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Can someone explain the basics of how SSRI medications like prozac and zoloft work?




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3 Answers

The short answer is that SSRIs (Selective Serotonin Reuptake Inhibitors) block reuptake sites on the neuron allowing serotonin, which usually has a calming effect, to reduce the over-excitation of the neurons.  Hopefully, this reduces the continuous thoughts that lead to depression and allow the person to replace depressing and possibly racing-depressing thoughts with thoughts of reaffirmation, or good thoughts.  It may be important to also receive psychotherapy so that you learn techniques for affirmation and to see what is happening in your life that is positive.
by (4.3k points)
Are there any medications currently available which target the process from the other end?  Meaning not at reuptake but as the neurotransmitter is released from the neuron into the synaptic gap?  Are most problems with Serotonin related to a lack of protein production during transcription and translation or is it more a matter of how long the ligands interact with the receptors?
I am not a psychiatrist or medical doctor, but I have had to be aware of medications and there possible effects and uses.  I don't know any medications that increase the production of Serotonin.  I am not sure that would be advisable.  As I recall from my reading, there is a cycle of absorption and release of Serotonin, as well as other neurotransmitters.  The neurotransmitters are made from amino acids, which from food and are processed through the body's organs.

Most problems with medication are that the body adjusts to the use of the medication.  Prolonged use of SSRIs results in neurons developing more receptors, thus requiring more medication to cover them.

It is interesting that psychotherapy can produce better neurological changes than medication, but it takes more time and perseverance.  Learning strategies to overcome the effects of biology has been shown to produce similar and longer-term results than medication, with much fewer side effects.  The research shows that a combination of medication and psychotherapy is the most effective (although I think they mean the quickest method for getting long-term effects) because the medication makes accepting the strategies easier and increases compliance.  Eventually the medication can be weaned down.
by
In the end doesn't this all come back to regulation of gene expression? The number of receptors on the cells surface as well as the amount of serotonin is controlled at the gene level.  I would be interested to know how the transcription and translation patterns of the proteins associated with both the receptors and the serotonin ligands change as a result of both medication and therapy. Can anyone point to any genetic reserach on these topics?  Are there any studies that have been done on gene expression and medication or psychotherapy?
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