Serotonin antagonist drugs, as well as reuptake inhibitor drugs, are typically prescribed as antidepressant medications. They can also be used to treat other conditions like insomnia and anxiety.
One of the most popular serotonin antagonist or reuptake inhibitor (SARI) drug is trazodone. This particular SARI drug isn’t really popular as a main treatment option for depression. It is often used as a supplemental medication in a much larger treatment plan.
These drugs are particularly effective in treating certain symptoms of depression. For example, SARIs have been known to help with psychomotor agitation or insomnia.
This class of drugs has a low risk of addiction. But there have been cases of abuse in combination with other drugs.
What Makes Serotonin Antagonists Effective?
The SARI family of drugs work by limiting the reuptake of serotonin into the brain. The drugs accomplish this by affecting a particular receptor in the brain known as the 5HT2a receptor. They also work to block the serotonin transporter proteins within the brain. Attacking serotonin reuptake in this way leads to higher levels of serotonin in the brain and central nervous system (CNS) in general.
Low doses of trazodone can help patients get to sleep and stay asleep. The drug can do so without creating any feeling of grogginess or drowsiness, as well. Patients can also be put on a regular schedule of trazodone without much risk of dependence. This is due to the drug’s very short half-life. Higher dosages of trazodone need to be taken for it to be effective as an antidepressant.
Serotonin antagonists can be effective for insomnia and anxiety immediately, but can take up to 4 weeks to start relieving depression symptoms.
Serotonin Antagonist Side Effects
Serotonin antagonists are much more developed than earlier antidepressants. They still have side effects, but much fewer than tricyclics and monoamine oxidase inhibitors (MAOIs).
Common side effects of trazodone, the most-commonly prescribed SARI are:
- dry mouth
- blurred vision
Although the above side effects are most common, there is still the risk for several potentially more serious side effects.
Occasionally, patients on the drug can experience a condition called Orthostatic hypotension. This occurs when a person’s blood pressure drops rapidly as they stand up. This can potentially be dangerous because it increases the risk of falling or injury. There is also a risk of fainting on serotonin antagonists as well.
Serotonin syndrome may also develop in certain patients. This condition can cause bouts of agitation, trouble walking, poor coordination, hallucinations, vomiting, nausea, and rapid heartbeat. Someone taking the drug could also experience low levels of sodium in the blood and unusual bruising.
Withdrawal symptoms from SARI medications can occur, but they typically occur in individuals who have taken the medication for at least several weeks.
Patients going through withdrawal from serotonin antagonists may experience dizziness, nausea, agitation, anxiety, and trouble sleeping. They may also struggle with diarrhea, vomiting, nausea, flu-like symptoms, agitation, and headaches.
Experts say that withdrawal symptoms tend to appear about 3 days after stopping or lowering the dose of medication. These symptoms can persist for a maximum of 2 weeks.
With SARIs, and many other drugs, the best way to prevent withdrawal symptoms is to work with a medical professional. A doctor that is familiar with the medication can prescribe you a tapering schedule to gradually decrease your dosage and get you off of the medication with minimal adverse effects. The length of the tapering period will depend on how high of dosage you were previously taking. It will also depend on how long you have been taking the drug.
Combining With Other Substances
SARI medications have been known to interact with other drugs. Non-steroidal anti-inflammatory drugs (NSAIDs), aspirin, and other anticoagulants can interact negatively with the medication. Interaction with these kinds of drugs may increase the risk of unusual bleeding.
Warfarin is another drug that can affect the body negatively when taken with SARIs. Being on both of these medications simultaneously can cause issues with blood clots.
MAOIs, when combined with SARIs, can alter the chemistry of the brain and produce serotonin syndrome. Combining serotonin antagonists with other serotonergic medications can have the same effect.
Central nervous system depressants like alcohol and benzodiazepines can also combine negatively with serotonin antagonists. Alcohol and benzodiazepines will increase the sedative effects of SARIs. This can lead to an increased risk of drowsiness or respiratory depression.
Digoxin and Phenytoin are two particularly dangerous substances to combine with SARI medications. Using these substances together can lead to increased amounts of the medications in the blood serum. Toxicity of both medications, digoxin or phenytoin, can lead to serious complications. Digoxin toxicity can lead to fatal cardiac arrhythmias, and phenytoin toxicity can lead to a whole host of neurological issues.
Various enzyme inhibitors can also lead to decreased effectiveness of SARIs. They can also lead to increased toxicity risk at lower doses.
It is possible to overdose on SARI medications. In the event of an overdose, it is important to seek medical attention. If you happen to be with someone who has overdosed, it is important to find out when they took the medicine, how much they took, and try to recover the pill bottle if you can.
EMTs and other medical professionals will typically treat an overdose by pumping the stomach, breath support, heart monitoring, CPR, airway maintenance, and activated charcoal. The activated charcoal is used to prevent any more of the medication from being absorbed into the system.
SARIs are a valuable part of any treatment plan for depression, but they are not the sole component. Patients should take advantage of therapy sessions, as well as make general lifestyle changes.
Eating well, getting enough sleep, and practicing relaxation techniques like breathing, meditation, and yoga are all beneficial for dealing with major depressive disorder.
Whether your treatment is for major depressive disorder, substance abuse, or some combination, it’s important to remain positive and believe that recovery is possible for you.
If you have any other questions, or would like further information on where to turn, contact Just Believe Recovery Center and we can help you start to move on with your life.