Monoamine reuptake inhibitor

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A monoamine reuptake inhibitor (MRI) [1] is a drug that acts as a reuptake inhibitor of one or more of the three major monoamine neurotransmitters serotonin, norepinephrine, and dopamine by blocking the action of one or more of the respective monoamine transporters (MATs), which include the serotonin transporter (SERT), norepinephrine transporter (NET), and dopamine transporter (DAT). This in turn results in an increase in the synaptic concentrations of one or more of these neurotransmitters and therefore an increase in monoaminergic neurotransmission.

Contents

Uses

The majority of currently approved antidepressants act predominantly or exclusively as MRIs, including the selective serotonin reuptake inhibitors (SSRIs), serotonin–norepinephrine reuptake inhibitors (SNRIs), and almost all of the tricyclic antidepressants (TCAs). [2] Many psychostimulants used either in the treatment of ADHD or as appetite suppressants in the treatment of obesity also behave as MRIs, although notably amphetamine (and methamphetamine), which do act to some extent as monoamine reuptake inhibitors, exerts their effects primarily as releasing agents. [3] [4] Additionally, psychostimulants acting as MRIs that affect dopamine such as cocaine and methylphenidate are often abused as recreational drugs. [5] As a result, many of them have become controlled substances, which in turn has resulted in the clandestine synthesis of a vast array of designer drugs for the purpose of bypassing drug laws; a prime example of such is the mixed monoamine reuptake inhibitor and releasing agent mephedrone. [6]

Types of MRIs

There are a variety of different kinds of MRIs, of which include the following:

Binding profiles

Binding profiles of MRIs at human MATs [7]
Compound SERT NET DAT TypeClass
Amfonelic acid NDND207DRIStimulant
Amineptine* [8] [9] >100,000 (rat)10,000 (rat)1,000–1,400 (rat)DRIStimulant
Amitriptyline 4.30353,250SNRITCA
Amoxapine 5816.04,310SNRITeCA
Amphetamine >100,000NDNDNDRAStimulant
   D-Amphetamine >100,0005302,900NDRAStimulant
   L-Amphetamine >100,000NDNDNRAStimulant
Atomoxetine 7751,451NRIStimulant
Bupropion 9,10052,000520NDRIStimulant
Butriptyline 1,3605,1003,940N/A (IA)TCA
Chlorphenamine 15.21,4401,060SRIAntihistamine
Citalopram 1.164,07028,100SRISSRI
   Escitalopram [10] 1.17,84127,410SRISSRI
Clomipramine 0.28382,190SNRITCA
Cocaethylene [11] 3,878>10,000555SDRIStimulant
Cocaine [11] 304779478SNDRIStimulant
Cocaine [12] 313±17 (IC50)292±34 (IC50)211±19 (IC50)SNDRIStimulant
Desipramine 17.60.833,190SNRITCA
Desmethylcitalopram 3.61,82018,300SRISSRI
Desmethylsertraline 3.0390129SRISSRI
Desmethylsibutramine [13] 152049SNDRISNRI
   (R)-Desmethylsibutramine 44412SNDRISNRI
   (S)-Desmethylsibutramine 9,200870180SNDRISNRI
Desoxypipradrol [14] 53,70055050NDRIStimulant
Desvenlafaxine* [15] 47531NDSNRISNRI
Didesmethylsibutramine [13] 201545SNDRISNRI
   (R)-Didesmethylsibutramine 140138.9SNDRISNRI
   (S)-Didesmethylsibutramine 4,3006212SNDRISNRI
Diphenhydramine 3,8009602,200N/A (IA)Antihistamine
Dosulepin (dothiepin) 8.6465,310SNRITCA
Doxepin 6829.512,100SNRITCA
Duloxetine* [16] 3.720439SNRISNRI
Etoperidone 89020,00052,000SRISARI
Femoxetine 11.07602,050SRISSRI
Fluoxetine 0.812403,600SRISSRI
Fluvoxamine 2.21,3009,200SRISSRI
GBR-12935 [11] 2892774.90DRIStimulant
Hydroxybupropion [17] ND1.7 (IC50)>10 (IC50)NDRIStimulant
Imipramine 1.40378,500SNRITCA
Indatraline [11] 3.1012.61.90SNDRIStimulant
Iprindole 1,6201,2626,530N/A (IA)TCA
Lofepramine 705.418,000SNRITCA
Maprotiline 5,80011.11,000NRITeCA
Mazindol 390.458.1NDRIStimulant
MDPV [18] 3,349264.1NDRIStimulant
Methamphetamine >100,000NDNDNDRAStimulant
   D-Methamphetamine >100,0006602,800NDRAStimulant
   L-Methamphetamine >100,000NDNDNRAStimulant
Methylphenidate >10,000788121NDRIStimulant
   D-Methylphenidate >10,000206161NDRIStimulant
   L-Methylphenidate >6,700>10,0002,250NDRIStimulant
Mianserin 4,000719,400NRITeCA
Milnacipran* [16] 15168>100,000SNRISNRI
   Levomilnacipran* [19] 19.010.5>100,000SNRISNRI
Mirtazapine >100,0004,600>100,000N/A (IA)TeCA
Modafinil* [20] >50,000136,0004,043DRIStimulant
Nefazodone 200360360SNDRISARI
Nefopam [21] 2933531SNDRIAnalgesic
Nisoxetine [11] 4272.31,235NRIStimulant
Nomifensine 1,01015.656NDRIStimulant
Norfluoxetine 1.471,426420SRISSRI
Nortriptyline 184.371,140SNRITCA
Oxaprotiline 3,9004.94,340NRITeCA
Paroxetine 0.1340490SRISSRI
Protriptyline 19.61.412,100SNRITCA
Reboxetine [22] 1291.1>10,000NRIStimulant
Sertraline 0.2942025SRISSRI
Sibutramine [13] 298–2,800350–5,451943–1,200SNDRISNRI
Trazodone 1608,5007,400SRISARI
Trimipramine 1492,4503,780SRITCA
Vanoxerine [11] 73.279.24.3DRIStimulant
Venlafaxine* [16] 1451,4203,070SNRISNRI
Vilazodone* [23] 0.2~60NDSRISMS
Viloxazine 17,300155>100,000NRIStimulant
Vortioxetine* [24] 5.4890 (rat)140 (rat)SRISMS
Zimelidine 1529,40011,700SRISSRI
Values are Ki (nM) or, in some cases (*), IC50 (nM). The smaller the value, the more strongly the
drug binds to or inhibits the transporter.

