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A comparison of trazodone and fluoxetine: implications for a serotonergic mechanis of antidepressant action

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Abstract

Trazodone is an atypical antidepressant drug that is commonly referred to as a serotonin (5-hydroxytryptamine; 5-HT) uptake inhibitor. However, the most potent pharmacological effect of trazodone appears to be antagonist action at 5-HT2/1C receptors. This is in contrast to fluoxetine, for which inhibition of 5-HT uptake is the most potent pharmacological action. The effects of trazodone and fluoxetine on several antidepressant drug screens are mediated by antagonist action at 5-HT2 receptors and inhibition of 5-HT uptake, respectively. While fluoxetine is an effective agent for the treatment of major depression, obsessive-compulsive disorder (OCD) and panic disorder, trazodone does not appear to be effective in the treatment of OCD and panic disorder. In addition, trazodone and fluoxetine differ in humans with respect to their effects on sleep and weight. Taken together, the preclinical and clinical data suggest that trazodone acts as an antidepressant via antagonist action at 5-HT2/1C receptors, while fluoxetine likely acts as an antidepressant via inhibition of 5-HT uptake.

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Authors and Affiliations

  1. Department of Psychiatry, Ribicoff Research Facilities, Clinical Neuroscience Research Unit, Connecticut Mental Health Center, Yale University School of Medicine, 34 Park Street, 06519, New Haven, CT, USA

    Gerard J. Marek, Christopher J. McDougle & Lawrence H. Price

  2. Department of Pharmacological and Physiological Sciences, The University of Chicago, 947 East 58th Street, 60637, Chicago, IL, USA

    Lewis S. Seiden

Authors
  1. Gerard J. Marek
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  2. Christopher J. McDougle
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  3. Lawrence H. Price
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  4. Lewis S. Seiden
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Marek, G.J., McDougle, C.J., Price, L.H. et al. A comparison of trazodone and fluoxetine: implications for a serotonergic mechanis of antidepressant action. Psychopharmacology 109, 2–11 (1992). https://doi.org/10.1007/BF02245475

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  • DOI: https://doi.org/10.1007/BF02245475

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