Section Review Central & Peripheral Nervous Systems: New antidepressant agents: Recent pharmacological developments leading to improved efficacy

Selective serotonin reuptake inhibitors: implications for advanced nursing practice

The efficacy of SSRIs in treating depression as compared to other classes of antidepressants is well documented. There is a growing body of knowledge documenting differences and similarities among these drugs, including half-life elimination, side effects, drug interactions, dosing and cost. These data must be reviewed before prescribing. Providers must take caution when giving SSRIs to patients who have been on other antipsychotics, especially MAO inhibitors, elderly patients, patients who are pregnant, and patients on type 1C antiarrhythmia agents.

Effect of modifications of the alkylpiperazine moiety of trazodone on 5HT2A and alpha1 receptor binding affinity

A series of triazolopyridine derivatives (compounds 2a-l) were synthesized in order to explore the effect of modifications of the alkylpiperazine moiety of trazodone (fragment A) on binding affinity for 5HT2A and alpha1 receptors. All of the synthesized compounds show a decrease of affinity for both 5HT2A and alpha1 receptors, as compared to trazodone, with the exception of compounds 2b,c which bear a methyl group in an alpha position to the aliphatic nitrogen atom N1. These compounds showed a decrease of affinity only for the alpha1 receptor. The stereochemical influence of the piperazine moiety of compound 2c was also evaluated. Enantiomer (S)-2c showed the most significant differences between 5HT2A and alpha1 receptor affinity (IC50 values) and among the corresponding functional properties (pA2 values). Since (S)-2c cannot generate the metabolite 4-(3-chlorophenyl)piperazine this product was selected for further pharmacological studies.