Depression is associated with reduced levels of the monoamines in the brain, such as 5-HT. The selective 5-HT and noradrenaline re-uptake inhibitors (SNRIs) are thought to restore the levels of 5-HT and noradrenaline in the synaptic cleft by binding at their re-uptake transporters preventing the re-uptake and subsequent degradation of 5-HT and noradrenaline. This re-uptake blockade leads to the accumulation of monoamines in the synaptic cleft and the concentration returns to within the normal range. Selective 5-HT and noradrenaline re-uptake inhibitors have demonstrated clinical efficacy in the treatment of depression In the presence of the SNRIs, small amounts of 5-HT and noradrenaline continue to be degraded in the synaptic cleft.

Click here: Explore the use of SNRIs in depression treatment

file_download Download in HQ

Related content

description Article
Treatment-Resistant Depression (TRD) – definition, clinical manifestation, and evidence-based treatment

Treatment-resistant depression (TRD) represents a significant clinical challenge, affecting approximately 30% of individuals with major depressive disorder (MDD) who fail to respond to at least two adequate antidepressant trials.

25.09.2025 Depression
image Image Diagram titled 'Sequential Treatment Optimization Scheme for MDD' showing patient improvement over treatment time across four stages. Stage 1 includes monotherapy, dose optimization, and rTMS; Stage 2 includes augmentation, combination antidepressant, add-on treatment, rTMS/ECT; Stage 3 includes add-on psychopharmacotherapy, switch to tranylcypromine, rTMS/TBS/ECT/VNS; Stage 4 includes repetition or experimental psychopharmacotherapy/brain stimulation. Curved lines represent different patient trajectories, with horizontal dotted lines indicating thresholds for response and remission. Some lines show improvement, while others show little or worsening response over time.
Sequental Treatment Optimization Scheme for Major Depressive Disorder

Sequential treatment optimization scheme for major depressive disorder generated according to international evidence.

18.09.2025 Depression
image Image Infographic titled 'Identification and Effective Management of Factors Potentially Confounding Treatment Response'. It shows eight stacked boxes listing key steps: Check dose and duration of the current antidepressant trial Explore and reduce side effects Consider and treat comorbidities Consider and reduce ongoing stressors Evaluate treatment adherence Pharmacogenomic testing (CYP450) Check and avoid unfavorable medical interaction Evaluate initial therapies and follow recommended treatment algorithm. At the bottom, references are cited (Dold & Kasper, 2017; Kraus et al., 2019), and the image is credited to Neurotorium."
Identification and Effective Management of Factors Potentially Confounding Treatment Response

Key steps for managing factors that may confound antidepressant treatment response, including dose, side effects, comorbidities, stressors, adherence, pharmacogenomics, interactions, and treatment algorithms.

18.09.2025 Depression