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Side Effects of
Serotonin Modulators


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Description: A distinct class of antidepressants is called serotonin modulator and stimulators (SMSs). These drugs are a small group of atypical antidepressants used to treat major depressive disorder. They are a newer approach to antidepressant medications, taking into account the multiple serotonin receptors and differing modes of interaction.SMSs have several modes of interaction with the various serotonin receptors in the brain, which are responsible for mood. SMSs simultaneously modulate one or more serotonin receptors and inhibit the reuptake of serotonin. They were developed in part to address serotonin uptake related to depression and rediscovered as the numbers of receptors known increased. Drugs in this class of antidepressants include nefazodone (Serzone), trazodone, and vilazodone (Viibryd).

Serious Side Effects of Serotonin Modulators

Cases of life-threatening hepatic (liver) failure have been reported in patients treated with Serzone (nefazodone). It is not recommended as a first line therapy. Each of these drugs should be used with caution in patients with cardiac abnormalities. Patients should be monitored for suicidal thinking and behavior. There is also risk of hypotension and of abnormal bleeding, (International Journal of Neuropsychopharmacology “Multi-modality: a new approach for the treatment of major depressive disorder,” Jul 2013).

Common Side Effects

Common side effects of serotonin modulators include:

  • Constipation or diarrhea
  • Dizziness or loss of balance
  • Dry mouth or dry eyes
  • Headache
  • Muscle ache
  • Nausea, vomiting, loss of appetite, or stomachache
  • Loss of interest in sex (erectile dysfunction in men)
  • Numbness, burning, or tingling sensations
  • Less Common Side Effects

    Less common side effects of serotonin modulators include:

  • Confusion about identity, place, and time
  • Burning, crawling, itching, numbness, prickling, “pins and needles,” or tingling feelings
  • Decreased concentration
  • General feeling of discomfort or illness
  • Fainting
  • Headache
  • Muscle tremors
  • Nervousness
  • Lack of coordination
  • Pounding in the ears
  • Slow or fast heartbeat
  • Shortness of breath
  • Swelling
  • (International Journal of Neuropsychopharmacology, “Multi-modality: a new approach for the treatment of major depressive disorder,” Jul 2013).

    Understand Your Risks with the Rxight® Genetic Test

    The Rxight® pharmacogenetics test by MD Labs is a state of the art platform that tests individual human genomes for variations in your drug metabolism genes. Your prescriber will be able to look at your genetic report from Rxight® and determine what drugs on a panel of over 200 common OTC and prescription pharmacological agents make you susceptible to side effects and what drugs are not recommended based on your genetic information.

    How Does Pharmacogenetic Testing Work?

    Serotonin modulators are primarily metabolized by the hepatic CYP450 3A4 enzyme system. Since the human genome was sequenced, many variations have been found for this gene among wide populations. The emerging field of pharmacogenetics, built on the human genome and more recent scientific advances, addresses the variations in gene sequence and thus downstream processing, such that variations can now be found that can help physicians and patients find the right dosage and medication for their condition without trial and error.

    Contributors to this Article:
    Michael Sapko, MD, PhD; Deborah Kallick, PhD, Medicinal Chemistry

    Serotonin Modulators Tested Include:

    • Vortioxetine (Brintellix)

    Read more about Rxight® Genetic Testing For Depression Medication