See also

Related Research Articles

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Antidepressants are a class of medications used to treat major depressive disorder, anxiety disorders, chronic pain, and addiction.

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<span class="mw-page-title-main">Monoamine transporter</span> Proteins that function as integral plasma-membrane transporters

Monoamine transporters (MATs) are proteins that function as integral plasma-membrane transporters to regulate concentrations of extracellular monoamine neurotransmitters. The three major classes are serotonin transporters (SERTs), dopamine transporters (DATs), and norepinephrine transporters (NETs) and are responsible for the reuptake of their associated amine neurotransmitters. MATs are located just outside the synaptic cleft (peri-synaptically), transporting monoamine transmitter overflow from the synaptic cleft back to the cytoplasm of the pre-synaptic neuron. MAT regulation generally occurs through protein phosphorylation and post-translational modification. Due to their significance in neuronal signaling, MATs are commonly associated with drugs used to treat mental disorders as well as recreational drugs. Compounds targeting MATs range from medications such as the wide variety of tricyclic antidepressants, selective serotonin reuptake inhibitors such as fluoxetine (Prozac) to stimulant medications such as methylphenidate (Ritalin) and amphetamine in its many forms and derivatives methamphetamine (Desoxyn) and lisdexamfetamine (Vyvanse). Furthermore, drugs such as MDMA and natural alkaloids such as cocaine exert their effects in part by their interaction with MATs, by blocking the transporters from mopping up dopamine, serotonin, and other neurotransmitters from the synapse.

<span class="mw-page-title-main">Serotonin–norepinephrine reuptake inhibitor</span> Class of antidepressant medication

Serotonin–norepinephrine reuptake inhibitors (SNRIs) are a class of antidepressant medications used to treat major depressive disorder (MDD), anxiety disorders, obsessive–compulsive disorder (OCD), social phobia, attention-deficit hyperactivity disorder (ADHD), chronic neuropathic pain, fibromyalgia syndrome (FMS), and menopausal symptoms. SNRIs are monoamine reuptake inhibitors; specifically, they inhibit the reuptake of serotonin and norepinephrine. These neurotransmitters are thought to play an important role in mood regulation. SNRIs can be contrasted with the selective serotonin reuptake inhibitors (SSRIs) and norepinephrine reuptake inhibitors (NRIs), which act upon single neurotransmitters.

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<span class="mw-page-title-main">Norepinephrine reuptake inhibitor</span> Class of drug

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<span class="mw-page-title-main">Norepinephrine transporter</span> Protein-coding gene in the species Homo sapiens

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<span class="mw-page-title-main">Serotonin reuptake inhibitor</span> Class of drug

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<span class="mw-page-title-main">Nisoxetine</span> Chemical compound

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<span class="mw-page-title-main">Reuptake inhibitor</span> Type of drug

Reuptake inhibitors (RIs) are a type of reuptake modulators. It is a drug that inhibits the plasmalemmal transporter-mediated reuptake of a neurotransmitter from the synapse into the pre-synaptic neuron. This leads to an increase in extracellular concentrations of the neurotransmitter and an increase in neurotransmission. Various drugs exert their psychological and physiological effects through reuptake inhibition, including many antidepressants and psychostimulants.

