| SNRIs and serotonin syndrome |
| Written by Fred McConnell | |
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Serotonin is a chemical synthesized in the brain that acts as a neurotransmitter. Serotonin has been described by many experts as the "volume control" of the brain, helping to regulate the intensity of messages sent through the brain. Serotonin has been found to have a major impact on mood, and some people who have a deficit of serotonin can experience sleep, mood, memory, cognition and other problems. In treatment, various drugs are used to treat serotonin problems by inhibiting the reuptake of serotonin. SNRIs regulate the reuptake of both serotonin and another neurotransmitter known as norepinephrine. Norepinephrine is important to the sympathetic nervous system and impacts a variety of bodily systems, such as the heart and cardiovascular system, the adrena medulla and several other internal organs. When someone has the proper level of norepinephrine, he or she will have a good level of alertness and increased functionality with cognition and memory. Norepinephrine also gives the subject a feeling of well-being, as it delays endorphins from breaking down. How SNRIs work and common brandsAntidepressant drugs have become the treatment of choice for depression in adults, along with therapy. As mentioned before, SNRIs work to fight depression by blocking the reabsorbtion of serotonin and norepinephrine by nerve cells in the brain. The use of SNRIs results in more serotonin and norepinephrine being available in the brain, thus increasing neurotransmission and positively effecting mood.Some common brands of SNRIs include Cymbalta and Effexor. Cymbalta is manufactured by Eli Lilly and first hit the market in the early 1990s. This drug has been found to be effective for the treatment of major depressive disorder and generalized anxiety disorder. The drug has been found to be less effective at treating major depressive disorder than more modern SNRIs. Effexor is manufactured by Wyeth, and was introduced in 1993. The drug is more effective at treating major depressive disorder than Cymbalta, and is one of the most commonly prescribed anti-depressants on the market. Suicide has been a noted, but rare, side effect of SNRIs. Use of the drugs may cause suicidal thoughts and actions early in the treatment as the body adjusts to the presence of SNRIs. This, among other potential side effects, is why good communication between patients and doctors concerning other medications and due diligence on the part of health care providers is necessary. SNRIs and serotonin syndromeSerotonin syndrome is a potentially life-threatening condition caused by an excess of serotonin in the brain. Serotonin syndrome requires immediate medical treatment, and some of its symptoms include:
In a 2002 review in The New England Journal of Medicine, it was reported that based on calls to U.S. poison control centers, about 7,349 cases of serotonin syndrome were reported that year, resulting in more than 90 deaths. In 2005, a similar study showed more than 100 deaths from serotonin syndrome. Experts believe cases and deaths will continue to rise as the use of SNRIs and other serotonin affecting drugs are prescribed for depression. Doctors should be aware of their patients medications and their potential for interacting and causing serotonin syndrome and other potentially dangerous side effects. It's also important for patients to understand the medications they've been prescribed and to truthfully and completely communicate with health care providers regarding their treatments. |
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