of SSRIs of enhancing serotonergic neurotransmission appears to explain their benefit, while lack of direct actions on other neurotransmitter systems is responsible for their superior safety profile compared with tricyclic antidepressants.

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Although SSRIs and venlafaxine have similar adverse effects, certain differences are emerging. Fluvoxamine may have fewer effects on sexual dysfunction and sleep pattern. SSRIs Ssri sexual dysfunction remedy herbicide a cardiovascular safety profile superior to that of tricyclic antidepressants for patients with cardiovascular disease; fluvoxamine is safe in patients with cardiovascular disease and in the elderly.

A discontinuation syndrome may develop upon abrupt SSRI cessation. SSRIs are more tolerable than tricyclic antidepressants in overdose, and there is no conclusive evidence to suggest that they are associated with an increased risk of suicide.

Although the literature suggests that there are no clinically significant Ssri sexual dysfunction remedy herbicide in efficacy amongst SSRIs, treatment decisions need to be based on considerations such as patient acceptability, response history and toxicity. Over the years, there have been considerable advances in the development of new antidepressants with the emergence of the selective serotonin [5-hydroxytryptamine 5-HT ] reuptake inhibitors SSRIs and 5-HT noradrenaline reuptake inhibitors SNRIs.

Since their introduction, it has become apparent that these drugs have certain advantages over the older tricyclic antidepressants and monoamine oxidase inhibitors, notably in the area of safety and tolerability.

Most clinicians now consider the SSRIs and some of the other new antidepressants first-line treatment for depression and anxiety disorders. However, the issue of safety and tolerability, and indeed efficacy, becomes more Ssri sexual dysfunction remedy herbicide when comparing members of the newer generations of antidepressants.

Not only are SSRIs chemically different from the tricyclic, tetracyclic and other antidepressant agents, considerable structural differences also exist between the various SSRIs. For example, fluvoxamine is the only monocyclic SSRI and belongs to the 2-aminoethyl oxime ethers of aralkylketones. Therefore, some differential pharmacology between the drugs in the same class may be expected.

Introduction

The aim of this review, which was based on a Medline literature search, is to provide a comprehensive comparative overview of the main clinical features of some antidepressants based on pharmacology, pharmacokinetics, tolerability and safety. Most of the effects of antidepressants, whether therapeutic or adverse, can be directly related to their pharmacology.

Although the ultimate mechanism of action of antidepressants remains uncertain, it is reasonable to assume that the effects on monoamine systems in the brain are central to their therapeutic effects. Venlafaxine, for instance, is one of the most potent antidepressants at blocking the dopamine transporter, and paroxetine, although the most potent blocker of 5-HTT, also has appreciable affinity for the noradrenaline transporter NAT 1.

In comparison with the other SSRIs, paroxetine has the highest affinity for the muscarinic receptor Figure 1 1which at higher dosages, or at low dosages in slow metabolisers, may lead to anticholinergic side effects such as dry mouth, constipation, dizziness, tachycardia, blurred vision, urinary retention and Ssri sexual dysfunction remedy herbicide 7.

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Anticholinergic side effects also include memory impairment 78confusion 7problems with concentration 7 and sexual dysfunction, but these side effects are less likely to occur at normal dosages of paroxetine 9 — Compared with other antidepressants, paroxetine also has an affinity for binding at the NAT Figure 2 1.

Relative potency of the antidepressants for binding at muscarinic receptors. Potency of antidepressants for binding at muscarinic receptors based on IC 50 values: Relative potency of the antidepressants for binding at the noradrenaline transporter.

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