Receptors that are paired with G-proteins, such as 5-HT1 and 5-HT2 receptors, have a relatively slow reaction time because of the intermediaries involved. Also, the signal does not trigger an action potential directly, but instead alters the probability that one will be triggered. In such cases, the serotonin is said to act as a neuromodulator.
In contrast, in a 5-HT3 receptor, the ion channel opens almost instantly, and the serotonin directly transmits a signal that can trigger the propagation of a new action potential. In this case, the serotonin acts as a neurotransmitter (or neuromediator).
AND OTHER MOLECULES INVOLVED IN DEPRESSION
Two of the nine serotonergic nuclei in the brainstem,
the dorsal and medial raphe nuclei, are
composed of neurons whose fibres terminate in many different
areas of the brain, such as the forebrain and the limbic
system. The fibres arising from the dorsal and medial
raphe nuclei represent almost the only source of serotonin
in the anterior portions of the central nervous system.
There are 15 known types of serotonin receptors (also known as 5-HT receptors,
after the chemical name for serotonin, 5-hydroxytryptamine). These 15 types can
be grouped into 3 major families according to their mode of operation. Click
on each of the 3 buttons below to see how each of these 3 families of receptors
Serotonin is clearly not the only neurotransmitter involved in
depression. For example, there are known, close linkages between
the serotonergic system and the norepinephrinergic system in the
central nervous system. Thus norepinephrine, which
is affected by several antidepressants, also is involved in
Several other serotonin
receptors have been identified (5-HT4, 5-HT5,
5-HT6, 5-HT7). For the most part,
they work like 5-HT1 and 5-HT2 receptors:
with a G protein that modifies an ion channel or a membrane
Since roughly the 1970s, neurotransmitters and their receptors
have been the main focus of research on mental disorders. But
with the discovery of increasingly complex biochemical cascades
within the cell, scientists are increasingly realizing that
fluctuations in neurotransmitters such as serotonin may be
only the tip of the iceberg, and that to understand complex
phenomena such as depression, they will need to examine in
happens inside a neuron once a neurotransmitter
has bound to its receptor.
molecules are slightly larger than amino acid molecules
and form a very large class of neurotransmitters that includes
dopamine, epinephrine, norepinephrine, and serotonin. Monoamines
are divided into two sub-classes: catecholamines (dopamine,
epinephrine, and norepinephrine) and indoleamines (serotonin).
The involvement of monoamines in depression was discovered
in the 1950s. Early in that decade, some physicians noticed
that nearly 15% of the patients who were taking reserpine
as a treatment for hypertension had fallen into a deep depression.
It was then discovered that the reserpine was breaking down
the catecholamines in the patients' brains.
At just about the same time, the opposite observation was
made for another medication: a molecule that was being prescribed
as a treatment for tuberculosis was improving the mood of
certain depressed patients. A more extensive analysis of
this molecule revealed that it inhibited the normal degradation
of monoamines by the enzyme monoamine oxidase (MAO). The
researchers inferred that this beneficial effect on the patients'
depression was attributable to higher levels of monoamines'
being active in the synapses of their brains. This insight
quickly led to the development of monoamine oxidase inhibitors
(MAOIs), the first generation of antidepressants.
different molecules are now regarded as antidepressants.
Each of these molecules increases the amount of certain
specific neurotransmitters in certain specific regions
of the brain.
There are also a number of new medications that act through unique mechanisms
and are therefore known as atypical antidepressants. Though they have no action
mechanisms in common, all of these atypical antidepressants increase the level
of certain neurotransmitters in the synapses.
Lastly, a mood-stabilizing medication such as lithium plays a distinctive role
in the treatments available for bipolar disorder, both because of its effectiveness
and because it consists of a single chemical element.
Click on each link below to learn more about
the mode of action and effects of each type of antidepressant
the mood regulator most commonly used in treating bipolar disorder.
It is effective in nearly three-quarters of all patients with
this disorder. Lithium is a single chemical element; it belongs
to the alkali metals, the same group on the periodic table
as sodium and potassium, with which it shares many properties.
The mechanisms by which lithium controls both the manic and
the depressive phases of bipolar disorder are still poorly
understood. It may alter the transport of sodium across the
cell membrane and thus modify neural
communication. It may also increase the activity
of the serotonergic system.
Lithium may also act on a second-messenger system in the postsynaptic
neuron. Certain neurotransmitters, when they bind to a postsynaptic
receptor, trigger a cascade of biochemical reactions, one of
which involves the second messenger phosphatidylinositol.
Lithium may inhibit the enzyme that converts inositol phosphate
into free inositol, thus causing an accumulation of inositol
phosphate that might have numerous effects in the postsynaptic
The main difficulty in administering lithium
remains determining the proper dosage, which must be calibrated
very precisely in order to minimize the side effects, which can
range from nausea, diarrhea, thirst, and loss of appetite to kidney
There are various brands of lithium, such as Cibalith-S, Eskalith,
Lithane, Lithobid, Lithonate, and Lithotabs, and it is available
in tablets, capsules, and liquid form.