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Re: How does Rem increase 5HT

Posted by rod on August 2, 2003, at 6:47:57

In reply to How does Rem increase 5HT, posted by linkadge on August 2, 2003, at 4:10:13

> I've heard that Remeron increases 5ht neurotransmission but how is this possible if it has no reputake capabilities. I understand it blocks some serotonin receptors but how does this lead to increase 5ht neurotransmission.
>
>
> Linkadge

Hi linkadge,

I once looked it up myself, so here it comes:

Remeron blocks alpha2-Autoreceptors and alpha2-heteroreceptors. alpha2-autoreceptors are the usual norepinephrine autoreceptors. The are negativley coupled to the release of norepinephrine. I guess you know how this works. But Remeron , unlike Mianserin, has an equal affinity towards alpha2-heteroreceptors. alpha2-heteroreceptors are Autoreceptors, located at serotonergic neurons, which inhibit upon activation (like all autoreceptors) the release of serotonin. but alpha2-heteroreceptors do not get activated by serotonin but norepinephrine (hetero = different, other). It seems like norepinephrine is also controlling the serotonergic system. (I guess also vice versa) fascinating, isnt it? But the effect of this blockade is increased serotonergic neurotransmission. Like Lithium, but this one targets serotonergic autoreceptors, which are activated by serotonin...

There is a nice picture on the web, but it comes from switzerland, so it is in german. But the used terms in this graphic are very similar to the english ones.
http://www.kssg.ch/fachbereiche/klinikeninstitute/psychosomatik/img/remeron9.jpg

full artile:
http://www.kssg.ch/fachbereiche/klinikeninstitute/psychosomatik/veroeffentlichungen/antidepressiva/31antdepressivatext.htm

Roland


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