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Atypical antidepressants (ATAs) are antidepressants that do not belong to the other classes of antidepressants. Their definition varies according to who you ask, but for the purpose of this Wiki they include (where * indicates that the drug is no longer marketed): agomelatine, benactyzine, bupropion, etoperidone*, mianserin, mirtazapine, nefazodone, reboxetine, setiptiline, trazodone, vilazodone, viloxazine or vortioxetine. Their mechanism of actions vary, according to the drug in question.

Noradrenergic and specific serotonergic antidepressants[]

Mianserin, mirtazapine and setiptiline are all noradrenergic and specific serotonergic antidepressants (NaSSAs). They are all tetracyclic antidepressants (TeCAs). They work by antagonizing (blocking) the α2 adrenergic receptors, 5-HT2A/2C and 5-HT3 receptors. Setiptiline is also a noradrenaline reuptake inhibitor too. They are very sedating and prone to cause weight gain, due to prominent antihistamine effects. They are significantly less toxic in cases of overdose than the tricyclic antidepressants and the monoamine oxidase inhibitors. They can cause (albeit rarely, in fewer than 0.1% of patients treated with them) agranulocytosis

Serotonin antagonist and reuptake inhibitors[]

Serotonin antagonist and reuptake inhibitors (SARIs) includes etoperidone, nefazodone and trazodone. They all work by inhibiting the reuptake of serotonin while simultaneously antagonizing the 5-HT2A receptor. They are fairly sedating, nefazodone is also prone to causing liver damage and this has resulted in its withdrawal from the market in numerous countries, including: virtually every European country (including the U.K., Ireland, Germany, Italy, Spain and Switzerland), except Greece; all of the North and South American continents, except the U.S.A.; Australia, Hong Kong, New Zealand and Singapore

Multi-modal antidepressants[]

Multi-modal antidepressants (MMAs) includes vilazodone and vortioxetine. They both work by inhibiting the reuptake of serotonin while simultaneously interacting with serotonin receptors. They both serve as partial agonists at the 5-HT1A receptors; vortioxetine also antagonizes the 5-HT3 and 5-HT7 receptors.[1] They are very new and only available in the U.S.A. at the time of writing (according to Martindale).

Others[]

Agomelatine is melatonin receptor agonist and antagonist of the 5-HT2C receptor; bupropion is a noradrenaline-dopamine reuptake inhibitor; reboxetine and viloxazine are selective noradrenaline reuptake inhibitors (NRI) and benactyzine is an anticholinergic.

External links[]

Agomelatine[]

  1. PubMed provides review articles from the past five years (limit to free review articles or to systematic reviews)
  2. The TRIP database provides clinical publications about evidence-based medicine.

Benactyzine[]

  1. PubMed provides review articles from the past five years (limit to free review articles or to systematic reviews)
  2. The TRIP database provides clinical publications about evidence-based medicine.

Bupropion[]

  1. PubMed provides review articles from the past five years (limit to free review articles or to systematic reviews)
  2. The TRIP database provides clinical publications about evidence-based medicine.

Etoperidone[]

  1. PubMed provides review articles from the past five years (limit to free review articles or to systematic reviews)
  2. The TRIP database provides clinical publications about evidence-based medicine.

Mianserin[]

  1. PubMed provides review articles from the past five years (limit to free review articles or to systematic reviews)
  2. The TRIP database provides clinical publications about evidence-based medicine.

Mirtazapine[]

  1. PubMed provides review articles from the past five years (limit to free review articles or to systematic reviews)
  2. The TRIP database provides clinical publications about evidence-based medicine.

Nefazodone[]

  1. PubMed provides review articles from the past five years (limit to free review articles or to systematic reviews)
  2. The TRIP database provides clinical publications about evidence-based medicine.

Pirlindole[]

  1. PubMed provides review articles from the past five years (limit to free review articles or to systematic reviews)
  2. The TRIP database provides clinical publications about evidence-based medicine.

Reboxetine[]

  1. PubMed provides review articles from the past five years (limit to free review articles or to systematic reviews)
  2. The TRIP database provides clinical publications about evidence-based medicine.

Setiptiline[]

  1. PubMed provides review articles from the past five years (limit to free review articles or to systematic reviews)
  2. The TRIP database provides clinical publications about evidence-based medicine.

Trazodone[]

  1. PubMed provides review articles from the past five years (limit to free review articles or to systematic reviews)
  2. The TRIP database provides clinical publications about evidence-based medicine.

Vilazodone[]

  1. PubMed provides review articles from the past five years (limit to free review articles or to systematic reviews)
  2. The TRIP database provides clinical publications about evidence-based medicine.

Vortioxetine[]

  1. PubMed provides review articles from the past five years (limit to free review articles or to systematic reviews)
  2. The TRIP database provides clinical publications about evidence-based medicine.

Reference list[]

  1. Richelson, E (January 2013). "Multi-modality: a new approach for the treatment of major depressive disorder.". The International Journal of Neuropsychopharmacology: 1–10. PMC 3670520. PMID 23363735. doi:10.1017/S1461145712001605. 
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