Could you explain how antidepressants work, specifically SSRIs. I know they increase seretonin levels in the brain but how does that work?
Yes of course! So SSRI is an abreviation for Selective Serotonin Reuptake Inhibitor.Ā Prozac is probably the most well known example of an SSRI medication used to treat depression, anxiety, easting disorders and sometimes PTSD.Ā
To understand how SSRIs work, we first need to look at where it takes effect. SSRIs work in your synapses; the gaps between neurones where neurotransmitters diffuse across to send a signal. And as I am oh so nice Iāve a made a some diagrams to explain:
As you can see, when an impulse travels along the first neurone (known as the presynaptic neurone), it is stimulated to release neurotransmitters, in this case serotonin, across the gap (known as the synaptic cleft). These neurotransmitters then move by diffusion across the gap and bind to their receptors on the next neurone, known as the post-synaptic neurone. If enoughĀ neurotransmitter binds in a given time, the signal will then be carried down through that neurone (keyword here is enough; there is a threshold and if that is not met/exceeded, NO impulse AT ALL will be generated in the postsynaptic neurone). Since serotonin is a neurotransmitter that contributes to feelings of wellbeing, this resulting impulse promotes a generally good mood. However, serotonin tends to lack in those with depression which means it is harder for them to generate such impulses (as it is harder to meet the threshold). So how do SSRIs fit in and work to compensate for this?Ā
Youāll remember SSRI stands for selective serotonin reuptake inhibitor, in other words it stops serotonin from being absorbed back into the neurone it came from. This process is called reuptake. Reuptake happens through channels like the one shown in pink, where the serotonin molecules pass through so they can be used by the neurone again for the next impulse.Ā
What the SSRI does is block this reuptake channel, which leaves more serotonin in the synaptic cleft. As a result, more serotonin can bind to receptors on the post-synaptic neurone which creates a stronger signal more likely to exceed the threshold. The overall result is that the feelings of sadness and emptiness that are caused by depression are counteracted by the increased effect of serotonin.Ā
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