Although the more recent non-tricyclic antidepressives have less serious unwanted effects than the tricyclic compounds, the delay in their antidepressive effect, and their failure in some patients, still remain. All antidepressives act at least in part by blocking the re-uptake of noradrenaline (NA) and 5-hydroxytryptamine (5HT) into the nerve terminals of central neurones, with a subsequent change in the rate of synthesis of these transmitters and a fall in the number of post-synaptic receptors. Other actions lead to the unwanted central and peripheral effects. Some antidepressives (e.g. maprotiline - Ludiomil) predominantly reduce NA re-uptake whilst others (e.g. clomipramine - Anafranil) influence mainly 5HT neurones.
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