5-羥色胺和去甲腎上腺素再攝取抑制劑

5-羥色胺和去甲腎上腺素再攝取抑制劑（英語：SNRIs, Serotonin–norepinephrine reuptake inhibitors），是一種用來治療重度抑鬱症和其他精神障礙的抗抑鬱藥。SNRI有時候也用來治療焦慮症，強迫症，多動症，慢性神經性疼痛，軀體化障礙，纖維肌痛症候群和緩解更年期症狀。

SNRI是高效的5-羥色胺和去甲腎上腺素再攝取抑制劑。^[1]已知這些神經遞質在控制情緒時發揮著重要的作用。 SNRI比使用更廣泛但只能單獨作用於5-羥色胺的選擇性5-羥色胺再攝取抑制劑（SSRI）作用更多。

活性成分	藥品名稱	治療用途	受體親和力 (K_i, nm)	結構
文拉法辛（Venlafaxine）	怡諾思（Efexor）	重性抑鬱障礙，包括對其他治療沒反應的患者，廣泛性焦慮症，慢性疼痛綜合症^[2]	5-HT:7.8 NE:1920 D:6050 ^[3]
米那普侖（Milnacipran）	Savella, Ixel, Dalcipran, Toledomin	纖維肌痛症候群及其併發症，重度抑鬱障礙^[4]	5-HT:8.4 NE:22 D:>100000^[3]	Milnacipran
度洛西汀（Duloxetine）	Cymbalta, Ariclaim, Xeristar, Yentreve	重度抑鬱障礙和纖維肌痛症候群^[5]	5-HT:0.07 NE:1.2 D:230^[3]	Duloxetine
左旋米那普倫	Fetzima	成人重度抑鬱障礙	5-HT:NA NE:NA D:NA	Levomilnacipran
去甲文拉法辛（Desvenlafaxine）	Pristiq	成人重度抑鬱障礙^[6]	5-HT:61.4 NE:2953 D:NA
西布曲明（Sibutramine）	Meridia, Reductil	肥胖^[7]	5-HT:298 NE:5451 D:943

5-HT: 5-羥色胺- NE: 去甲腎上腺素- D: 多巴胺- NA: 不可用

引用

^ Cashman, JR; Ghirmai, S. Inhibition of serotonin and norepinephrine reuptake and inhibition of phosphodiesterase by multi-target inhibitors as potential agents for depression. Bioorganic & Medicinal Chemistry. 2009, 17 (19): 6890–7. PMID 19740668. doi:10.1016/j.bmc.2009.08.025.
^ Gutierrez, MA; Stimmel, GL; Aiso, JY. Venlafaxine: A 2003 update. Clinical Therapeutics. 2003, 25 (8): 2138–54. PMID 14512125. doi:10.1016/s0149-2918(03)80210-2.
^ ^3.0 ^3.1 ^3.2 Stahl, SM; Grady, MM; Moret, C; Briley, M. SNRIs: Their pharmacology, clinical efficacy, and tolerability in comparison with other classes of antidepressants. CNS Spectrums. 2005, 10 (9): 732–47. PMID 16142213.
^ Morishita, Shigeru; Arita, Seizaburo. The clinical use of milnacipran for depression. European Psychiatry. 2003, 18 (1): 34–5. PMID 12648895. doi:10.1016/S0924-9338(02)00003-2.
^ Hunziker, ME; Suehs, BT; Bettinger, TL; Crismon, ML. Duloxetine hydrochloride: A new dual-acting medication for the treatment of major depressive disorder. Clinical Therapeutics. 2005, 27 (8): 1126–43. PMID 16199241. doi:10.1016/j.clinthera.2005.08.010.
^ Perry, R; Cassagnol, M. Desvenlafaxine: A new serotonin-norepinephrine reuptake inhibitor for the treatment of adults with major depressive disorder. Clinical Therapeutics. 2009, 31 (1): 1374–404. PMID 19698900. doi:10.1016/j.clinthera.2009.07.012.
^ Luque, CA; Rey, JA. The discovery and status of sibutramine as an anti-obesity drug. European Journal of Pharmacology. 2002, 440 (2–3): 119–28. PMID 12007530. doi:10.1016/S0014-2999(02)01423-1.

[Cashman,_J._R._and_Ghirmai,_S._(2009)._Inhibition_of_serotonin_and_norepinephrine_reuptake_and_inhibition_of_phosphodiesterase_by_multi-target_inhibitors_as_potential_agents_for_depression._''Bioorganic_&_Medicinal_Chemistry,_17'',_6890–6897_PMID_19740668-1] Cashman, JR; Ghirmai, S. Inhibition of serotonin and norepinephrine reuptake and inhibition of phosphodiesterase by multi-target inhibitors as potential agents for depression. Bioorganic & Medicinal Chemistry. 2009, 17 (19): 6890–7. PMID 19740668. doi:10.1016/j.bmc.2009.08.025.

[Gutierrez-2] Gutierrez, MA; Stimmel, GL; Aiso, JY. Venlafaxine: A 2003 update. Clinical Therapeutics. 2003, 25 (8): 2138–54. PMID 14512125. doi:10.1016/s0149-2918(03)80210-2.

[Stahl-3] 3.0 ^3.1 ^3.2 Stahl, SM; Grady, MM; Moret, C; Briley, M. SNRIs: Their pharmacology, clinical efficacy, and tolerability in comparison with other classes of antidepressants. CNS Spectrums. 2005, 10 (9): 732–47. PMID 16142213.

[Morishita-4] Morishita, Shigeru; Arita, Seizaburo. The clinical use of milnacipran for depression. European Psychiatry. 2003, 18 (1): 34–5. PMID 12648895. doi:10.1016/S0924-9338(02)00003-2.

[Hunziker-5] Hunziker, ME; Suehs, BT; Bettinger, TL; Crismon, ML. Duloxetine hydrochloride: A new dual-acting medication for the treatment of major depressive disorder. Clinical Therapeutics. 2005, 27 (8): 1126–43. PMID 16199241. doi:10.1016/j.clinthera.2005.08.010.

[Perry-6] Perry, R; Cassagnol, M. Desvenlafaxine: A new serotonin-norepinephrine reuptake inhibitor for the treatment of adults with major depressive disorder. Clinical Therapeutics. 2009, 31 (1): 1374–404. PMID 19698900. doi:10.1016/j.clinthera.2009.07.012.

[Luque-7] Luque, CA; Rey, JA. The discovery and status of sibutramine as an anti-obesity drug. European Journal of Pharmacology. 2002, 440 (2–3): 119–28. PMID 12007530. doi:10.1016/S0014-2999(02)01423-1.

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