Increased neurotransmitter release

Amphetamines cause increased release of noradrenaline (norepinephrine) and dopamine and have mood-enhancing effects. Inhibition of neurotransmitter reuptake

Most antidepressants inhibit the reuptake of monoamines into the presynaptic nerve ending after their release. (.16> The effects of different antidepressants on monoamine reuptake are listed in Table. ...2.. Reduced reuptake of monoamines occurs immediately, but the full therapeutic effects of antidepressants take some weeks to occur. This is explained by the occurrence of adaptive changes in presynaptic and postsynaptic receptors, including downregulation of b-adrenoceptors, reduced sensitivity of b- and a2-adrenoceptors, and increased sensitivity of a -adrenoceptors and 5-HT receptors, although it is not known how these actions are translated into the therapeutic effect. The last of these effects has led to the addition of 5-HT autoreceptor antagonists, in the hope of producing a quicker onset of antidepressant action by enhancing 5-HT neurotransmission.(1, I8) Another strategy involves drugs with several actions, which inhibit more than one reuptake system and are antagonists at neurotransmitter receptors/1.9)

Table 2 Effects of antidepressants on monoamine reuptake

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