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We’ve known for decades that SSRIs are safe and effective for treating depression and anxiety, but the precise way they work has long been a mystery. New 3-D images are finally providing some answers.

Let’s back up for a minute, though, and talk about what SSRIs are.

The image depicts a slice through a surface representation of the serotonin transporter bound to the antidepressant S-citalopram. S-citalopram molecules bound to the allosteric (yellow) and central (magenta) sites are shown as spheres. Knowing the structure of serotonin transporters will help scientists develop more effective SSRIs.

Selective Serotonin Reuptake Inhibitors are a popular antidepressant. They affect the balance of a chemical messenger in the brain called serotonin, which has a lot of jobs, including regulating mood. Many scientists believe an imbalance of serotonin in the brain — whether there’s not enough of it or it’s not being received correctly — can lead to depression.

SSRIs block cells from reabsorbing serotonin, meaning it can stay in circulation longer. That often leads to a mood boost.

The discovery we’re talking about was published just last week. Scientists used X-ray crystallography to develop 3-D images of what’s called the serotonin transporter. The transporter is what cells use to reabsorb (or reuptake) the serotonin, and it’s the part SSRIs specifically target.

The images show where SSRIs attach to the transporter and what position the transporter holds while the antidepressant is attached. The important news for us is that these images will help scientists develop more effective antidepressants.

Here’s what the lead researcher had to say:

“The heavy toll that devastating illnesses like anxiety and depression have on families and communities is, in many ways, incalculable. Revealing the precise structure of the serotonin transporter holds tremendous promise for the development of life-changing drug treatments for these diseases.” (Eric Gouaux, Ph.D., senior scientist in the Vollum Institute at Oregon Health & Science University)

Many of my patients experience much-needed relief from these medications, which work best when combined with therapy and lifestyle changes. I’m excited to see SSRIs continue to get better and better!

Satu Woodland is owner and clinician of Mental Health Solutions, an integrative mental health practice located at Bown Crossing in Boise, Idaho. She sees children, adolescents, and adults.

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