Serotonin releasing agent

Chlorphentermine, a highly selective SRA that is no longer marketed.

A serotonin releasing agent (SRA) is a type of drug that induces the release of serotonin into the neuronal synaptic cleft. A selective serotonin releasing agent (SSRA) is an SRA with less significant or no efficacy in producing neurotransmitter efflux at other types of monoamine neurons, including dopamine and norepinephrine neurons.[1]

SRAs, for instance fenfluramine, dexfenfluramine, and chlorphentermine, have been used clinically as appetite suppressants.[2][3] However, these SRAs were withdrawn from the market due to toxicity in the 1990s and no SRAs were available or employable for clinical study for many years.[2][3][4] In any case, a low-dose formulation was reintroduced for treatment of Dravet syndrome in 2020 and this allowed clinical and research use of SRAs in humans once again.[5]

Aside from use as appetite suppressants, SSRAs have been proposed as novel antidepressants and anxiolytics, with the potential for a faster onset of action and superior effectiveness relative to the selective serotonin reuptake inhibitors (SSRIs).[6][7]

A closely related type of drug is a serotonin reuptake inhibitor (SRI), for instance fluoxetine.

  1. ^ Cite error: The named reference Marona-LewickaNichols1994 was invoked but never defined (see the help page).
  2. ^ a b Rothman RB, Baumann MH (April 2002). "Serotonin releasing agents. Neurochemical, therapeutic and adverse effects". Pharmacol Biochem Behav. 71 (4): 825–836. doi:10.1016/s0091-3057(01)00669-4. PMID 11888573.
  3. ^ a b Cite error: The named reference RothmanBaumann2006 was invoked but never defined (see the help page).
  4. ^ Cite error: The named reference RothmanBaumann2003 was invoked but never defined (see the help page).
  5. ^ Colwell MJ, Tagomori H, Shang F, Cheng HI, Wigg CE, Browning M, Cowen PJ, Murphy SE, Harmer CJ (August 2024). "Direct serotonin release in humans shapes aversive learning and inhibition". Nat Commun. 15 (1): 6617. Bibcode:2024NatCo..15.6617C. doi:10.1038/s41467-024-50394-x. PMC 11315928. PMID 39122687. Until recently, it has been challenging to characterise the effects of SSRAs in humans because of the lack of available licensed pharmacological probes. However, in 2020, low dose fenfluramine (up to 26 mg daily; racemic mixture) was licensed for the treatment of Dravet epilepsy41.
  6. ^ Cite error: The named reference ScorzaSilveiraNichols1999 was invoked but never defined (see the help page).
  7. ^ Nichols DE, Marona-Lewicka D, Huang X, Johnson MP (1993). "Novel serotonergic agents". Drug des Discov. 9 (3–4): 299–312. PMID 8400010.

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