Is the bell-shaped dose-response curve of the selective serotonin reuptake inhibitor due to 5-HT1A auto-receptors?

A dose-response curve is a plot of drug efficacy versus dose. Interestingly, some antidepressants show a bell-shaped dose-response curve where increasing dose leads to increasing efficacy only up to a point, whereupon further increases lead to decreasing efficacy. Here, we propose that the first par...

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Veröffentlicht in:Medical hypotheses 2020-07, Vol.140, p.109681-109681, Article 109681
Hauptverfasser: Terao, Takeshi, Ishii, Nobuyoshi, Hirakawa, Hirofumi, Aoshima, Eiji
Format: Artikel
Sprache:eng
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Zusammenfassung:A dose-response curve is a plot of drug efficacy versus dose. Interestingly, some antidepressants show a bell-shaped dose-response curve where increasing dose leads to increasing efficacy only up to a point, whereupon further increases lead to decreasing efficacy. Here, we propose that the first part of the curve reflects the basic, uncomplicated dose-response relationship of these antidepressants whereas the second, decreasing part remains to be explained. Our hypothesis is that a negative feedback pathway through 5-HT1A auto-receptors decreases the efficacy of selective serotonin reuptake inhibitors with increasing dose, thereby creating the second, anomalous part of the dose-response curve. This effect can also account for the so-called therapeutic window of such antidepressants.
ISSN:0306-9877
1532-2777
DOI:10.1016/j.mehy.2020.109681