Serotonin antagonist and reuptake inhibitor

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Chemical structure of the serotonin antagonist and reuptake inhibitor trazodone.

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 act as α1-adrenergic receptor antagonists. The majority of the currently marketed SARIs belong to the phenylpiperazine class of compounds.

List of SARIs

Vilazodone is a related drug but does not fit into this class as it does not function as a serotonin antagonist, acting as a 5-HT1A receptor partial agonist instead.

Niaprazine is also related to this group but does not inhibit the reuptake of serotonin or the other monoamines.

Medifoxamine could perhaps also be said to belong to this group, as it is a serotonin-dopamine reuptake inhibitor and 5-HT2A and 5-HT2C receptor antagonist.[1]

Pharmacology

Binding profile

The affinities (Kd (nM)) of a selection of SARIs have been compared below at an assortment of binding sites:[2][3][4][5]

Compound SERT NET DAT 5-HT1A 5-HT2A α1 α2 D2 H1 mACh
Etoperidone 890 20,000 52,000 85 36 38 570 2,300 3,100 >35,000
Nefazodone 200 360 360 80 26 48 640 910 24,000 11,000
Trazodone 160 8,500 7,400 78 16 39 405 3,650 725 324,000

The selected ligands act as antagonists (or inverse agonists depending on the site in question) at all receptors listed except at 5-HT1A where they are partial agonists,[6] and as inhibitors of all transporters listed.[2][3][4][5]

See also

References

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