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5-
hydroxytryptamine
receptor 2A
5-
hydroxytryptamine
receptor 2C
Alpha-1A
adrenergic
receptor
Beta-1
adrenergic
receptor
Beta-2
adrenergic
receptor
Sodium-
dependent
serotonin
transporter
Sodium-
dependent
noradrenaline
transporter
Voltage-
dependent
P/Q-type
calcium channel
subunit
alpha-1A
Voltage-
dependent
L-type calcium
channel subunit
beta-1
Voltage-
dependent
calcium channel
subunit
alpha-2/delta-2
Synaptic
vesicular amine
transporter
Voltage-
dependent
P/Q-type
calcium channel
subunit
alpha-1A
Voltage-
dependent
L-type calcium
channel subunit
beta-1
Voltage-
dependent
calcium channel
subunit
alpha-2/delta-2
Synaptic
vesicular amine
transporter
Solute carrier
organic anion
transporter
family member
1A2
Aromatic-L-
amino-acid
decarboxylase
Dopamine beta-
hydroxylase
Tyrosine
3-monooxygenase
Tryptophan
5-hydroxylase 1
Aromatic-L-
amino-acid
decarboxylase
Cytochrome P450
1A2
Cytochrome P450
2C19
Cytochrome P450
3A4
Ca
+
Norepinephrine
Ca
+
Serotonin
Serotonin
Norepinephrine
Clomipramine
Desmethylclomipramine
Ca
+
Norepinephrine
Ca
+
Serotonin
Clomipramine
Clomipramine
Desmethylclomipramine
Desmethylclomipramine
Clomipramine
Clomipramine
Desmethylclomipramine
L-Dopa
Dopamine
CO
2
Ascorbic acid
O
2
Dehydroascorbic acid
H
2
O
L-Tyrosine
Tetrahydrobiopterin
O
2
Dihydrobiopterin
H
2
O
L-Tryptophan
Tetrahydrobiopterin
O
2
5-Hydroxy-L-tryptophan
4a-Hydroxytetrahydrobiopterin
CO
2
O
2
NADH
Formaldehyde
NAD
H
2
O
Pyridoxal
5'-phosphate
Pyrroloquinoline
quinone
Copper
Fe2+
Fe2+
Pyridoxal
5'-phosphate
Heme
Heme
Heme
Gq signaling
cascade
Gq signaling
cascade
Gs signaling
cascade
Cytosol
Postsynaptic Neuron
Presynaptic Neuron
Cytosol
Synaptic Vesicle
Synaptic Vesicle
Cytosol
Cytosol
Presynaptic Neuron
Postsynaptic Neuron
Synapse
Synapse
Mood Improvement
Serotonin is synthesized and
stored in synaptic vesicles
at the nerve terminal
Clomipramine inhibits the
serotonin reuptake
transporter, thereby
increasing synaptic
serotonin
Serotonin activates 5HT2A
and 5HT2C receptors, which
are responsible for mood
improvements
Norepinephrine is
synthesized and stored in
synaptic vesicles at the
nerve terminal
Desmethylclomipramine
inhibits the norepinephrine
reuptake transporter,
thereby increasing synaptic
norepinephrine levels
Mood Improvement
Norepinephrine activates
post synaptic adrenergic
receptors which are
responsible for mood
improvements
Hepatocyte
Liver
Blood-Brain Barrier
Diffusion
Diffusion