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5-
hydroxytryptamine
receptor 1A
Sodium-
dependent
serotonin
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
Multidrug
resistance
protein 1
Tryptophan
5-hydroxylase 1
Aromatic-L-
amino-acid
decarboxylase
Ca
+
Serotonin
Serotonin
Fluvoxamine
Ca
+
Serotonin
Na
+
Na
+
Fluvoxamine
Fluvoxamine
L-Tryptophan
Tetrahydrobiopterin
O
2
5-Hydroxy-L-tryptophan
4a-Hydroxytetrahydrobiopterin
CO
2
Fe2+
Pyridoxal
5'-phosphate
Increase in
vagus nerve
stimulation and
electrical
impulses
Synaptic Vesicle
Cytosol
Cytosol
Presynaptic Neuron
Postsynaptic Neuron
Synapse
Serotonin is stored in
synaptic vesicles at the
nerve terminal
Fluvoxamine binds to the
sodium dependent serotonin
transporter and enhances
serotonergic activity by
binding to the orthosteric
site. This allows serotonin
to accumulate in the
synaptic cleft.
Serotonin helps with
learning, memory, happiness,
body temperature, sleep,
sexual behaviour, and
hunger, which helps supress
depression and anxiety
Suppression of depression
and Anxiety
Brain
Raphei nuclei producing
serotonergic neurons
Blood vessel - blood brain
barrier
Fluvoxamine crosses the
blood brain barrier via a
non stereoselective,
bi-directional and
symmetrical carrier-mediated
mechanism (MRP 1/ P-gp)
Axon carrying sodium
dependent serotonin
transporters (SERT)
Fluvoxamine is well absorbed
from the gastrointestinal
tract
HTR1A
SLC6A4
CACNA1A
CACNB1
CACNA2D2
SLC18A2
ABCB1
TPH1
DDC
Calcium
Serotonin
Serotonin
Fluvoxamine
Calcium
Serotonin
Sodium
Sodium
Fluvoxamine
Fluvoxamine
L-Tryptophan
Tetrahydrobiopterin
Oxygen
5-Hydroxy-L-
tryptophan
4a-
Hydroxytetrahydrobiopterin
Carbon dioxide
Increase in
vagus nerve
stimulation and
electrical
impulses
HTR1A
SLC6A4
CACNA1A
CACNB1
CACNA2D2
SLC18A2
ABCB1
TPH1
DDC
Ca
+
5-HT
5-HT
Fluvoxa
Ca
+
5-HT
Na
+
Na
+
Fluvoxa
Fluvoxa
Trp
BH4
O
2
5-HTP
4aHtHbp