<span class="mw-page-title-main">Monoamine releasing agent</span> Class of compounds

A monoamine releasing agent (MRA), or simply monoamine releaser, is a drug that induces the release of a monoamine neurotransmitter from the presynaptic neuron into the synapse, leading to an increase in the extracellular concentrations of the neurotransmitter. Many drugs induce their effects in the body and/or brain via the release of monoamine neurotransmitters, e.g., trace amines, many substituted amphetamines, and related compounds.

<span class="mw-page-title-main">Plasma membrane monoamine transporter</span>

The plasma membrane monoamine transporter (PMAT) is a low-affinity monoamine transporter protein which in humans is encoded by the SLC29A4 gene. It is known alternatively as the human equilibrative nucleoside transporter-4 (hENT4). It was discovered in 2004 and has been identified as a potential alternate target for treating various conditions.

<span class="mw-page-title-main">Serotonin antagonist and reuptake inhibitor</span> Class of drug

Serotonin antagonist and reuptake inhibitors (SARIs) are a class of drugs used mainly as antidepressants, but also as anxiolytics and hypnotics. They act by antagonizing serotonin receptors such as 5-HT2A and inhibiting the reuptake of serotonin, norepinephrine, and/or dopamine. Additionally, most also antagonize α1-adrenergic receptors. The majority of the currently marketed SARIs belong to the phenylpiperazine class of compounds.

<span class="mw-page-title-main">RTI-83</span> Chemical compound

RTI-83 is a phenyltropane derivative which represents a rare example of an SDRI or serotonin-dopamine reuptake inhibitor, a drug which inhibits the reuptake of the neurotransmitters serotonin and dopamine, while having little or no effect on the reuptake of the related neurotransmitter noradrenaline. With a binding affinity (Ki) of 55 nM at DAT and 28.4 nM at SERT but only 4030 nM at NET, RTI-83 has reasonable selectivity for DAT/SERT over NET

<span class="mw-page-title-main">Serotonin–dopamine reuptake inhibitor</span> Class of drug

A serotonin–dopamine reuptake inhibitor (SDRI) is a type of drug which acts as a reuptake inhibitor of the monoamine neurotransmitters serotonin and dopamine by blocking the actions of the serotonin transporter (SERT) and dopamine transporter (DAT), respectively. This in turn leads to increased extracellular concentrations of serotonin and dopamine, and, therefore, an increase in serotonergic and dopaminergic neurotransmission.

The pharmacology of antidepressants is not entirely clear. The earliest and probably most widely accepted scientific theory of antidepressant action is the monoamine hypothesis, which states that depression is due to an imbalance of the monoamine neurotransmitters. It was originally proposed based on the observation that certain hydrazine anti-tuberculosis agents produce antidepressant effects, which was later linked to their inhibitory effects on monoamine oxidase, the enzyme that catalyses the breakdown of the monoamine neurotransmitters. All currently marketed antidepressants have the monoamine hypothesis as their theoretical basis, with the possible exception of agomelatine which acts on a dual melatonergic-serotonergic pathway. Despite the success of the monoamine hypothesis it has a number of limitations: for one, all monoaminergic antidepressants have a delayed onset of action of at least a week; and secondly, there are a sizeable portion (>40%) of depressed patients that do not adequately respond to monoaminergic antidepressants. Further evidence to the contrary of the monoamine hypothesis are the recent findings that a single intravenous infusion with ketamine, an antagonist of the NMDA receptor — a type of glutamate receptor — produces rapid, robust and sustained antidepressant effects. Monoamine precursor depletion also fails to alter mood. To overcome these flaws with the monoamine hypothesis a number of alternative hypotheses have been proposed, including the glutamate, neurogenic, epigenetic, cortisol hypersecretion and inflammatory hypotheses. Another hypothesis that has been proposed which would explain the delay is the hypothesis that monoamines don't directly influence mood, but influence emotional perception biases.

<span class="mw-page-title-main">Decynium-22</span> Cationic derivative of quinoline

Decynium-22 is a cationic derivative of quinoline, and a potent inhibitor of the plasma membrane monoamine transporter (PMAT), as well as all members of the organic cation transporter (OCT) family in both human and rat cells. However, it has little effect on high affinity monoamine transporters such as the dopamine transporter and norepinephrine transporter.

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